Inspection on 08/08/07 for Oaklands

This inspection was carried out on 8th August 2007.

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

Other inspections for this house

Oaklands 29/08/06

Oaklands 19/04/06

Oaklands 21/12/05

Oaklands 04/08/05

Oaklands 14/09/04

Oaklands 15/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Oaklands Shaw Road Royton Oldham OL2 6DA Lead Inspector Michelle Haller Key Inspection 8th August 2007 09:00 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 Oaklands DS0000005513.V339717.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. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Address Shaw Road Royton Oldham OL2 6DA 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) 0161 627 1142 F/P 0161 627 1142 Oaklands Rest Home Limited Michelle Shaw Care Home 18 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (10), Sensory Impairment over 65 years of age (2) Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 10). Dementia over 65 years of age: Code DE(E) (maximum number of places: 8). Sensory Impairment over 65 years of age: SI(E) (maximum number of places: 2). Mental Disorder, excluding learning disability or dementia over 65 years of age: Code MD(E) (maximum number of places: 1). The maximum number of people who can be accommodated is: 18. Date of last inspection 29th August 2006 Brief Description of the Service: Oaklands Rest Home is a privately owned care home with 18 registered places for people over 65 years of age and whose needs fall within the following categories: dementia; physical disability; mental disorder and old age. The building, which is a detached property, is situated on the main Shaw Road in the Royton area of Oldham. It is approximately two miles from the town centre and is in easy reach of public transport and community facilities. Accommodation comprises of three single en-suite bedrooms, three single and six double bedrooms with shared en-suite toilet facilities. Lounge/dining facilities are provided in three adjoining areas, which comprise two lounge areas and a dining area, the latter being situated to the rear of the building and next to the kitchen. The home charges £360.00 each week. The manager was advised that the CSCI report was to be kept on display and made readily available to prospective customers and their families. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection which included a site visit was undertaken over a period of 8hours and 35 minutes. The manager of the home was not told we were coming to inspect. This is called an unannounced inspection. The inspection process included interviews with three people living in the home, and relatives. One member of staff was interviewed and the interactions between staff and residents in the home were observed. In depth discussion with the registered manager also took place. Five care files and other records and reports pertaining to care provided and the running of the home were also examined. A tour of the bedrooms and communal areas of the home was undertaken and during the course of the inspection the interactions between staff and service users was observed. The manager also provided information about the home by completing the Commission for Social Care Inspection (CSCI) Annual Quality Assurance Assessment (AQAA). This shows what the manager thinks they do well, and what they need to improve on. The CSCI also received five completed ‘service user’ surveys and two surveys completed by relatives. Responses about the service provided were positive. What the service does well: People at Oaklands receive support that is based on their assessed needs that are continually monitored, and changes are responded to appropriately. Staff are available in sufficient numbers to meet the needs of people in the home, these staff are actively supervised and aware of the issues relating to dignity, privacy, choice and adult protection. People said: ’I find the staff easy to approach and very helpful.’ And ‘ They always make time to speak to you.’ General care including personal care and diet provided in the home is of a good standard, people were, in the main, well-groomed, records indicated that they were well nourished and observation confirmed that they enjoyed their meals. People said, ’ ….looks much better since coming into the home.’ And ‘Can’t fault the food.’ The routines in the home are flexible and when people express clear preferences or opinions these are supported. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 6 Through her development of effective professional relationships with health care professionals, the manager ensures that people receive appropriate health care. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that people have their physical and psychological care needs fully assessed prior to, or soon after, becoming resident in the home. EVIDENCE: Five assessments, care plans and other correspondence were examined and case tracked. All the files contained an assessment that detailed the health and psychological needs and social interests of people, and included medical diagnosis, moving and handling needs, dietary needs and self help skills, communication and mood. It was clear from this information that people had been visited by the manager either in hospital or their own homes prior to admission. Social service assessments were also in place. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 9 People who were interviewed stated that they felt that their needs were met from the time they were admitted to the home and everyone who returned CSCI surveys felt that the home had gathered sufficient information about them. Comments included-‘she was visited in hospital and I visited we didn’t want anywhere too big.’ Intermediate care is not provided. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in the outcome area is good. This judgment has been made using available evidence including a visit to this service. The health and personal care provided in the home meets the needs of those living in the home and peoples privacy and dignity is promoted by the actions taken by the staff. EVIDENCE: The care files that were examined contained care plans that provided detailed information to staff about the support needed and the manner in which it was to be provided. It was also noted that one case the care plan was incomplete due to an oversight. This was discussed with the manager. Risk assessments were in place concerning falls, poor appetite and pressure area care. Moving and handling assessments were also in place. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 11 Records and reports also demonstrated that preferences such as when to go to bed and food preferences were also recorded and steps taken to make sure that staff facilitated these choices. It was clear from the records that care plans were updated in response to information provided in response to outpatient appointments or hospital admissions, as well as routinely on a monthly basis. Signatures also demonstrated that people continue to be involved in the process of planning their care. People who commented stated that ‘They keep us informed of the care and volunteer information.’ The assessment and care planning process would be improved if information included an in-depth social history, life experiences and current and past interests of people receiving a service. Daily reports were written in a manner that indicated that people were treated with respect and supported in making choices about the care they received. Letters, examination results and other correspondence confirmed that specialist and routine health care was provided. This included, district nurses, the falls team, continence support service, optician, dentist and general practitioners. Daily reports confirmed that instructions were followed and the general condition of service users monitored and any changes were responded to. The medication policy was read and assessed as been detailed enough to provide staff with guidance in relation to storing, administrating and recording medication. Certificates confirmed that staff responsible for administering medication had received update medication training in January 2007. The home has purchased a lockable cupboard that houses the medicine fridge. Staff were observed distributing medication and this was in keeping with the guidelines and service users were not put at any risk. Reports and correspondence produced by the manager confirmed she was diligent and competent in monitoring the effects of medication and reporting this to doctors, staff and relatives. All shared bedrooms contained privacy screens The home now has sit and weigh scales and so weights are now measured accurately. Body charts and diagrams for recording the condition of the skin were in use but the home still needs to make sure they are used for all people who are vulnerable to pressure areas or who may suffer knocks or bruises, however nursing records and records of skin care regime in the home ensures, that Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 12 pressure area care is provided to a high standard and appropriate intervention is arranged as soon as a skin blemish is noted. Oaklands DS0000005513.V339717.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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are encouraged and assisted to make choices about their life and experience a lifestyle that is flexible. EVIDENCE: The activities record and discussion with people indicated that since the previous inspection the choices in this area have diminished. The calendar indicates that activities including armchair aerobics, board games, bingo, singa-longs, and film nights are made available. The manager stated that she arranged for people to have access to the library service that also provides ‘Talking Books’ for people who were frail. Comments about the activities in the home included: -‘ We mostly play games.’; Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 14 ‘I would like to go out more-you know to the market.’; ‘It’s ok we have someone come in now and again.’; ‘We had an Easter bonnet competition.’; ‘I enjoy the bingo.’ And ‘ We have sing-a-longs and quiz nights.’ People are able to practice religious observance and have their spiritual needs met as a Vicar attends the home on a regular basis. Statements included:’ Since I moved to Oaklands I practice my faith C of E and the home manager has arranged for the local vicar to come to the home once a month to give Holy Communion.’ During the day of the inspection it was noted that people have a good rapport with each other and staff were, in the main, calm and gentle. Staff who were interviewed indicated that routines in the home flexible, with no set times concerning going to bed or getting up, receiving visitors and people could delay when they had their meals to suit their preference. The outcomes in this area could be improved if people were supported in recording their comprehensive social histories and current and past interests. People commented that there were no problems receiving guests: ‘Visiting is fine- no set times.’ And a number of visitors were observed throughout the day of inspection. During the tour of the premises it was observed that the majority of service users had brought with them their own belongings and rooms had been personalised. Meals and mealtime in the home is good. The dining room is clean and furniture is clean and pleasant to use. The menus indicated that people are offered a variety of home prepared and ready made meals that they enjoy. On the day of inspection the menu for the breakfast included, eggs, cereal, fruit and toast; lunch was beefsteak casserole or egg and chips. People were observed enjoying their meals and every one commented that the food was plentiful and tasty. People were provided with equipment to maximise their independence, and staff provided assistance in a dignified manner. The larder and freezer were stocked with a varied selection of quality brand frozen foods that included vegetables, white and brown bread, pies and burgers as well as frozen joints of meat. Tinned and fresh fruit was also in Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 15 evidence. Food and drink intake records were also in place for the frailest person. People expressed a high level of satisfaction with the meals and diet provided at Oaklands, stating: ‘They provide excellent meals.’; ‘………has put on weight since she came here.’; ‘The food is excellent. Our cook makes lovely dinners.’ ‘I enjoy the meals.’ And, ‘If they want a snack or have a taste for something we’ll always make it for them.’ Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to express their feelings, complaints are dealt with fairly and they are protected from abuse. EVIDENCE: Each bedroom has a copy of the home’s complaint procedure and people said that if they had any concerns they would speak to the manager. They were confident that these would be dealt with fairly. All respondents to the CSCI survey confirmed that they knew how to complain and that they always felt listened too. People said ‘We were given the information when ……went into the home.’ The complaints log was read through and demonstrated that the manager completed in depth investigations and kept those concerned informed about the outcomes and the actions she had taken. Records also confirmed that allegations of abuse were fully investigated involving the relevant professionals including the police, social services, relatives and other concerned parties. This demonstrated that people were Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 17 protected through an open and transparent response to concerns and complaints. The adult protection policy was examined and found to be in keeping with the guidelines provided by the local authority although they need to be reviewed. Staff files contained copies of certificates confirming that Protection of Vulnerable adults (POVA) training had been undertaken and the manager stated that this training had also been requested from the Oldham Training Partnership. The member of staff who was interviewed was confident hat the manager would take any concerns seriously and that these would be dealt with fairly and quickly. People commented ‘This is a very open home and I have never seen any if the service users treated with anything other than respect and care.’ Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 18 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): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home have a spacious and clean environment suitable to their needs. EVIDENCE: The home is currently under going some refurbishment and an extension is being built. On discussion with the manager regarding the building works, it was evident that she had not undertaken a plan of action to reduce the impact of this work on people living in the home. On the day of inspection the home was, in the main, clean and free from unpleasant odours. The furniture majority of the furniture was clean and free of unpleasant stains. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 19 Bed bases that were checked were clean although a number of bed heads looked worn. People were observed mobilising around the home independently. And comments made were mostly positive and included ‘I have a lovely room.’ Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 20 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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager promotes health and well being through ensuring that there are sufficient staff on duty, with the appropriate experience and attitude to meet the assessed needs. EVIDENCE: On the day of inspection the staffing included the manager, three care assistants, one domestic staff and the cook. Certificates confirmed that during the year staff have been encouraged to complete relevant training courses including: moving and handling, health and safety, better food better business, medication administration, infection control, first aid, food hygiene, and fire safety. The manager is developing a training calendar that runs in conjunction with the training offered by Oldham Social Services. The training record provided information about the training received by staff and evidenced that some staff were still awaiting statutory training such as POVA and moving and handling. This was discussed with the manager. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 21 Staff files were examined and each contained a copy of the application form, two references and a copy of the criminal record bureaux check. These appeared to be in order, however the manager should also retain additional proof of identification such as a copy of a birth certificate or drivers licence in each file. This matter was discussed. Staff supervision records were read through confirmed that the manager used these sessions to reiterate issues concerning POVA, identify training needs and discuss issues related to improving the performance of the individual carer. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 22 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager runs the home in a manner that is safe and to the benefit of people using the service. EVIDENCE: The manager has successfully completed the process of becoming a registered manager with the CSCI. Discussion with the manager indicated that she had a clear plan of how she wanted the service to progress particularly in relation to continued staff development, activities and improving the environment. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 23 The manager has commenced a quality monitoring system and has been introduced and relatives, health and social care professionals who are involved in the home are asked to comment about the general atmosphere in the home, quality of care, the attitude of staff, whether they found anything ‘offensive’ about the home and their over all impression. Discussion with the manager and feedback in the CSCI surveys also confirmed that issues highlighted during this process were acknowledged and dealt with. Oldham Local authority continue to audit the finances of people living in the home, the financial transactions and records for five people were examined and no anomalies were noted. The manager confirmed in the information returned to CSCI that all services had been maintained and serviced in accordance with manufactures instructions. The portable hoist was last services in February 2007, which means that a service is now due as safe practice dictates that these should be maintained every six months. Fire safety equipment has been recently serviced and the fire records indicated that the manager undertook weekly fire checks, the fire safety officer inspected the home on 03/08/07 and the report is imminent. Certificates confirmed that staff have received health and safety training, appointed first training, infection control and control of substances hazardous to health (coshh) training. The accident records were examined and those logged appeared to have been dealt with appropriately. The manager needs to introduce a system of analysing the information that is collected. Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 24 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 1. Refer to Standard OP19 Good Practice Recommendations The provider should extend the refurbishment of the home beyond replacing carpets and decorating bedrooms, to the replacement of stained bed bases and bed heads. This will further enhance the environment for the people living at the home. Service users should be consulted on the types of activities they would like to see take place in the home so that they feel more occupied. The manager needs to have a plan in place regarding the building works which shows that she has considered the disruption which may be caused, and how she is going to address this for the people living at the home. 2. OP12 3 OP19 Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Oaklands DS0000005513.V339717.R01.S.doc Version 5.2 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. 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!