Inspection on 27/01/06 for Mountview Community Support Centre

This inspection was carried out on 27th January 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Mountview Community Support... 07/08/07

Mountview Community Support... 12/12/06

Mountview Community Support... 16/05/06

Mountview Community Support... 30/06/05

Mountview Community Support... 03/11/04

Mountview Community Support... 28/06/04

Mountview Community Support... 19/02/04

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 Mountview Community Support Centre Melton Drive Congleton Cheshire CW12 4YF Lead Inspector Sue Dolley Unannounced Inspection 10:10 27th January and 21 February 2006 st 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 Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 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. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mountview Community Support Centre Address Melton Drive Congleton Cheshire CW12 4YF 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) 01260 272925 01260 297386 Cheshire County Council Helen Margaret Riley Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability (6) of places Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This care home is registered for a maximum of 36 service users to include: * Up to 36 service users in the category OP (Old age not falling within any other category) * Within the total of 36, up to 5 service users may be in the category PD (Physical disability aged between 55 and 65 years) * Within the total of 36, up to 1 service user may be in the category PD (Physical disability aged between 50 and 65 years) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The registered provider must provide staff to meet the dependency needs of service users at all times and shall comply with any guidance, which may be issued through the Commission for Social Care Inspection. 30th June 2005 2. 3. Date of last inspection Brief Description of the Service: Mountview is a community support centre providing personal care and accommodation, on a short stay/respite basis, for 36 older service users and including up to 5 people with disability aged between, 55 and 64 years and 1 person with a physical disability aged 52 to 53 years. It is owned and managed by Cheshire County Council, which operates a number of similar facilities in Cheshire. Mountview is in Congleton, close to a small shopping arcade with a variety of shops including two supermarkets, a post office, a newsagent, a chemist a bakery and a public house. It opened in August 1988 and consists of a twostorey building. Part of the ground floor has been adapted to provide office accommodation for the home and for the community based services that operate from the building. All the bedrooms are single rooms and have washbasins. Access between the ground and the first floors is via a passenger lift. The garden is accessible to service users. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a total of eight hours and during two days to ensure the registered manager was available to provide some input and be available for feedback. A tour of the premises included the communal areas, the shared bathrooms and toilets, the kitchen and laundry. Several members of the senior management and care staff contributed to the inspection process. The staff handover meeting was observed and four service users were spoken to. Two experienced managers manage Mountview under a job share arrangement. Some management responsibilities have been divided. What the service does well: What has improved since the last inspection? Mountview receives support from a Specialist Practitioner Nurse from Eastern Cheshire Primary Care Trust on a sessional basis, usually every Tuesday. The input has proved beneficial to both service users and staff and has aided the assessment process and liaison with General Practitioners. A new updated statement of purpose was produced in January 2006 and a copy is to be provided to all bedrooms. The registered manager continues her training and hopes to complete the Registered Managers Award within the next six months. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 6 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. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 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 Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 and 5 The service user guide needs updating to provide service users with an accurate description of the services provided. The centre has recently admitted service users beyond their categories of registration. EVIDENCE: The statement of purpose was updated in January 2006 and is well written. It provides prospective and existing service users and their supporters with a brief description of the services provided. It contains information about the qualifications and experience of staff and explains the criteria for admission. Supplies of the document are awaited and when received a copy will be provided in every bedroom within the centre and supplies will be available within the reception area. The service user guide was produced in September 2003 and needs updating to ensure service users have accurate information to enable them to make an informed choice about placement. It must provide service users with an accurate description of the services provided and should include all information to meet section 1.2 of the National Minimum Standards. See Requirement 1. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 9 Prospective service users and their supporters are welcome to visit the centre and assess the quality, facilities and suitability of the centre prior to agreeing to a short stay. Service users’ needs are assessed before they receive care at the centre. During the inspection 4 service users’ care files were checked. The assessments and care files were positively written, self –care abilities were described, and relevant information and contacts were provided. Recent social history information and circumstances leading to the placements were well described. Records of health visits had been completed advising of symptoms and treatment prescribed. Advice was given at feedback to the inspection to ensure infection control information is appropriately recorded and staff members are aware. Two of the care files checked indicated that service users required specialised services. The assessments must be thoroughly checked prior to agreeing placements. The centre needs to ensure all assessed needs can be met, and staff members are appropriately trained to provide the necessary care. The registered person must ensure that if necessary an appropriate variation to the registration is arranged and agreed prior to the commencement of placement. See Requirement 2. During the inspection care staff were seen to encourage service users to retain their independence and to support them. Care staff were attentive and provided prompt assistance. The staff handover was observed and provided evidence of effective communication throughout the centre and between staff. Contacts between service users and staff members were kindly, reassuring and respectful. Within the centre two intermediate care beds can be used for rehabilitation for up to six weeks as a transitional arrangement. Staff members are deployed, and specialist services from relevant professions including physiotherapy are secured, to meet the assessed needs of service users admitted for rehabilitation. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 11 Medication administration records indicate a need for careful and accurate recording and close monitoring of recording to ensure service users receive the correct medication. The management team and senior care staff are very experienced in the care of older people. In the event of a death, all concerned can be assured that they would be treated with care, sensitivity and respect. EVIDENCE: Some service users are able to store and administer their own medications with supervision and lockable space is provided in most bedrooms for storage. Otherwise, medication is managed and administered by the senior support workers as necessary. Staff members had been provided with guidance notes regarding particular diseases and conditions to inform their practice. All the medication records were checked. Each contained a list of omission codes for staff members to refer to and use. Special instructions were provided regarding, for example, when there was a need for staff to prompt service users or to check that medication to be self- administered had been taken. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 11 Despite these areas of good practice many anomalies were found in the recording of administration. There were many unexplained gaps in recording, unrecognised omission codes had been used and some medication had not been given as prescribed. Some abbreviations had been used and one record did not contain a photograph of the service user to aid identification. The standard of recording indicates a need for close monitoring. See Requirement 3. The management team and senior care staff are very experienced in the care of older people, and would support and supervise care staff in handling seriously ill and dying service users with dignity and sensitivity. A policy and procedure is in place to guide staff in the event of a death. Although the centre is currently used for short stay/respite care and residential intermediate care, it is important that staff members have sufficient family contact information and/or information regarding service users wishes regarding death and dying should an unexpected death occur. Social work team members are asked to provide sufficient information on assessment documentation in respect of this. The four, sample care files checked provided sufficient contact information. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 There is little involvement by local community groups to accord with service users’ preferences. EVIDENCE: Service users are encouraged to maintain contact with family and friends as they wish, and are helped to exercise choice and control over their lives. Service users confirmed that they are able to see visitors in private, at any time. Currently there is little involvement in the centre by local community groups and/or volunteers to accord with service users’ preferences. See Recommendation 1. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Printed information should be made available to advise service users and their supporters of local available advocacy services. EVIDENCE: Where service users lack capacity, the registered person should be able to facilitate access to available advocacy services. See Recommendation 2. A quality standards questionnaire is provided to each service user every twelve months or at the end of their short stay to obtain their views of the service they have received. The centre offers predominantly short stay care and therefore has limited involvement in promoting the civil rights of service users to vote and take part in the political process. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23,24,25 and 26 Rooms are well furnished and specialist equipment is available to assist service users to maximise their independence and make their stay comfortable. Mountview is clean, welcoming and inviting. Storage for equipment and furniture is problematic and leads to some bathrooms being inappropriately used for this purpose. Some minor repair work is necessary to enhance the environment and evidence of regular water temperature control checks needs to be provided to complete the inspection process. EVIDENCE: Service users were seen moving freely between their bedrooms and the communal areas. Access for service users between the ground floor and first floor is via the passenger lift or stairways. Within the centre there is some specialist equipment to assist service users who have mobility difficulties. For example there a few electrically- operated beds, grab rails to corridor and bathroom areas, a toilet for the disabled is provided, specialist bathroom equipment has been installed. The centre can accommodate wheelchair users. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 15 A call alarm system is in place and is soon to be replaced with a more advanced system. Service users have comfortable bedrooms and are encouraged to bring in some small personal items to make them feel at home during their stay. Since the last inspection three remaining bedrooms have been provided with lockable storage space. There are clearly marked accessible toilets for service users close to lounge and dining areas and near to service users own private accommodation. Ample communal space is provided in which a variety of social activities can take place. Lounges are homely and varied in size and dining areas are attractively presented. There are adjacent satellite kitchens, which are well equipped. Throughout the centre there is a lack of storage space available for larger equipment and several bathrooms were being used for storage and were cluttered with equipment. See Requirement 4. On the inspection dates, some old discarded chairs and mattresses etc. were in the grounds, on view near to the entrance and awaiting removal. This distracts from the presentation of the building and the items should be removed promptly. See Recommendation 3. Some minor repair work is necessary to enhance the environment. During the inspection the registered manager was unable to locate evidence of regular water temperature control checks. Evidence of these checks need to be provided to complete the inspection process. See Recommendation 4 During feedback to the inspection the registered manager was advised of the following matters to be addressed. Wiring protruding from the walls in three toilet/bathroom areas and uncovered. • Staining to a ceiling in a toilet area opposite bedroom 12. • Redecoration of corridor ceilings near bedrooms 34 and 37. • Redecoration to 1 bedroom. • 1 bedroom was slightly odorous. See Requirement 5. Cheshire County Council has produced policies and procedures for the control of infection to guide staff members in the use of basic good hygiene practices. • Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 16 The laundry and kitchen area were checked were well equipped, clean and well organised. However in a room adjacent to the kitchen, plastic buckets containing soil from potatoes were being stored on food racking used for the storage of tinned and dried foods. Also protective headwear was hanging on the racking system and a small amount of frozen meat had been placed in the freezer and had not been dated. Advice was given during the inspection and these matters were immediately rectified. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed at the previous inspection on 30th June 2005. EVIDENCE: Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35,36 and 38 Two experienced managers run the community support centre. They share a full time post and are supported by an experienced and confident staff team. Service users’ best interests are safeguarded and the health, safety and welfare of service users and staff are promoted. The last registered provider report available related to August 2005. Monthly visits to the centre must be undertaken to monitor the provision and services provided. EVIDENCE: Two experienced people manage the centre, sharing a full time post within a job share arrangement. The arrangement commenced in September 2005. One manager awaits a fit person interview to register to manage at Mountview. Both managers have had leave entitlements and initially some absences of management have created tensions for remaining senior staff within the home. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 19 The processes of managing and running the home are open and transparent and managers are aware of the need for a settling in period within their new roles and have begun to divide and share management responsibilities to ensure the staff team are supported and a clear sense of direction and leadership is maintained and developed. The last available report of monthly visits by the registered provider/locality manager to view was dated 30th August 2005.See Requirement 6. Suitable accounting and financial procedures are adopted to demonstrate there is effective and efficient management of the business and evidence of appropriate insurance was seen. A member of staff was advised regarding security during the inspection. Examples of service users’ balances of personal monies held for safekeeping and the related records were checked and were accurate. Staff members receive regular planned and formal supervision. The management team each supervise a group of staff and supervision covers all aspects of practice, philosophy of care in the centre and career development needs. In addition there are monthly group meetings and annual appraisals to inform and support staff members. Four whole day meetings per year are being planned for seniors to attend away days to discuss and progress various topics related to their roles and responsibilities. The health, safety and welfare of service users and staff are promoted at Mountview. Staff members are aware and report potential hazards. A record of accidents was checked and was fully completed and the fire policies and procedures manual was well maintained. Risk assessments are carried out for all safe working practice topics and significant findings are recorded so that risks can be minimised. To improve safe working practices the metal cage to the outside of the building near to the laundry used to store some corrosive cleaning solutions must be kept locked. Although a combination lock had been obtained for the cage since the last inspection and was in place, the cage was not locked. See Requirement 7. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 20 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 2 X 2 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 1 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 2 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 2 18 X X X X 2 3 2 2 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X 3 3 3 X 2 Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 5 and 6 Requirement Timescale for action 2 OP4 14 The registered person must produce a written guide to the care home, keep it under review 30/04/06 and where appropriate revise it and notify the Commission of any such revision within 28 days. a). The registered person must not provide accommodation to a service user at the care home unless, so far as it has been practical to do so there has been appropriate consultation regarding the assessment with the representative of the service 31/03/06 user. b). The registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 22 3 OP9 13 4 OP22 23 5 OP24 23 6 OP31 26 7 OP38 23 The registered person must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. (This requirement was also made at the previous inspection on 30/06/05 and remains unmet). Ensure that suitable provision is made for storage for the purposes of the centre. (This requirement was made at the previous inspection on 30/06/05 and remains unmet). Ensure all parts of the centre are kept clean, reasonably decorated and in a good state of repair. (This requirement was made at the previous inspection on 30/06/05 and remains unmet). Ensure that a representative of the organisation visits the centre at least once a month. Ensure that a written report is prepared on the conduct of the centre and a copy of the report is made available for inspection. Keep the metal cage to the outside of the building near to the laundry locked to ensure safe storage of some corrosive cleaning solutions. (This requirement was made at the previous inspection on 30/06/05 and remains unmet). 28/02/06 30/04/06 30/04/06 30/04/06 28/02/06 Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 23 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 OP13 Good Practice Recommendations Encourage involvement in the home by local community groups and/or volunteers to accord with service users preferences. (This recommendation was also made at the previous inspection on 30/06/05 and the situation remains unchanged). Provide service users and their supporters with printed information about local advocacy services available. Make arrangements for the prompt removal of old discarded chairs and mattresses etc. from the grounds. Provide evidence of regular water temperature control checks to complete the inspection process. 2 3 4 OP17 OP22 OP25 Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Mountview Community Support Centre DS0000036720.V265360.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!