Inspection on 24/05/07 for Milton Lodge

This inspection was carried out on 24th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Milton Lodge 17/07/06

Milton Lodge 10/10/05

Milton Lodge 01/06/05

Milton Lodge 15/10/04

Milton Lodge 12/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Milton Lodge 35 Mount Road Fleetwood Lancashire FY7 6EX Lead Inspector Christopher Bond Unannounced Inspection 25th May 2007 09:30 24/05/07 09:30 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 Milton Lodge DS0000009694.V334550.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. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milton Lodge Address 35 Mount Road Fleetwood Lancashire FY7 6EX 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) 01253 770904 01253 776011 Fylde Care 1990 Limited Mrs Susan Waldermar Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 21 service users in the category OP (older persons 65 and over). 17th July 2006 Date of last inspection Brief Description of the Service: Milton Lodge is situated in a quiet residential area of Fleetwood opposite the Mount Gardens and close to the sea front. There is a range of community leisure activities available within a half -mile radius of Milton lodge. Fleetwood town centre is within walking distance of the home and there are local shops close by. Local bus and tram services operate from close by and there is a regular bus service into Blackpool from Fleetwood town centre. The home provides personal care for service users aged 65 years and above. Milton Lodge is registered for both male and female service users, however traditionally it is used by only by females. The Home offers accommodation for 21 residents. There are 6 double rooms and 9 single rooms; none of these have en-suite bathroom facilities. Information relating to the home’s Service User Guide and Statement of Purpose is included in the welcome pack, which is given to all prospective residents. This information explains the care service that is offered, who the owner and staff are, and what the resident can expect if he or she decides to live at the home. At the time of this visit, (25/05/07) the information given to the Commission showed that the fees for care at the home are from £315.50 to £355.00 per week, with added expenses for hairdressing and chiropody. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of the inspection process an unannounced site visit took place over a total of 4 hours on the 25th May 2007. A tour of the home was carried out, which included bedrooms, lounge, dining areas, and bathrooms. All areas were clean and hygienic. The residents’ personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates and medication records for the home were also examined. The managers, residents, care staff and visitors to the home were spoken to during the inspection and the lunchtime meal was sampled. There were three care staff on duty, including the manager, during the site visit. There were 17 residents living at the home at the time of the site visit. The Commission for Social Care Inspection sent out survey comment cards to the residents and their families for them to express their views on the service. A number of these were returned and the results of this survey have been expressed in the report. What the service does well: There were some excellent reports from residents and their friends and relatives regarding the standard of care offer at Milton Lodge. One relative wrote about the service as part of a Care Home Survey (carried out by the Commission for Social Care Inspection): ‘They do their best at all times, they give my mother the love and care she needs and deserves.’ Another relative wrote, ‘having experienced less satisfactory support at other homes where our relatives were living, I feel that Milton Lodge is well above average.’ The service is very homely and comfortable. Many of the residents looked happy and content in pleasant and relaxing surroundings. Everybody who lives at the home has a plan of care setting out the action that is needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents are met. These plans are reviewed regularly and any changes are written down in the plans. This ensures that the care staff has current information about each of the residents. Daily routines for the people living within the home are flexible and the residents’ personal routines and lifestyles are respected. Mealtimes are relaxed Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 6 and unrushed. Menus showed that there was plenty of choice available. The food that was being cooked on the day was nutritious and appealing. Several of the residents spoke of how much they enjoyed the cooking at the home. Almost all of the care staff either have a nationally recognised qualification in care or are working towards this. Over 50 of the staff are now qualified. This means that the care staff are better prepared to provide care for the residents of the home. 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. Milton Lodge DS0000009694.V334550.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 Milton Lodge DS0000009694.V334550.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): Standards 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information provided by the service is good, meaning that people can make an informed choice as to whether the home can meet their individual needs. Pre-admission assessments were thorough meaning that the home was confident that people’s needs could be met. EVIDENCE: The care plan records of four residents showed that assessments had been carried out before admittance. The assessments included information on religious, cultural, health and relationship needs of the residents. The relative of one resident confirmed they had been involved in the assessment process and were happy that the needs of their relative were being met. The service had a detailed Statement of Purpose and a Service User Guide, which described the facilities and services offered by the home. Two of the residents were able to confirm that they had been given this information before they made the choice as to whether the home was right for them, and Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 9 would meet their particular needs. One relative confirmed that their family were able to visit and look round the home before making a final decision as to whether or not the home was right for their parent. This is important because services and facilities could be viewed first hand to assess the suitability of the home. Milton Lodge DS0000009694.V334550.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): Standards 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Medication procedures and practices which could put the residents of the home potentially at risk. People were otherwise well cared for and treated with dignity and respect at this home. Care within the home was planned and reviewed to facilitate positive outcomes for the residents. EVIDENCE: Individual records are kept for each resident with a plan of care setting out the action that is needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed once a month. The care plans were then updated to reflect any changing needs in the health and personal care of the resident. No one in this home had been assessed as being able to control their own prescribed medication. A number of record sheets were looked at which showed how frequently the residents were given their medication. There were Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 11 several unexplained gaps where the senior carers had not recorded if medication had been given. This meant that either the record had not been filled in properly or some residents had not been given their medication when they should have been. Missing prescribed medication is dangerous and could affect the physical wellbeing of the residents. One resident had been prescribed medication that was ‘controlled’ because of its content or strength. The senior carers were no longer following the correct procedure regarding how this was recorded: the recording log register wasn’t being filled in. This meant that there were no records of who had administered the drug, how many tablets had been given and how many should be left. Controlled drugs should also be kept within a designated cupboard. This was not being done. There were two tablets of prescribed medication on the office floor close to the medication cupboard. This had been dropped either by a resident, who had been given their medication, or by the staff member who administered the medication. This could have affected the well being of the resident who should have been assisted to take it. Recent training had taken place at the home regarding medication awareness for the senior care staff that gave out medication. This was aimed at improving the good practice of the home regarding the handling of medication and this should have been addressed, and practice improved after this training. A referral was made to the Commission for Social Care Inspection Pharmacist for a more detailed inspection of the medication practices at Milton Lodge. There were some very positive comments made by the friends and family of people who lived at the home about the standard of care. One relative, who was spoken to, said, “Excellent, I can’t speak highly enough of them.” Another relative wrote of the home, via a Care Homes Survey (sent out by the Commission for Social Care Inspection), ‘ It (the home) cares for the varying individual need of a variety of residents with efficient and very caring staff. Despite the pressure of work they always have a positive outlook whatever time of day or night.” A resident who was spoken to during the inspection said, “Yes, I like it here, I like the way I’m looked after and the home is very comfortable.” Information was recorded by the carers about visits by health care professionals, such as doctors and district nurses. This is important because it enables the care staff to know the current state of health of the resident and what treatment, if any, they are receiving from healthcare professionals. No one who lived within the service had any pressure sores and there was equipment available within the home to prevent these. A nationally recognised Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 12 assessment tool was being used on a monthly basis to help ensure that pressure sores and tissue breakdown did not occur. Three of the residents were spoken to during the visit. All said that they were treated well and were spoken to with respect by the care staff. The inspector observed care staff talking respectfully to the residents of the home. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: Those residents who had special dietary needs had this recorded on their care plans. The Commission for Social Care Inspection sent out surveys to relatives and friends of the residents at the home and one person commented, “They always pay attention to (the residents) needs. My relative is diabetic and the staff are fully aware of what they can, or can’t eat.” Eleven surveys were received from residents and all said that they ‘always’ or ‘usually’ liked the meals at the home. The residents were eating lunch in the dining room at the time of the inspection. The surroundings were pleasant and the meal was unrushed. Four of the residents that were spoken to said that they enjoyed the food provided by the home. The cook was spoken to during the visit. She said that fresh vegetables were always used and that care was taken to ensure that the residents had a balanced and nutritious diet. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 14 Residents spoken to were very happy with the arrangements in place for social activities. These were varied and arranged individually and in groups. Several residents said they enjoyed activities both inside the home and in the local community. There was a schedule of daily activities on the notice board of the home. These included bingo, days out, quizzes and dominoes. Several residents were playing dominoes during the inspection of the home. Entertainers were booked to appear at the home on a regular basis. A varied activities programme adds to the wellbeing of the residents of the home. There were several visitors to the home during the inspection. One visitor said, “I’m really happy about how they treat (my relative). The staff are always polite and look after us well when we visit.” Another relative commented via a care home survey supplied by the Commission for Social Care Inspection, ‘Although myself and other relatives visit regularly every week, the staff do not hesitate to ring me on any matter concerning my mother. They make us feel very welcome when we visit.” Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring any safeguarding matters are appropriately managed. EVIDENCE: The manager of the home and the senior carer were spoken to during the visit. Both had a good knowledge of how people should be safeguarded from harm whilst living at the home. They were aware of the procedures to follow should they be unhappy about any aspect of care at Milton Lodge. There were policies and procedures available for the staff to read regarding keeping people safe. There had also been recent training regarding ensuring that people are safeguarded from harm. There were certificates to verify this in the care staff files. One of the residents commented, “I feel really safe here.” The home had a detailed complaints procedure, which is made available to all residents on their admission. Residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. The relatives of three residents also said they were aware of the complaints procedure but hadn’t had any cause to make a complaint about the home. At the time of this site visit no complaints had been received by the home or referred to the Commission for Social Care Inspection. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 16 All of the residents and relatives who filled out care surveys sent out by the Commission for Social Care Inspection wrote that they knew how to make a complaint about the home if they needed to. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 17 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): Standards 19, 23, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely, clean and safe environment. EVIDENCE: Some of the bedrooms had been decorated since the last inspection and the stairs and hallway areas had been fitted with a new carpet. The lounge and dining areas also had new carpets. Some of the beds in the residents’ rooms had been replaced. The provider had also recently purchased new matching curtains and bed heads for some bedrooms; these were waiting to be fitted. It is important that things are replaced when they show signs of wear, making the home a better place for people to live in. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 18 A tour of the building confirmed resident bedrooms had been personalised with their own belongings. All residents spoken to were happy with their rooms and said they had the choice of spending time on their own or in the lounge area’s. It was observed during the visit the home was clean and hygienic ensuring a pleasant environment in which to live. All residents spoken to said the home was always nice and clean. The service was very homely and comfortable. Many of the residents looked happy and content in pleasant and relaxing surroundings. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 19 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): Standards 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers of staff on duty throughout the day is sufficient to meet the needs of residents. Staff are trained and competent to do their jobs. EVIDENCE: Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of residents are met. Records show over 50 of staff members have achieved National Vocational Qualifications ensuring the residents are being cared for by a well trained and competent staff team. Discussion with staff and examination of records confirmed training had been provided for staff members to ensure they had a clear understanding of the specific care needs of residents accommodated at the home. The staffing rota showed that there were usually enough care staff on duty to ensure that the assessed needs of the residents were being properly met. Several care staff files were looked at during the visit. It was clear that staff were being recruited properly and that checks were being made to ensure that only suitable staff were being employed at the home. The files had been renewed and information was easy to find. All the correct information was being held for each staff member. Milton Lodge DS0000009694.V334550.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): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures in place to ensure the health and safety of residents and staff are promoted and protected. The home is run in the best interests of residents. EVIDENCE: The manager had completed a recognised qualification in management (the registered manages award). She had been employed in services for the elderly for a number of years and had worked at Milton Lodge for some time. The care staff that were spoken to were complementary of her management style and a number of the residents said that she was friendly and approachable. Residents spoken to confirmed they are consulted about any changes taking place within the home and kept fully informed about forthcoming events being organised. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 21 It was clear that this home was being managed in the best interests of the residents who lived there. Their care was well planned and the home was run safely and professionally. There was evidence on the personal files of the care staff to show that everyone was being supervised properly. This means that time was set aside for regular one to one meetings with the staff to ensure that they were happy and doing their jobs successfully and professionally. Professional trades people had checked all the gas system, electrical installations, lift, fire system and lifting equipment recently. There were certificates available to verify this. The care staff had completed several training courses in safety aspects around the home, including how to move people safely which helped to ensure that people lived in a safe environment and their wellbeing was taken seriously. Good and accurate records were kept of residents’ finances and regular checks were made of these by the owners of the home. This helped to make sure that the residents money and personal belongings were as safe as possible. The care staff had a set of policies and procedures to look at if they were unsure of how to handle a specific situation. These were a set of instructions that explained the ‘rules’ of how the care home should be run and how the staff should follow these. Milton Lodge DS0000009694.V334550.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Milton Lodge DS0000009694.V334550.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 2 Standard OP9 OP9 Regulation 13 (2) 13 (2) Requirement All prescribed medication must be stored properly and safely. Accurate records must be completed regarding the administration of all prescribed medication. Timescale for action 31/07/07 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations It is recommended that the use of the controlled drug register be re-instated at the home to record details of the administration of controlled drugs. This is in addition to the standard way of recording administration of medication. Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Milton Lodge DS0000009694.V334550.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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