Inspection on 21/03/06 for Musmajas

This inspection was carried out on 21st March 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

Musmajas 06/10/08

Musmajas 19/05/08

Musmajas 05/11/07

Musmajas 11/09/06

Musmajas 13/07/05

Musmajas 11/08/04

Musmajas 17/05/04

Musmajas 27/08/03

Musmajas 17/06/03

Musmajas 29/08/02

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

CARE HOMES FOR OLDER PEOPLE Musmajas Priory Hall Wolston Nr Coventry West Midlands CV8 3FZ Lead Inspector Michelle O`Brien Unannounced Inspection 21st March 2006 08:20 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 Musmajas DS0000004256.V287700.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 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. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Musmajas Address Priory Hall Wolston Nr Coventry West Midlands CV8 3FZ 02476 542701 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) Latvian Welfare Fund, Mrs Diane M Springthorpe Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2005 Brief Description of the Service: Musmajas is a care home set in its own grounds approximately 1 mile from the village of Wolston. The property is owned by the Latvian Welfare Society and was developed into a care home to serve the Latvian community in the Midlands. The home can accommodate up to 18 service users in single room accommodation. Accommodation is sited in the large manor house and surrounding bungalows. Musmajas provides personal care to frail elderly people most of whom originate from Latvia. The home’s staff consists of English and Latvian speaking carers who can also converse in English. No intermediate or specialist care is offered at this home. Service users with nursing needs are cared for by the visiting community nurses. Medical services are provided by the local GP practice. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection of the inspection year (April 2005 – March 2006) and was unannounced. The inspection took place over 7 hours commencing at 8.20am. The focus of this inspection was to assess the key standards not assessed during the previous inspection and review the home’s progress in meeting the requirements made. For a full overview of the home this report should be read along with the inspection report of 13th July 2005. On the day of inspection there were 15 residents being cared for in the home; this included two residents for respite care and one resident who was in hospital. The home currently does not have a registered manager. The previous registered manager left the home at the beginning of the month. The person in charge on the day of inspection was a senior care assistant. The senior carer’s assessment was that there was one resident with high dependency need and the majority of the remaining residents had medium dependency needs. Most of the residents were observed to be independently mobile and moved freely around the home and grounds, although one resident was observed to require the assistance of two staff to transfer from chair to bed. The inspector joined residents in the dining room for their midday meal, toured the home and visited residents in their rooms, observed working practices and staff interaction with residents. The inspector had the opportunity to meet and chat with most of the residents in the home and talked to six of them at length about their experience of living in the home. The chairman of the Latvian Welfare Fund, which owns the home, was present in the home and had a brief discussion with the inspector. Documentation maintained in the home was examined and this included care files of residents, staff personnel files and training records, policies and procedures and records maintaining safe working practices. The inspector would like to thank staff and residents for their co-operation and hospitality. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 6 What the service does well: 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. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 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 Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 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): The key standards in this section of the report were assessed and met during the last inspection and have not been reassessed during this inspection. No progress has been made to produce a suitable statement of purpose and service user’s guide and this requirement remains outstanding. EVIDENCE: Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 9 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): Standards 7, 8 and 10 were assessed. Residents’ care plans described the actions necessary to meet the identified needs of residents but were disorganised and had no consistent evaluation which could result in an oversight of care. Risks to residents’ health are not identified by the home which increases the possibility of deteriorating health and poor outcomes for the residents. Residents are treated with respect and dignity resulting in an increase in selfesteem and general wellbeing. EVIDENCE: The inspector met with most of the residents on the day of inspection. Residents looked generally well cared for and everyone spoke positively of the care they received and told the inspector that they were happy in the environment of the home. Residents were observed to be at ease when asking for assistance and staff were attentive to the individual needs of residents. Staff interacted well with residents, were caring towards them and addressed them respectfully. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 10 The care files of three residents were examined. Care plans were available for the identified needs of residents but were disorganised and the information was difficult to find. There was no standard layout as each of the files were set out differently. All these factors make it increasingly difficult to for care staff to use the information contained in the care plans to direct them to give appropriate care. It was evident that regular evaluation of the care plans had stopped in August 2005. There was no evidence that care plans had been discussed and agreed with the residents or their families. The home uses risk assessment tools for monitoring risk of developing pressure sores, however risk assessment tools are not used to monitor nutrition, falls or moving and handling. Consequently, residents’ risks of developing healthcare problems are not identified and preventative care plans are not in place. Residents’ weight is not consistently monitored. All residents are registered with local G.Ps who visit on request. Service users spoken to said they were happy with the G.P. Residents have access to dental care, chiropody and sight tests as arrangements are in place for all these services to visit the home. It was noted that all spoke to the service users with respect and maintained their dignity. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 11 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): Standards 12 and 13 were assessed. The current arrangement for activities and entertainment are limited and so therefore do not provide adequate recreation or motivation for residents which may result in boredom and low self-esteem. Residents are encouraged and supported to maintain contact with their family, friends and local community resulting in supporting their social skills and increase in their mental well being. EVIDENCE: The home does not have any organised activity programme. On the day of inspection the majority of residents remained in their room and few were observed to be engaged in any activity other than watching television. One resident pottered around the large grounds between the buildings and told the inspector that many residents came outside in the better weather. The inspector expressed concern about the social isolation of residents who remain in their rooms because of their limited mobility. It was noted that the interests and lifestyle choices of residents were well recorded in their care files. This information needs to be analysed and an activity programme implemented so that residents have an opportunity to engage in stimulating, meaningful activity. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 12 The home has an ‘open visiting’ policy that allows relatives or friends to visit at any time. Residents spoken to confirmed that they are able to receive visitors in the communal lounge or in the privacy of their bedrooms. The home supports residents in their spiritual needs by the involvement of the Latvian church minister visiting and holding monthly services in the home. One resident still attends a day centre in the local community. On the day of inspection one of the residents took the bus into Rugby. The care home is in a very rural location but does have some community input; there are function rooms adjoining the care home which are hired by the local community for parties, weddings and other social events. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 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): Standards 16 and 18 were assessed. The complaints procedure for the home needs to be reviewed so that residents and their families can be confident that their concerns will be heard and acted upon. The lack of policies and staff awareness of the protection of vulnerable adults leaves residents at risk of harm. EVIDENCE: The home does not have an up to date complaints policy that is accessible to residents and their families. The policy should give information about how to raise a complaint or concern in the home and also how to contact the Commission at any time. Residents spoken to during the inspection all confirmed through questioning what they would do if they had any concerns and all felt that the staff and management were approachable. It was evident through these discussions that residents felt confident about raising concerns, being listened to and appropriate action taken. The home does not maintain a record of complaints but it was informed that none have been received. The Commission has received no complaints about this service. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 14 The home does not have an adult protection policy in place for responding to suspicion or allegations of abuse. There is no evidence that staff have received training in abuse awareness although it was informed that this is planned for later this year. The home must develop an adult protection policy and ensure all staff receive training in how to respond to allegations or suspicions of abuse. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 15 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): Standards 19, 21 and 25 were assessed. The home is in need of improvements to provide a well-maintained environment with sufficient and suitable equipment and facilities, which ensure safe and comfortable surroundings, are provided for all residents. EVIDENCE: The inspector toured the home and visited all the residents’ bedrooms. Residents’ accommodation in the care home consists of 5 bedrooms in the main house and 13 bedrooms housed in 3 bungalows in the grounds separate from the main house. The communal lounges and dining room is situated in the main house which means that residents accommodated in the bungalows must go outside and cross to the house to use these facilities. The laundry is in an adjacent outbuilding. The home has well-kept, mature, extensive gardens and there is outside seating for residents to use. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 16 All of the bedrooms seen contained personal items of residents such as photographs, soft furnishings and small pieces of furniture. The environment is generally traditionally decorated, cosy and homely. Some of the furniture, carpets and wallcoverings are worn and drab. Some of the bedrooms have been refurbished but the home would benefit from a programme of planned maintenance. Radiator covers have been installed in response to the previous requirement to safeguard residents from risk of harm. The bathing and toilet facilities on the first floor of the main house require refurbishment. This was identified during the last inspection and is yet to be addressed, however, it was informed that quotations have been obtained for this work. The large windows on the landing of the staircase between the ground and first floors of the main house open onto a balcony. This window must have suitable locks or restrictors installed to reduce the risk of falls from a height for service users. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 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): Standards 27 and 29 were assessed The numbers of staff are not sufficient to meet the needs of residents accommodated in the home, which could result in a reduction of the care provision. The recruitment practices in the home are not sufficient to ensure the support and protection of the residents. EVIDENCE: It was informed that the usual staffing complement for the home is:8am – 8pm 8pm – 8am 3 members of care staff 1 wakened member of care staff and one ‘sleeping in’. The member of staff ‘sleeping in’ remains awake between 8pm and 9.30pm, is on-call between 9.30pm and 7am, and works between 7am and 8am. This staffing complement was not confirmed when the inspector examined three weeks of staff duty rota between 5th March and 25th March 2005. The rota demonstrated that there were only 2 care staff on duty for half of all the daytime shifts. It was also informed that the home employs no cleaning staff or laundry staff and that these additional non-caring duties are undertaken by the care staff. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 18 It was evident from observation of working practices that staff had little time to spend talking to residents and residents’ needs are met in a task-orientated way as opposed to holistically. This was also confirmed during discussion with two residents who felt that they would like staff to be able to spend more time with them that did not involve a caring task. Inadequate staffing may be contributing to the shortfall in meaningful activities for residents. The personnel files of two recently employed staff were examined. While most of the necessary information had been obtained it was found that staff members had commenced employment before Criminal Record Bureau (CRB) and Protection of Vulnerable Adult Checks (PoVA) checks had been obtained and that CRBs are accepted from previous employers. It was discussed with the senior carer during the inspection that the registered person must ensure that staff files contain evidence that CRB and PoVA checks have been obtained before a staff member starts working in the home. CRBs are not portable. In exceptional circumstances where there is pressure to recruit staff quickly, and service users would be at risk were staff not recruited, then staff can commence work subject to a PoVAFirst check and providing • • • a CRB has been applied for, they receive induction and are supervised until a full satisfactory CRB and PoVA check is received. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 19 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): Standards 31, 32, 33, 35 and 38 were assessed. The home does not have a manager which may result in a lack of guidance for staff to deliver appropriate care. The home has no method of monitoring the quality of service that the residents receive which makes it potentially difficult to maintain and improve standards. There are no procedures in place to manage residents’ monies and valuables so their interests are not effectively safeguarded. The policies and procedures for safe working practice in the home are ensuring that service user health, safety and welfare is being promoted and protected. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 20 EVIDENCE: On arriving at the home on the day of inspection the inspector was informed that the home currently has no registered manager with the previous manager leaving employment on 1st March. The Commission was not informed of this vacancy or of any proposal from the provider of how the home was to be managed in the absence of a registered manager, or plans for recruitment of a replacement. A senior care assistant is currently undertaking some management duties. There was no evidence of any progress in implementing a method of auditing working practice to monitor standards or enabling residents to express their views. Only one resident has left personal monies with the administrator for safekeeping. Monies were securely stored but, although receipts were available, no records of accounts of income and expenditure were maintained. This must be implemented and kept up to date to ensure residents’ interests are safeguarded. Records were examined to establish safe-working practices within the home and these included contracts and servicing documentation for electrical equipment, gas and all other services supplied to the home. Fire records are up to date and the stair lift has been serviced and is currently in good working order. The Environmental Health officer’s report of February 2006 noted ‘overall very good standards’. The Fire Officer’s report of December 2005 found compliance to be ‘satisfactory’. The hoist for used for moving residents has not been serviced since 2003, it was informed that the hoist is not currently being used. This must be serviced and tested before use with any resident. The health and safety of people in the home is promoted by a planned programme of statutory training for staff in health and safety, fire safety, first aid, moving and handling and food hygiene. Staff training in infection control is planned for June 2006. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 21 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X 1 X X X 3 X STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 1 X 2 X X 3 Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 22 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 4, 5 Sch 1 Requirement Timescale for action 30/06/05 2 OP7 3 OP8 4 OP12 The registered person must ensure that there is a suitable Statement of Purpose and service user’s guide available for existing and prospective residents. (Outstanding from the previous inspection) 15,2bc,Sc The registered manager must 30/05/06 h. 3,1b ensure that all care plans are reviewed and evaluated at least monthly and changes in care needs are documented 14, 15, 17 The registered person must 30/04/06 Sch. 3, ensure that all residents have full assessments of potential risks to their health and, where a risk is demonstrated, an appropriate plan of prevention must be devised. These risk assessments must be assessed monthly and changes in risk factors clearly recorded. 16 The registered person must 30/05/06 ensure that there are organised activities that meet the residents social, cultural and interest needs. Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 23 5 OP16 22 6 OP18 The registered person must ensure that the complaints procedure for the home is updated to include contact details for the Commission and instruction that the Commission may be contacted at any time. A record of complaints received by the home must be maintained. 12, 13, 18 The registered person must ensure that a policy is developed for the protection of vulnerable adults within the framework of local and national policy. The registered person must ensure that all staff receive training in the protection of vulnerable adults (Abuse Awareness) The registered provider must implement a programme of refurbishment and renewal of the fabric and decoration of the home. The registered person must ensure that suitable locks or restrictors are installed on the large windows to the landing of the main house. The registered provider must ensure that the bathroom and toilet area on the first floor is reorganised and refurbished as soon as possible. An action plan with timescales must be forwarded to the commission. (Outstanding from the previous inspection) 30/05/06 30/05/06 7 OP19 13, 23 30/06/06 8 OP38OP19 13, 23 30/05/06 9 OP21 23 30/05/06 Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 24 10 OP27 18 11 OP29 19 Sch 2 12 OP31 8, 39 13 OP33 24 14 OP35 16, 20 The registered person must, having regard to the size of the care home, the statement of purpose and the number and needs of the service users, ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. The registered person must ensure that staff files contain evidence that a Criminal Record Bureau (CRB) check, Protection of Vulnerable Adult (PoVA) check and satisfactory references are obtained before a staff member starts working in the home. The registered person must inform the commission of the proposals to recruit and appoint a registered manager and contingency plans for the management of the home in the absence of a registered manager. The Registered Person must introduce systems which will effectively monitor and audit working and care practice in the home. These procedures must be ongoing. The registered person must maintain suitable records of service users’ personal monies held for safekeeping. 30/04/06 30/05/06 30/04/06 30/06/06 30/04/06 Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Musmajas DS0000004256.V287700.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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