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Inspection on 27/06/07 for Nicholas Rothwell House

Also see our care home review for Nicholas Rothwell House for more information

This inspection was carried out on 27th June 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There was comprehensive information supplied to prospective residents and their families, to assist in them making a choice as to whether the home would be right for them. The homes statements of purpose and service users guides were available for residents and visitors to access, (these documents set out how the home aims to meet the needs of residents and provides information on the range of services available at the home). The care plans were clear and specific to individual residents, there was evidence to show that the home works hard to ensure that the residents receive a high standard of care and support. The residents are enabled to live their lives as they wish, freedom of choice is fully respected, residents spoken with expressed their satisfaction at living at the home, saying that it didn`t feel like they living in `a care home` that it was very relaxed and flexible in meeting their needs. The environment is very clean, welcoming and well maintained and there is a repairs and refurbishment programme in place, that ensures that the building is maintained to a high standard. Written feedback received about the home from residents, visitors and healthcare professionals prior to the unannounced visit was very positive again this was verbally confirmed during the visit.

What has improved since the last inspection?

The requirement made following the last inspection visit in relation to ensuring that resident`s medication is administered according to prescription instructions has been met.

What the care home could do better:

No requirements or recommendations have been made.

CARE HOMES FOR OLDER PEOPLE Nicholas Rothwell House 290 Harborough Road Kingsthorpe Northampton Northants NN2 8LR Lead Inspector Irene Miller Unannounced Inspection 27th June 2007 11:45 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 Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nicholas Rothwell House Address 290 Harborough Road Kingsthorpe Northampton Northants NN2 8LR 01604 841882 01604 850845 margaretnrh@tiscali.co.uk 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) Charity of St Giles Mrs Margaret Rafferty Care Home 21 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (2), Old age, of places not falling within any other category (21), Physical disability over 65 years of age (2) Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person falling within the category of PD (E) can be admitted where there are 2 persons in that category already in the Home. No person falling within the category of MD (E) can be admitted when there are 2 persons in that category already in the Home. 29th November 2005 Date of last inspection Brief Description of the Service: Nicholas Rothwell House is a Residential Care Home owned by the St. Giles Charity Estates. The Charity, founded in the 15th Century, is non-profit making. The running of the Home is overseen by a Board of Trustees who meets regularly at the premises to monitor practice, plan and develop services and to consult with Residents on their overall satisfaction of the service. The Manager is Mrs. M. Rafferty. The Home provides care for Residents over the age of 65 and includes two places for People with Physical Disabilities. The premises are situated in quiet and pleasant surroundings on the north side of Northampton and are easily accessible by public transport being just off the main A508 Harborough Road. The Home is near to the suburb of Kingsthorpe and its local amenities The accommodation provided to Residents is solely on the ground floor and the facilities include a large comfortable lounge/dining room and a conservatory/lounge overlooking the patio garden. Residents are provided, in the main, with single bedrooms, there is one double bedroom. There is a central kitchen supplying all meals and the home has its own laundry. Currently there are up to twelve permanent places with the rest of the places offering short-term care. Residents come to the Home for a variety of different reasons, such as respite care whilst their relatives or carers are on holiday, upon discharge from hospital and unable to go straight home or require long term care. The current fees range from £381.15 to £404.25 per week for permanent stay and £462.00 to £532.00 per week for short stay (respite care). Chiropody, hairdressing services, and newspapers can be arranged and are charged separately. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for people using the services and their views of the service provided. This visit was unannounced and focused on the ‘key standards’ under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. The care needs of two people living at the home were looked at in depth this involved looking through written information available on their care, such as the residents individual care plans (a care plan sets out how the home aims to meet a residents personal, healthcare, social and spiritual needs). During the visit discussions took place with the residents, the staff and the registered manager, and observation were made on the general well being of residents, their daily routines and interactions between staff. Sample checks were carried out on the homes policies and procedures and records in relation to staff recruitment, the homes medication and quality assurance areas, in addition health and safety records on the general maintenance and upkeep of the facility were viewed, and general observations on the environment were made. The Commission for Social Care Inspection sent out to the home a pre inspection questionnaire (PIQ) for completion by the registered manager and ‘Have your say’ feedback questionnaires for completion by residents, their relatives and advocates. In addition comment cards were sent out to the general practitioners involved in the care of the residents. Prior to this visit the pre inspection data was returned to the Commission for Social Care Inspection. Time was spent reviewing the PIQ, comment cards and other information about the home, such as the previous inspection report and the homes service history, (which details all contact with the home, such as notification of events reported by the home, correspondence and information on any complaints or concerns received). Collectively this provided information on the general care provided and the management and administration systems within the home. The feedback received from residents, their relatives and advocates and from visiting healthcare professionals provided an overview on the services provided from their perspective. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 6 The registered manager Margaret Rafferty was available at the home throughout the visit. What the service does well: What has improved since the last inspection? What they could do better: Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 7 No requirements or recommendations have been made. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 8 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 Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (Standard 6 is not applicable to this service) Quality in this outcome area is excellent. People that use the service can be assured that before moving into the home that their needs will be assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the care plans viewed there was full needs assessments in place and pre assessments had been carried out prior to resident’s moving into the home. In discussion with the manager it was confirmed that a six-week trial period is applied to determine that the home can continue to fully meet the residents needs, and there were records of the six-week reviews taking place to confirm permanent admission into the home. Information about the services provided at the home was contained within the homes statement of purpose and a service user guide, these documents were Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 10 available for residents and visitors to access within the lounge /diner. In addition these statutory documents the home provides prospective residents with an easy read information pack that provides sufficient information for them to make a judgement about whether the home will meet their needs. In discussion with residents they had come to live at the home through different means one resident had chosen to live in the home saying that they ‘did not want to live in any other care home’, the residents husband had been cared for at the home and she had been impressed with the care provided. Another resident had been admitted straight from hospital and another had moved from another care home to be with her husband. All residents spoken with expressed great satisfaction with the home, saying that ‘ they were extremely lucky to live in such a nice home’. All residents spoken with were aware of their individual care plans. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 & 10 Quality in this outcome area is excellent. People that use the service can be assured that their health and personal care needs will be fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents spoke of seeing their general practitioner, and of receiving treatment from their optician, dentist and chiropodist, saying that they were very pleased with the healthcare and support provided at the home. On checking individual care plans it was confirmed that the information contained within them was fully reflective of their needs and subject to regular reviews. Where changes in needs had been identified the care plans had been updated. On checking the accident reports and risk assessments one of the residents was at high risk of falls, it was identified that there was a high risk time of the day when the falls had occurred, discussion took place with the Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 12 registered manager on how the home could reduce the risk of falls to the individual resident to an acceptable level. A sample check of resident’s medication against the medication administration records (MAR) confirmed that the medication was well managed. During the visit a resident was admitted to the home for short stay respite care, the staff were observed to follow the homes medication procedure on receipt of the new residents medication. The care of a resident with high physical dependency needs was looked at in depth, there was clear records of regular input from healthcare professions and pro active monitoring of pressure area care, dietary intake and pressure relieving equipment was seen to be in use. Arrangements are made for residents to access complimentary therapies an aroma therapist visits the home regularly to provide massage treatments for residents. Observations of staff interaction with residents showed that the staff respected the resident’s rights to privacy and dignity, they were observed to knock on doors before entering and heard to speak to resident’s in a respectful manner. Residents spoken with were very praising of the staff saying that the staff always treated them with respect. In discussions with staff it was confirmed that they were fully aware of the Resident’s range of care and support needs. A comment received through the feedback questionnaires sent to relatives stated ‘mums needs have changed over the past twelve months, the staff have always been very much aware of this, and have done all they can to accommodate her needs’. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is excellent. Suitable activities are provided and visitors are encouraged to remain fully involved in the lives of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents said that they lived their lifestyles according to their preferred routines; they confirmed that there were opportunities to go out within the local community, and their visitors often facilitate this. Residents spoke of being invited over to the care home next door to watch some musical entertainment, and of events taking place within the home, such as receiving holy communion once per month, they said that there is no church service that takes place within the home. Recently the home had arranged for a qualified keep fit person to come and do armchair aerobics, however this activity was only taken up by a few of the residents and the residents said that a decision had been made to no longer continue with this activity, saying it was a shame as they had enjoyed it. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 14 On the day of the visit residents were observed to spend their time doing as they wished, spending time within the communal lounges and within their own private bedrooms. There was a range of board games available within the large lounge/diner; this room was split into two seating areas where a television was available at one end of the room. Residents said that they were looking forward to watching Wimbledon on the TV. That afternoon. Newspapers are delivered daily for individual residents and on the afternoon of the visit a member of staff was busy going around the home making a list of what newspaper individual residents would like delivered the next day. The home welcomes visitors, and the visiting arrangements are flexible which helps residents’ to maintain contact with their friends and relatives. Residents’ and relatives spoken with were happy with the visiting arrangements and confirmed that they are able to receive visitors either in the lounges, dining rooms or to see them in the privacy of their rooms. Residents’ choice about where to spend their day is respected, some resident’s preferring to stay in their rooms and others spending time in the communal lounges. In discussion with residents they were very praising of the meals provided, and spoke fondly of one of the catering staff referring to them as the ‘pudding queen’ saying that she made wonderful puddings. Comments received from questionnaires sent to residents were ‘the meals are exceptionally well prepared and cooked’, ‘excellent food, carefully prepared and served by staff’. Comments received from questionnaires sent to relatives indicated satisfaction with the meals provided, however one comment indicated that fresh fruit was sometimes in short supply. At the time of the visit there were no residents that required special diets, in discussion with the registered manager she was aware of the importance of ensuring that peoples dietary and cultural needs are respected and accommodated. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. People that use the service can be can be assured that any concerns or complaints they may have will be taken seriously and acted upon by the homes management. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One complaint had been received at the home since the last inspection, the provider had responded to the complainant in line with the homes complaint procedure. Information on the homes complaints procedure was made available to residents within the information pack supplied upon admission into the home. In addition information on how to raise any concerns or complaints was available within the homes statement of purpose and service user guides that were located within main the lounge/ diner at the home, and there was also a suggestions box within the corridor outside of the lounge/diner. Satisfactions surveys are carried out at the home to seek the views of residents in order to further improve on the services provided. Resident’s spoken with during the visit, said that they had no concerns about how they are treated at the home, saying that they felt confident that any Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 16 concerns that they have are listened to and acted upon by the homes management. Discussion with staff indicated that they were fully aware of the importance of protecting residents from any potential abuse and demonstrated an awareness of their responsibilities and the actions to take if they had any concerns. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is excellent. People living in the home are provided with a homely, and well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the areas of the home seen during the visit were clean and pleasantly furnished, the private bedrooms viewed contained personal items such as photographs, pictures, ornaments and small items of personal furniture. Repairs and refurbishment works discussed with the registered manager and information supplied on the maintenance of equipment confirmed that the home was maintained to a high standard. Quotes had been obtained to replace the front entrance doors, some of the carpets and to extend the patio seating Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 18 area within the courtyard garden, in addition the home planned to have some solar panels installed. Residents spoken with confirmed that they were very pleased with their bedrooms saying that they were always kept clean. Infection control procedures were followed and staff were seen to use protective clothing to minimise the risks of cross infection. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 & 30 Quality in this outcome area is good. The staff team are trained and competent to meet the needs of people living within the home, and people are protected from any potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observations made of staff and resident interactions during the visit indicated that there were sufficient staff on duty to meet resident’s needs, and discussion with staff and residents confirmed that this is usually the case. Staff spoken with demonstrated an awareness of their individual and collective responsibilities towards the care of residents, they staff spoke of working as a team and their attitude was contributory in created a happy and relaxed atmosphere within the home that benefit residents. Relatives were very complimentary about the staff team and the care they received. A sample check of staff recruitment files confirmed that written references and checks with the criminal record bureau (CRB) and the protection of vulnerable adults (POVA) register are obtained. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 20 Upon checking a selection of staff recruitment files it was established that a new member of staff had commence their employment at the home whilst awaiting their (CRB) clearance. In discussion with the registered manager it was confirmed that in this event, whilst awaiting the CRB clearance the member of staff had been assigned to work under close supervision alongside an experienced member of staff. There was evidence of staff having received instruction on the homes policies and procedures and health and safety training in moving and handling, food hygiene, fire awareness and staff having achieved the National Vocational Qualification (NVQ) in care levels 2 and 3. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 & 38 Quality in this outcome area is excellent. The home is run in the best interests of the people that use the service, ensuring that their health, safety and welfare is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has worked at the home for a number of years and has the necessary management skills and experience to ensure that the home is managed effectively and that a high standard of care is consistently provided. Residents spoke highly of the staff saying that the home was very well managed and that all the staff were very friendly, kind and helpful, that they Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 22 could do as they pleased and that they didn’t think of living at the care home as ‘living in a home’. Small amounts of money are held on behalf of residents to assist with paying for things such as chiropody and hairdressing and a sample check of two cash accounts confirmed that the money was held securely and records of transactions were in order. There were records available of resident satisfaction surveys having taken place, which had sought the views of people living at the home with the aim of further improving on the services provided. Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 23 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 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 24 No 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. Standard Regulation Requirement Timescale for action 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 Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Nicholas Rothwell House DS0000012872.V340093.R01.S.doc Version 5.2 Page 26 - 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!