Inspection on 19/04/07 for Latimer Grange

This inspection was carried out on 19th April 2007.

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

Latimer Grange 16/03/10

Latimer Grange 31/01/09

Latimer Grange 20/08/07

Latimer Grange 12/04/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Latimer Grange Ltd 119 Station Road Burton Latimer Northants NN15 5PA Lead Inspector Keith Williamson Key Unannounced Inspection 19th April 2007 09:00 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 Latimer Grange Ltd DS0000064335.V333503.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. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Latimer Grange Ltd Address 119 Station Road Burton Latimer Northants NN15 5PA 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) 01536 722456 01536 725217 Latimer Grange Limited Mrs Sharon Elizabeth Payne Care Home 27 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (27) of places Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No one falling within category DE(E) may be admitted into the home where there are 10 persons of category DE(E) already accommodated within the home. To be able to admit the male service user who is 57 years of age as applied for in Variation Application No.V29167 dated 1st February 2006 To be able to admit one person of category OP (under 65 years) named in variation application number V36294 dated 16 October 2006 The maximum number of residents that the registered provider can accommodate in Latimer Grange, Northamptonshire is 27. 12th April 2006 Date of last inspection Brief Description of the Service: Latimer Grange is a residential care home providing personal care for up to 27 older people over the age of 65 years, of which number, up to 10 can be older people with Dementia. Latimer Grange is situated close to the town centre of Burton Latimer. Accommodation consists of 19 single bedrooms, 14 of which have ensuite facilities, and 4 double bedrooms, two of which are en-suite. 5 of the single ensuite rooms were provided through an extension and have only been recently opened. One of the double rooms is currently being used as a single. The range of fees at the home is £348-£477 per week. There are charges for continence wear supplied by the home of £17.40 per month, with a further £10.00 charged for disposal. Optional services such as hairdressing, newspapers and private chiropody services are charged separately. Information is made available to Residents and their relatives in the form of the Residents guide. Other relevant leaflets and items of information (for example access to advocacy) are available in the hallway. Consideration is being given to the best way to ensure residents all have access to the Inspection reports. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections is on outcomes for residents and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting a sample number of clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation, in this case three residents were chosen. This visit took place over one day, commencing at 10.00am and took seven hours to complete. One inspector conducted the visit. An opportunity was taken to look around the home, view records, policies and care plans and to talk to residents and staff. Information was gathered prior to the site visit from sources such as residents, their relatives and staff surveys; the pre inspection questionnaire from the manager and in some cases complaint information. The majority of residents were seen and nine spoken with during the inspection process, though due to the frailty of the resident group, few comments were made, some have been included in this report. What the service does well: Pre-admission assessments are completed prior to residents moving into the home. Contracts are issued, however these do not hold full information regarding the full charges residents are expected to pay. Care plans are adequately detailed to provide staff with information to enable residents’ care. “I have never had any concerns about my husbands care” “It’s a very good home, people there are very well cared for” Residents’ privacy is maintained in the home. Visiting is open and unrestricted. Meals are nutritious and provide residents with appropriate dietary choices. Meals and food appear to be very good”. The complaint process is in place, staff are aware how the process operates, so protecting residents safety in the home. Residents spoken with felt safe in the home and live in a homely, comfortable and clean environment, and staff are aware of how to maintain standards of hygiene. “The home is always very clean, my father is given all the help he needs. I always go to see him without warning the home. My father is cheerful and well cared for”. The appropriate Criminal Records Bureaux checks are in place prior to staff commencing employment. Safety records, including various health and safety kept within the home were viewed, these were up to date and so protected residents in the home. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 6 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. Latimer Grange Ltd DS0000064335.V333503.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 Latimer Grange Ltd DS0000064335.V333503.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): 2, 3 & 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment process for residents is detailed and effective; resulting in a accurate and detailed information for staff to ensure care needs shall be met. The contract or terms and conditions does not fully reflect all charges to residents, resulting in residents not being aware of all charges prior to commencing their stay. EVIDENCE: All of the sampled residents had an appropriate contract in place; and these were signed by the resident or a representative. The contract however was not fully detailed and did not contain reference to the charges for continence wear, or its disposal. These are charged by the home to residents who are not receiving prescribed continence wear supplied by an appropriately qualified health care worker. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 9 The assessment information for recently admitted residents was viewed, two of whom had pre-admission assessments on file. The information gathered by the Manager was complete, and adequate in providing the amount of detail from which a plan of care could be completed. Standard 6, the home does not provide services for residents with Intermediate Care needs. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are looked after well in respect of their health and personal care needs. Poor medication recording, results in residents being placed at risk in the home. EVIDENCE: Care plans for the three residents included enough detail for staff to enable them to undertake health, personal and social care needs, on a consistent basis. The care plans are known as support plans and are split into day and night providing detailed information for specific staff. Health care was monitored with a number of records covering weight gain and loss, and other information to assist health professionals ascertain specific needs to be met. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 11 Plans also included information on dietary preferences, likes and dislikes. Daily records were suitably detailed, and covered ongoing issues for residents. Medication recording was of a poor quality with a number of missing signatures from the medication administration records (mar charts), and lack of information of stock carried over form one month to another. Observations made by the inspector indicated that residents’ privacy is maintained for example staff were observed knocking on residents’ bedroom doors before entering their bedrooms. Staff spoken with, also showed an awareness of residents privacy, and how this was maintained in other areas of care provision. Verbal and written comments received from residents and relatives include “It’s a very good home, people there are very well cared for” “Generally satisfied with the care of home, useful that the owner is regularly on premises”. Latimer Grange Ltd DS0000064335.V333503.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 & 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents with Dementia are offered limited stimulation, due to activities not being appropriately researched. Residents are offered a balanced and nutritious diet. The interaction between the residents and staff was very positive. EVIDENCE: Information on activities and pastimes is gathered at the point of assessment. The range of activities offered to residents is varied, but has not been guided by reference to specifically relate to those with Dementia. There is no specific plan for activities, staff preferring to offer activities based on circumstances at the time. The recording of activities in the daily records, confirms activities are not undertaken regularly. When activities have taken place, these are photographed to remind residents what topics they have taken part in. Relatives said that visiting was open and unrestricted. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 13 Menus were viewed and demonstrated that meals provided are nutritionally balanced. The cook produces meals offering a varied choice to residents. Residents, who require a special diet, have their personal preferences and dislikes, recognised with specific information being supplied to the cook. A number of residents were observed discreetly being assisted with their meals; three separate dining areas are in use, satisfying residents’ personal preferences, and providing a choice of dining areas suitable for differing tastes. Verbal and written comments received from residents and relatives include “Homely atmosphere, generally caring staff, involve relatives in social events. Meals and food appear to be very good”. “Entertainment is provided, staff respect that dad likes a quiet life and ensure that he is seated accordingly”. Latimer Grange Ltd DS0000064335.V333503.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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse by appropriate complaints and adult protection policies. EVIDENCE: Residents and relatives who were spoken with stated that they felt comfortable discussing any concerns with the home’s manager or staff. The complaints procedures are available for residents and visitors, are included in the Statement of Purpose and Service User Guide, and freely available along with the comment book in the foyer of the home. One visitor pointed out that they were quite happy to approach the homes’ owner, who frequently visits the home. Residents who passed an opinion felt they were safe and protected. The Adult Protection procedure has been introduced and staff spoken with confirmed their recent training and were aware of their duties to alert a senior member of staff of any concerns. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 15 Verbal and written comments received from residents and relatives include “A booklet is issued by the home to relatives of residents at the time of admission, and which is available in the entrance hall of Latimer Grange – containing the necessary information about making a complaint” Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comfortable and safe standard of accommodation is provided for the residents. EVIDENCE: Residents live in a homely, comfortable and clean environment. The home is decorated and furnished to a standard that creates a comfortable atmosphere. The internal courtyard provides a secure external environment for Residents with dementia, and is liberally provided with seating and raised flowerbeds and a multitude of pigeons and doves. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 17 Residents’ bedrooms showed evidence of personalisation, with small items of personal furniture, pictures and ornaments on display. Separate housekeeping staff are employed to maintain standards of hygiene, and all staff spoken with showed an awareness of cross infection and cross contamination issues, thus increasing resident safety in the home. Verbal and written comments received from residents and relatives include “The home is always very clean, my father is given all the help he needs. I always go to see him without warning the home. My father is cheerful and well cared for”. “It (the home) is clean and homely, the management and staff have empathy with residents and considerable patience; the food provided is excellent; visitors are made welcome and invited to become involved with the activities and social events” Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents are not supported or protected by the homes recruitment practices, or adequate training regime. EVIDENCE: The staffing rota was viewed and on the day of the inspection three staff were on duty, this did not include kitchen, domestic and office staff. Comment has been made by some residents’ relatives of care staff shortages, however they stated this has improved recently. The recruitment practices within the home were viewed. Three staff files were viewed, of staff that have commenced since the last visit to the home in July 2006. Of the three files viewed, one member of staff was employed and no application form or appropriate references could be evidenced on file. Individual staff did have a number of proofs of Identity and Criminal Records Bureaux checks in place. Some staff requiring visas to work in this country had such paperwork on file. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 19 No evidence of foundation or induction training was evident, for any of the three case tracked staff. Staff training is poorly organised and no training plan was evident for the staff. Neither staff supervision nor staff appraisals take place on a consistent basis, and residents and staff are being placed at risk through lack of consistent training practices. Verbal and written comments received from residents and relatives include “I think a little more one to one contact with carers and patients during the day i.e. just to sit and chat for a few moments. I find on visits there are no staff in the lounge they all seem to be busy and don’t have much time to spend with patients” “My aunt is cared for quite well, and most of the staff give her a lot of love, but if people cannot speak English very well, old people do not understand”. “More staff are required in the home as there are so many patients with Senile Dementia and shout and wander a lot” Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36 & 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The management approach does not promote effective care practice in the home for residents’ care and protection. EVIDENCE: The questionnaires form the home sent out for quality assurance purposes, were available for the Inspector to view. These have not been collated or the findings circulated with any of the current resident group or relatives. Nor have the results been included in the Statement of Purpose, which sets out the latest aims, objectives and philosophy of the home, about its services, facilities, and current staffing, nor the Service User Guide. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 21 An overview of residents’ finances was undertaken. The staff manage personal finances for one resident, both the accounting and balance of monies were incorrect. Staff supervision is currently not undertaken in the home, the registered provider must ensure the commencement, and then maintain appropriate levels of supervision. This would allow individual staff time to develop care practices along with the homes policies and practice, and allow individual staff training to be clarified and developed. A number of records were sampled and checks are in place to ensure safe practices for fire and testing of the fire alarm and warning system. The maintenance and service record of the hoist was seen and this was up to date. There is full recording of accidents, with these correlating to the daily records of Residents. “We are very pleased with the support and caring approach of management and staff at the home. If we were not we would raise the matter with them”. Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 2 X 3 Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 17 (1) Requirement Timescale for action 28/05/07 2 OP9 13 (2) All Residents must have a written contract or statement of terms with the home. This shall ensure residents are offered appropriate information on which to base a choice of stay in the home. 21/05/07 There must be an accurate record of all medication received, administered and disposed of by the service including: • • Defined codes for any nonadministration Quantity administered where a variable dose is prescribed 3 OP9 13 (2) Quantity and date of any medication given to residents for self administration Quantities received and balances carried forward from the previous month. This shall ensure residents safety is promoted in the home. Handwritten medication administration records must be accurate, include full dosage DS0000064335.V333503.R01.S.doc • 21/05/07 Latimer Grange Ltd Version 5.2 Page 24 4 OP12 12 (1) a 5 OP29 19 6 OP30 18 (1) c 7 OP33 24 8 9 OP35 OP36 17 (2) 18 instructions, be signed and dated and referenced to who has authorised the change. This would ensure residents are offered the appropriate information and that is then recorded appropriately. Activities must be provided that are appropriate to the needs, abilities and interests of residents. This shall ensure residents are offered activities at an appropriate level for their intellect. Staff must not be employed unless the required checks have been carried out. These include Application form References Full employment history This would ensure staff have a checkable work history, and are suitable to work with vulnerable adults in the home. Staff must have induction and foundation training appropriate to their level of expertise. This would ensure staff are equipped to work with residents in the home. The outcome of any quality assurance exercise is used to inform any prospective residents to the home, and improve the quality of care. Accurate financial records must be kept. This would protect the interests. Staff supervision must be undertaken regularly. This would ensure staff could develop individual resident care plans and explore policies and procedures in the home. 28/05/07 21/05/07 25/06/07 25/06/07 21/05/07 21/05/07 Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 25 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 5 Refer to Standard OP9 OP9 OP9 OP12 OP14 Good Practice Recommendations Any known medication allergies should be recorded in the medication administration records file Regular audits of medication should be carried out to ensure that medication stocks are adequate to maintain a continuous supply of all prescribed medication Individual residents files should contain details including consents to staff giving medication and medication profiles Residents should be offered recreation and activities through a planned process, and records made of individual resident intervention. A review should be undertaken to explore where Service Users areas of choice can be extended. The rota should identify the person who is left in charge of the shift when the Registered Manager is not on duty. 6 OP27 Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Latimer Grange Ltd DS0000064335.V333503.R01.S.doc Version 5.2 Page 27 - 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!