Inspection on 21/06/06 for Mermaid Lodge

This inspection was carried out on 21st June 2006.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mermaid Lodge 10/11/05

Mermaid Lodge 17/01/05

Mermaid Lodge 15/06/04

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

CARE HOME ADULTS 18-65 Mermaid Lodge 68 Brighton Road Lancing West Sussex BN15 8LW Lead Inspector Mr E Mcleod Unannounced Inspection 21st June 2006 09:15 Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 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 Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Mermaid Lodge Address 68 Brighton Road Lancing West Sussex BN15 8LW 01903 763945 01903 763945 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) Mrs Nilda Yasuda Dooraree Mr Raj Narsing Dooraree Mrs Nilda Yasuda Dooraree Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2005 Brief Description of the Service: Mermaid Lodge is situated near to the seafront in Lancing, with access to local bus services and shops. The service has been providing a family home type of support for up to three service users with a present or past history of mental health problems. The registered providers Mr and Mrs Dooraree advised at the inspection that, further to rebuilding work which has taken place at the property and the adjacent property, that an application has been made to seek a change in registered numbers. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was not announced and was arranged to update outcomes assessed at the previous inspection. The visit to the premises lasted 3 hours during which the three residents, the registered manager and a member of staff were interviewed, a tour of the premises was carried out, and policies, procedures and records were sampled. All key standards have been assessed during this inspection. The inspector would like to thank everyone who contributed to the inspection. What the service does well: What has improved since the last inspection? Arrangements for administering medication have been improved. Improvements to the premises includes the addition of an office, and re carpeting to the stairs. There are now two sitting room/ dining rooms, each of which has been redecorated, has new flooring, new dining room tables and chairs and lounge chairs. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 6 Two new shower rooms and two new toilets have been added to the communal accommodation. One of the toilets has been designed as to be suitable for wheelchair use. Arrangements have been put in place to ensure a good and safe transition to an increase in staff and resident numbers, including new staff recruitment and training procedures, and new formats for care plans. 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. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Arrangements are in place for the proper pre-admission assessment of residents, including trial visits and stays, and assessments. The outcomes for residents were seen as good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The home is presently in process of being registered for up to 10 persons. Fees in the home are £300-400 per week. A new statement of purpose has been provided, signed and dated. A Contract of terms and conditions for residents seen. This includes advice on trial visits and stays, and advises that the first four weeks of residence are a trial period. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 9 A new service user guide has been provided. Service users’ views of the home and the availability of most recent inspection report need to be included in the service user guide. No new referrals have been received since the previous inspection, so the inspector was unable to assess pre-admission procedures. However, new forms for pre-admission assessments have been produced by registered manager Mrs Dooraree, and new forms for referral, assessment interview, assessment, and individual fire risk assessment were sampled. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 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 the following standard(s): 6, 7, 9 Good care plans and risk assessments are in place which are assisting residents to develop their choices and independence. Outcomes for residents were assessed as good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: There is a new risk assessment format, seen by the inspector. A completed risk assessment for kitchen and bathing for one resident was seen, and this had been agreed and signed by the resident. The risk assessment was being used to minimise risks to the resident while encouraging their independence. Two sets of care plans were seen. Care plans are being regularly reviewed. On the day after the inspection Mrs Dooraree said that a review including the Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 11 resident’s social worker was planned for two residents. Care plans were found to reflect the interests and aims of each resident, and are assisting residents to achieve their aims. Interviews with residents indicated that staff are respecting their right to make decisions, and are encouraging them to achieve greater self confidence and independence. One resident talked of enjoying doing tasks around the house, and felt she had been able to influence types of meals provided in the home. One resident who now goes out more has agreed to have a house key. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16 Residents are encouraged to have a full and independent lifestyle. Good meals are provided. The outcomes for residents were seen as good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: There is evidence from care plans and interviews with residents that each resident is being enabled to develop his or her lifestyle. The resident’s individual interests (such as drawing, writing, making toys) are being encouraged, and the inspector noted that since the previous inspection each resident has had a more active lifestyle. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 13 One resident continues to do an art class at a local day centre, and undertakes a few hours of light gardening work each week. One resident is on a waiting list for a place at a day centre. Residents are making use of the local library, and are taking responsibility for their own clothes shopping. One resident does food shopping. Activities provided in the home include cooking sessions, video evenings, and games. There has been since the previous inspection more attention given to spending one to one time with residents both in the home and outdoors - for example, Mrs Dooraree goes walking for half an hour each day with a resident, which is assisting the resident’s health and fitness, and giving the resident an opportunity to talk about important issues. Residents said that the staff assisted them in maintaining good links with family and friends, and that staff acted towards family and friends in a professional and friendly manner. Mrs Dooraree indicated that good relations with family and friends are seen as important in the home. Residents are encouraged to be involved in the planning of meals, food shopping, and preparation of meals. Residents’ meetings are now taking place, and a record of one resident’s meeting was seen during the visit. There are now two dining rooms, so residents can choose in which room they wish to eat. New dining tables and chairs have been provided, and the rooms have been redecorated. One resident said Mrs Dooraree “cooks some very good English food and gets to know what food you like and how you like it. Meals are interesting, they’re very very good”. Other residents agreed the food was good. Meals are home cooked. Tea and snack making facilities are provided for residents, and one resident has a fridge and kettle in his bedroom. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 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 the following standard(s): 18, 19, 20 Good arrangements to ensure residents are accessing health services are in place. Arrangements for administering medication have been improved. Outcomes for residents were seen as good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: All residents are registered with a local GP, dentist, and optician, and have access to local chiropody services. Discussions with residents indicated that they are accessing other health services such as district nursing and community psychiatric specialists. Residents are being assisted to maintain good mental health in the home. Staff are enabling residents’ wellbeing by providing a healthy diet and encouraging residents to have an active lifestyle. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 15 Blister packs are now being provided for residents’ medication, and printed MAR sheets are now used to record dosages administered. One resident said he was aware he could self-administer his medication if he wished, but preferred for his medication to be administered by staff. Suitable storage for medication is provided. Discussion with residents and Mrs Dooraree indicated that residents’ medication is being regularly reviewed, and changes in medication have assisted residents towards better physical and mental health. Residents are aware that they can ask to be responsible for their own medication. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 22, 23 Good arrangements are in place for responding to adult protection incidents and for protecting residents. Good arrangements for dealing with complaints are in place. Outcomes for residents were seen as good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: A complaints policy and procedure is in place, and a system for ensuring that staff are maintaining good practice in dealing with complaints has now been introduced. No complaints have been received in the past 12 months. Mrs Dooraree has introduced new Protection of Vulnerable Adults management guidelines, and these together with a new policy and procedure for the protection of vulnerable adults were sampled. Local guidelines on responding to adult protection incidents are being updated, and Mr and Mrs Dooraree say they have arranged to attend training on these. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 24, 25, 27, 28, 30 The accommodation provided has been improved, and is suitable for purpose. Redecoration needs to be carried out to the exterior of the property, particularly on the south side. Outcomes for residents were seen as good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: In preparation for the proposed registration of a further six bedrooms for the service, a large amount of refurbishment and redecoration has taken place. An office has been added to the provision. There are now two sitting room/ dining rooms, each of which has been redecorated, has new flooring, new dining room tables and chairs and lounge chairs. The decoration and Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 18 refurbishment have been carried out to a good standard, and the rooms are light and airy with access to a balcony overlooking the sea. A new fire exit has been created, and stairs have been re-carpeted. Some redecoration has been carried out to the exterior front of the building, but as yet the exterior rear of the building remains in need of redecoration. A new washing machine and a dryer have been provided which are capable of bigger wash loads. Mrs Dooraree said there were plans to install a dishwasher and redecorate the kitchen. The bedrooms of the three residents presently accommodated were seen. Each resident has personalised their bedroom, and choose how it is to be decorated and arranged. None of these bedrooms have en suite facilities. Two of the bedrooms are smaller than 10 square metres, but this is partly compensated by them having good sea views which the residents concerned said they liked. Two new shower rooms and two new toilets have been added to the communal accommodation. One of the toilets has been designed as to be suitable for wheelchair use. All parts of the care home visited were clean and hygienic. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Arrangements have been put in place to ensure a good and safe transition to an increase in staff and resident numbers. Effective staff support for residents is being provided. Outcomes for residents were assessed as good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: – The present staff team is Mr Dooraree and Mrs Dooraree (both of whom were present during the inspection visit) plus two bank care staff. Mr or Mrs Dooraree are usually on the premises 24 hours per day – when not, she advises cover is provided by two bank care staff who have worked shifts at the home for a number of years and who the residents know well. Mr Dooraree has just completed NVQ level 3, and is due to commence NVQ level 4. Mr and Mrs Dooraree planning to undertake PoVA training July 2006. Mrs Dooraree presently undertaking NVQ level 4. Mr and Mrs Dooraree Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 20 attended training on food and hygiene legislation February 2006. Mrs Dooraree said that new staff employed will be offered the opportunity to do NVQ level 2 or 3 as required, by the home. Mrs Dooraree said she is seeking to undertake training in Equality and Diversity. A number of new policies and procedures have been provided in anticipation of an increase in the staff team and number of residents. A sample staffing rota was seen. A copy of the new staff induction programme and new staff training policy were sampled. Job descriptions, terms of employment, induction, supervision and appraisal records have been put in place. New staff recruitment paperwork has been put in place, such as reference requests, a staff employment procedure, an employment checklist, and job application form. In order to process the CRB/ PoVA First checks for new staff, Mrs Dooraree advised that she is applying to become a registered body for the administration of such checks. Good interaction between residents and staff was noted during this visit. Progress made by residents in developing their skills, self confidence and independence were noted to have been assisted by a good and trusting relationship they have with Mr and Mrs Dooraree, and the encouragement they have provided. This was confirmed by the residents, who referred to Mr or Mrs Dooraree as having influenced their decision to try new things. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 The home is being well managed and is prepared for the proposed transition to a larger number of staff and residents. Arrangements for health and safety in the home are in place. An annual development plan and system for quality assurance which includes the views of residents, relatives and others must be developed. The requirements and recommendations made at the environmental health inspection of 6.6.06 must be met. Outcomes for residents were seen as good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 22 EVIDENCE: Mrs Dooraree has advised the Commission of the most recent equipment and service checks carried out in the home. Fire drills and training are taking place. A fire hazard analysis record was completed in June 2006, and other environmental risk assessments are being carried out. Records for kitchen cleaning rotas and fridge temperatures were seen. The report of an environmental health officer inspection carried out on 6.6.06 was seen. This recommends the provision of a wash hand basin and dishwasher in the kitchen, for walls in the kitchen to be washable, and for separate tea making and cooking areas in the kitchen. It was also recommended that staff undertake basic food hygiene training. Recruitment and referral procedures have been updated, as have a number of other policies and procedures, in preparation for an increase in resident and staffing numbers. Health and safety policies have been appropriately updated. “Safer food” checks are now being carried out further to recent changes in food hygiene legislation. All three service users handle their own money. Mrs Dooraree is appointee for one resident but he receives and cashes his giro weekly by himself. Mrs Dooraree said she had definite ideas for areas of improvement in the home over the next year, but that an annual development plan was not in place. Mrs Dooraree said that residents views on the service were being sought, and residents’ meetings were helpful in this regard. However, no systematic way to record the views of residents, relatives and others on the service, no summary of views gathered, or publication of these views and outcomes is in place. Residents believe the home is well managed, and that there is a good atmosphere in the home. New policies and procedures and arrangements to assist the proposed transition to a larger number of staff and residents have been provided. Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 23 Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 1 X X 2 x Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 25 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 YA39 Regulation 24 Requirement The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided in the care home (Previous timescale of 10.2.06 not met). The registered person shall ensure that all requirements and recommendations made at the Environmental Health Department inspection on 6.6.06 are complied with. The provider shall ensure that the exterior of the property is reasonably decorated Timescale for action 04/09/06 2. YA42 13.4 04/09/06 3. YA24 23.2 (d) 04/09/06 Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 26 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 YA39 Good Practice Recommendations The provider should ensure there is an annual development plan for the home, based on a systematic cycle of planning-action-review, and reflecting aims and outcomes for service users Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Mermaid Lodge DS0000014629.V293095.R01.S.doc Version 5.1 Page 28 - 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!