Inspection on 04/07/06 for Newburgh Road, 13

This inspection was carried out on 4th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newburgh Road, 13 23/07/07

Newburgh Road, 13 19/10/06

Newburgh Road, 13 21/02/06

Newburgh Road, 13 25/11/04

Newburgh Road, 13 21/07/04

Newburgh Road, 13 23/01/04

Newburgh Road, 13 26/06/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Newburgh Road, 13 Acton London W3 5DQ Lead Inspector Robert Bond Key Unannounced Inspection 4th July 2006 09:30 Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 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 Newburgh Road, 13 DS0000027736.V300767.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newburgh Road, 13 Address Acton London W3 5DQ 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) 0208 993-5992 0208 993 5992 Ealing Consortium Limited Mr Dominic Shingleton Care Home 8 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0), Mental disorder, excluding of places learning disability or dementia (0), Physical disability (0) Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to include Learning Disability Users who are Elderly or have a Physical Disability or are Mental Health Illness 21st February 2006 Date of last inspection Brief Description of the Service: Newburgh Road is currently registered for eight adults with learning disabilities, that may be associated with a physical disability and/or mental health needs. Only seven service users are actually accommodated, those with physical disabilities being on the ground floor. The registered provider is Ealing Consortium and the building is owned by Acton Housing Association who have responsibility for its maintenance. The home is located on a quiet residential street, close to Acton town centre, its shops, facilities and bus links. The building has three floors, linked by an elevator, but access to certain upstairs rooms involves negotiating stairs. On the ground floor there are two en-suite bedrooms that are suitable for service users who use a wheelchair, a large communal kitchenette/diner, an office and staff sleeping in room, a laundry, and a large garden and wheelchair friendly patio area to the rear. On the first floor there is the non-smokers lounge, bedrooms, adapted bathroom, and the managers office. On the top floor are further bedrooms, a bathroom, and the smokers lounge. The staff team comprises a manager, three senior support workers, eight support workers and domestic staff. Fees are £4,421 per annum. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a key inspection that looked in particular at the identified key National Minimum Standards (NMS) for younger adults in registered care homes. The Inspector spent most of one day in the care home, interviewed the Registered Manager in depth, spoke to three other staff members and two service users, and examined a range of records including case-tracking one service user’s care plan file. There have been no changes to the occupancy of the home. Two support worker posts are vacant, hence agency staff are sometimes being used at the present time. The home’s performance was assessed against 24 of the NMS, and the Inspector found that 16 of the outcomes were fully met, whilst 8 outcomes were only partially met. This led to the Inspector making 8 requirements, one of which is restated from the previous inspection as the requirement had not been achieved within the timescale set, and one recommendation. What the service does well: What has improved since the last inspection? Internal door surfaces have been cleaned. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 6 Staff have received additional training in medication administration. Most of the outstanding maintenance issues have been undertaken. Regulation 37 reports are being sent to the CSCI were appropriate. Each service users has an activity timetable written in consultation with them. Two service users now attend a day centre for older people. Shift Leader assessments and training have been put in place. What they could do better: The registration of the home must be changed so that it reflects reality as only 7 service users are ever accommodated. The records of the home must show what food was eaten by which service users on a daily basis. There are too many gaps in the record at present. The records of medication returned to the pharmacist must be better maintained. The trip hazard in the kitchen floor must be made good urgently. When new agency employees are inducted into the work of the home, adequate records of this procedure must be kept. When new permanent employees are recruited the home must be provided with the necessary evidence that all appropriate checks have been undertaken by the Human Resources Department of Ealing Consortium. The home must aim to have at least 50 of the care staff with NVQ level 2 or 3 qualifications. All staff including agency employees must be appropriately supervised at the correct frequency. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 7 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. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is adequate. Service users’ individual aspirations and needs are assessed but the registration information needs to be amended. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home is currently registered for 8 service users but only 7 have ever lived there. The Registered Manager must apply for a registration variation in order to correct the anomaly. Requirement 1. No new service user has moved into the care home in recent times. However the Inspector noted that care files of existing long term service users contained detailed assessments of individual’s aspirations and care needs. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan; service users are consulted about their lives; and service users are supported to take risks as part of an independent lifestyle. EVIDENCE: The Inspector examined in detail (case-tracked) the care file and documents of one service users. The Inspector found that a detailed care plan was on file, that care plans are formally reviewed on a six monthly basis, relatives, the service user and where appropriate an advocate are all involved. The key worker system is in use. Service users are additionally regularly consulted in meetings about the home’s menu and activities. Four service users are able to manage their own finances with assistance. Risk assessments are undertaken and where possible signed by the service user. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is generally good. This judgement has been made using available evidence including a visit to the service. Service users are able to take part in age, peer and culturally appropriate activities; are part of the community; have appropriate personal, and family relationships; their rights and responsibilities are respected; and they are provided with a reasonably healthy diet, but better records of food eaten are required. EVIDENCE: The Inspector continued to case track the care records on one specific service user. The Inspector found that the service user, and one other service user, had started attending an Age Concern Day Centre. At this centre, the service user undertook keep fit exercises, dancing, games, bowling and bingo. Whilst in the care home, the service user enjoyed knitting and along with the other service users was involved with laundry and cleaning duties within the home. The Inspector noted that each service user has been consulted about their interests and that an individual activity timetable has been produced for each service user. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 12 The Registered Manager reported that two service users have employment in other care homes operated by Ealing Consortium, and that communal activities offered include shopping, pub trips and outings. The Registered Manager added that all the service users are registered to vote, all hold keys to their own bedrooms, and most service users have positive relationships with family and friends. The Inspector examined the home’s food menu and records for the last four weeks. He found that each week’s records of who ate what contained some gaps. Requirement 2. The Registered Manager reported that weekly meetings are held at which food choices for the following week are ascertained. The food diet has been improved by the Registered Manager. Dietary needs are discussed in staff meetings. One service user sees a dietician. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users receive personal care in the way they choose, their mental and physical health needs are met, and they are generally sufficiently protected by the home’s policies and procedures for dealing with medicines, except that the recording of medication returned to the pharmacist must be improved. EVIDENCE: The Inspector continued to case-track the care records of one service user. The Inspector found that the service users’ personal care requirements and wishes concerning bathing were adequately recorded. Likewise the service user’s health needs were identified, he received depot injections on site given by a community psychiatric nurse, his medication had been periodically reviewed by a consultant psychiatrist, and he had received physiotherapy in the past. The last six monthly care plan review included sections on dentistry, diet, chiropody, and physical and mental health. Regarding medication, the Inspector noted that he had recently received two Regulation 37 reports concerning the incorrect dose of medication given to service users. The reasons behind this were examined in detail by the Inspector who concluded that the Registered Manager had taken all appropriate steps to minimize the likelihood of it happening again. These steps Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 14 included additional training for all staff in medication by the Boots pharmacist, and excellent medication competency assessments for all staff that are to be undertaken annually. The Registered Manager reported that staff who have made medication errors have had a written warning in line with Ealing consortium’s disciplinary procedure. The Inspector examined the storage of medication within the home and the records of its administration. The Inspector found errors in the records of medication returned to the pharmacist. In one case the pharmacist’s representative had taken the spare medication but had not taken the record sheet that listed what was being returned. On other occasions this duplicated record sheet did not show the name of the care home or give the date of the collection. It is the responsibility of the staff in the care home to see that the proper procedure is followed and proper recording maintained when medication is being returned. Requirement 3. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users’ views are listened to and acted on; and service users are protected from abuse, neglect and self-harm by the policies and procedures the home has in place. EVIDENCE: The Registered Manager reported that no complaints had been received by the home since before the previous CSCI inspection. The Registered Manager also reported that all staff members had received training in the Protection of Vulnerable Adults during the last three years. The Inspector verified this by examining the home’s training plan. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users live in a homely, comfortable and generally safe environment that is clean and hygienic. The exception is the kitchen floor. EVIDENCE: The Inspector toured the home’s premises. They were seen to be clean, including the internal doors that had previously been dirty. Maintenance work that had been necessary at the previous inspection had mostly been undertaken. An important exception is the inspection cover in the kitchen floor that remains a trip hazard. Requirement 4 is restated from the previous inspection. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to the service. Service users are not sufficiently protected by the home’s recruitment policy and practices. This is because the home does not have the records to demonstrate that appropriate recruitment checks have been undertaken on new permanent staff. In addition the home does not keep a record of the induction training that is provided to new agency employees working at the care home. Neither are agency employees allowed by Ealing Consortium to be supervised by anyone within the care home less employment rights are deemed to have been conferred. Nor is the frequency of supervision of permanent staff, and the ratio of NVQ trained staff, sufficient. EVIDENCE: The Registered Manager provided the Inspector with details of which support worker staff are currently qualified with NVQ level 2 or 3 in Care. Only 2 out of 8 current staff are so qualified, that is 25 , although additional staff members are undertaking or about to start the qualification. Recommendation 1. The Inspector examined the home’s training records. The Registered Manager reported that the home has two support worker vacancies. In addition a new support worker has recently commenced work at the home. The Inspector examined the recruitment file for this person but it Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 18 did not contain an indication that appropriate recruitment checks had been undertaken as this information had not been sent to the home by Ealing Consortium’s Human Resources Department, despite it having been requested by email by the Registered Manager. Requirement 5. The Registered Manager reported that it is currently necessary for the home to use agency employees. The Inspector observed evidence that the agency used provides the Registered Manager with details of recruitment checks they have undertaken on their staff. The Registered Manager informed the Inspector that new agency staff were subject to an induction process within the care home, but no records could be produced to demonstrate which agency employees had received which induction training aspects, on which days. Requirement 6. The Inspector did however observe full induction training records for the new permanent employee. The Inspector requested to see the supervision records kept on permanent employees. He noted substantial gaps in the two records seen, one being a four month gap. The NMS specify formal supervision must take place at least 6 times per year, and the home’s policy is for monthly supervision. Requirement 7. The Registered Manager reported that Ealing Consortium have said that long term agency employees working in their care homes can no longer receive supervision from a member of Ealing Consortium’s staff less this be construed as confering employment rights. The Care Home Regulations however state in section 18(2) that the registered person shall ensure that persons working at the care home are appropriately supervised. Requirement 8. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users benefit from a well run home; their views are taken into account; and their health and safety is promoted. EVIDENCE: The Registered Manager reported that he is undertaking the A1 NVQ assessor’s award and will be commencing the Registered Managers Award training in February 2007. The Inspector observed and commends the home’s internal quality assurance system. Thorough and searching Regulation 26 visits are also undertaken, which is also commended. Ealing Consortium produce an annual plan for the organisation as a whole but which includes individual targets for certain homes. Service users are formally consulted on an annual basis. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 20 The Inspector checked the records of hot water, fridge and freezer temperatures. He found that a recent fault had developed in the fridge thermometer but the Registered Manager was already aware of the issue and was planning to replace the faulty item. The inspector checked a First Aid box that was adequately stocked. The Health and Safety trip hazard in the kitchen is reported on elsewhere, see Requirement 4. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 2 x Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard YA1 YA17 YA20 Regulation 4 Requirement Timescale for action 01/09/06 01/08/06 01/08/06 4. YA24 YA42 The Registration of the home must reflect the actual situation. 17(2)Sch4(13) Adequate records must be kept of food eaten by service users. 13(2) The registered person must make suitable arrangements for the safe disposal of medication, and the recording thereof. 13(4)(a) The floor in the kitchen must be made safe as the registered person must ensure that all parts of the care home are free from hazards to the safety of service users. THIS IS RESTATED FROM THE PREVIOUS INSPECTION AS THE PREVIOUS TIMESCALE HAS NOT BEEN MET. 17(2)Sch4(6) 01/08/06 5. YA34 6. YA35 18(1)© The care home must keep 01/08/06 records for inspection that indicate that appropriate recruitment checks have been undertaken on all staff. Agency employees must 01/08/06 undertake an induction DS0000027736.V300767.R01.S.doc Version 5.2 Page 23 Newburgh Road, 13 7. YA36 18(2) 8. YA36 18(2) process, which must be adequately recorded. The registered person shall ensure that persons working at the care home are appropriately supervised at the correct frequency. The registered person shall ensure that long term agency employees working at the care home are appropriately supervised. 01/08/06 01/08/06 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 YA32 Good Practice Recommendations The registered person shall promote the achievement of 50 of support workers gaining NVQ 2 and 3 awards in care by providing staff with the appropriate assistance to obtain the qualifications. Newburgh Road, 13 DS0000027736.V300767.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Area Office 26-28 Hammersmith Grove Hammersmith London W6 7SE 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 Newburgh Road, 13 DS0000027736.V300767.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. 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!