CARE HOMES FOR OLDER PEOPLE
Oasis House 20 Linden Road Bedford Bedfordshire MK40 2DA Lead Inspector
Carol Mitchell Unannounced Inspection 12th January 2008 09:30 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 Oasis House DS0000070190.V357379.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. Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Oasis House Address 20 Linden Road Bedford Bedfordshire MK40 2DA 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) 01234 346269 01234 345355 GB Care Ltd Mrs Jacqueline Cousins Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30) of places Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Can include residents who have physical disabilities. Date of last inspection First inspection visit under new ownership. Brief Description of the Service: Oasis House is a large detached Victorian House that has been adapted to provide permanent and respite residential care for thirty older people who may have dementia. New owners took over the running of the home in July 2007. The home is situated in a popular residential suburb of Bedford within walking distance of the towns amenities, which include rail and bus stations. The accommodation is provided on three floors and there is a shaft lift. There is a large lounge with views over the garden at the rear, and a smaller lounge is located to the front of the property. A variety of bedrooms for single and double occupancy are provided. Privacy screens are provided in the three shared rooms. Eleven bedrooms have en suite facilities. Toilet and bathing/showering facilities are located on each level of the home. There is a pleasant garden with patio furniture at the rear and side of the property. A few parking spaces are provided at the front of the house with metered parking on the road. The fees for this service are £425.86 per week. Fees do not include hair dressing, chiropody or toiletries. Further information about this home can be obtained by telephoning or visiting the home direct. Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report takes account of information received by the Commission since the new owners took over the running of the home in July 2007, and information obtained during the inspection visit. The unannounced inspection visit took place on Saturday 12th January 2008. During the visit the inspector spoke with residents and relatives, staff and the deputy manager. The inspector also checked some records and looked around some parts of the home. The manager was not present for the unannounced visit, but spoke with the inspector by telephone shortly afterwards. The inspector would like to thank everyone who was involved with the inspection visit. What the service does well:
The manager checks carefully that the home is the right place for people before they move into the home. Residents are supported and looked after by caring and respectful staff. Staff make sure that people living at the home make their own choices as far as possible. Residents have key workers to help people to get what they need, and staff call for help from family doctors and others when necessary. Residents say that they enjoy the food at the home, and the chef knows what people like and don’t like. Staff have received training. “I have had lots of training” said one care assistant. Staff are well supported and are pleased that the manager and owners care so much about the residents and how the home is run. They said “There is more support, they talk to us, they come around and ask if we are alright. It’s better”; “I have had lots of training”; “There is better support for residents and staff”. New staff are checked carefully before they start work, and their work is supervised until the manger is happy that they can do their job properly. Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 6 The manager and owners listen to residents, to the Commission and others and they make necessary changes for the benefit of people living at the home. Visitors can go to the home when it suits them and they are made to feel welcome. Relatives are pleased with the care at the home saying “We come every weekend, we always have a good look around and it seems fine”; “I am very pleased with the care. Standards are very good to excellent”. The manager of this home is helped by a senior manager as well as receiving good support from the owners. The home is kept clean by staff who are employed just for cleaning duties. These staff have everything they need and they really try hard to stay on top of the cleaning with good results. What has improved since the last inspection? What they could do better:
The home has lots of good documentation about care and support but this should be better organised to make it clearer to understand and more user
Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 7 friendly. Staff need to sign the record each time they write something down, and residents could be more involved with the care planning. The home takes people’s nutritional needs seriously, residents are weighed, and staff know about the food people like. However the home does need to routinely use a special form designed to highlight problems with nutrition and to guide staff if problems arise. This would lead to a more organised and consistent approach to all residents’ problems or possible problems with eating and drinking. Prescriptions written in case a resident needs a medicine should be checked to make sure firstly that they are necessary, and secondly that the reason for giving the medicine is clearly written on the record sheet. The manager wants to increase the things for people to do at the home. This includes helping people with dementia to feel useful and more fulfilled through “meaningful occupation”. To help with this, work to collect information from residents and family members about their lives has already started. The manager also wants to develop the training arranged for staff to make sure that they are receiving the right training. People living at the home could get more involved with the running of it, and more could be made of the part residents already play. Questionnaires are already sent out and regular residents/family meetings could also be held. 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. Oasis House DS0000070190.V357379.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 Oasis House DS0000070190.V357379.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): 3, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager makes sure she knows residents well before they move in. People living at the home can therefore be sure that their needs will be met. EVIDENCE: The manager assesses residents in their own home whenever possible, and uses a set format to do this. Three day-time visits to the care home are arranged prior to admission for each prospective resident. At the assessment stage, and during visits, potential residents, manager and staff have opportunity to consider the move carefully and before it takes place. Updated service user guides are placed in each bedroom, and residents are issued with contracts.
Oasis House DS0000070190.V357379.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, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff know the residents well, and they call in family doctors and others when residents need their help. Therefore, although some things need changing and the documentation could be better organised, people living at the home know that their health needs will be met. EVIDENCE: During the inspection visit staff were observed interacting with residents using a warm and friendly manner. Any care needs were attended to in private, and staff were observed routinely knocking on doors before entering rooms, and addressing residents politely. Screens were provided in the only shared room seen during the inspection visit. Staff were able to discuss the care and support needs of residents.
Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 11 The deputy manager described, and the care plans indicated good links with the local district nurses, and prompt communication with family doctors. The home has arrangements for regular services from professionals such as opticians and chiropodists. The home is able to call on the help of a dietician and other specialist health care professionals when necessary. A nutritional screening tool is not routinely used. The chef and care staff were however well aware of the nutritional needs of one resident whose care was considered during the inspection visit. Although some information was recorded about nutritional needs in the care plans checked, it is important to use a recognised screening tool for all residents so that any required interventions can be identified and acted upon in a timely and consistent manner. The medicines at the home are organised and senior carers who have received training administer the medicines. A small sample of orderly administration sheets was checked and found to be in good order. Examples of “as needed” prescriptions indicate a need for the home to check that such prescriptions are appropriate and minimised, and that specific reasons always accompany any such instructions on the administration sheet. (Staff present had good understanding of these prescriptions and medicine had been administered appropriately.) The safe administration of medicines was observed during the inspection visit. Care plans were available for the residents checked, although any input from them was not clear from the records which had not been signed by residents or their representatives. The care plans contained a lot of helpful information and covered comprehensive areas of care and support. Time and effort has clearly been put into care planning and this is acknowledged. The system of documentation in use would benefit greatly if it were presented in a more logical and complete manner. Some aspects of assessment and risk assessment were not evident from the readily accessible information, being held only on computer in the office. A clearer system would benefit residents and staff. For example, a current care plan may sometimes detail interventions for a problem which does not exist according to the assessment information. The care plans checked had been regularly reviewed, and daily entries are made in a separate file with other information. (The use of separate files further demonstrates the need for increased clarity.) It is important that all entries are signed. These issues were discussed with the deputy manager and the manager who are encouraged to continue with their efforts to improve documentation.
Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 12 Oasis House DS0000070190.V357379.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, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager and staff try hard to make sure that residents have as good a life as possible. This means that even though some things can be improved, the expectations of people living at the home will mostly be met. EVIDENCE: Staff at the home confirmed that they have received training about caring for and supporting people with dementia. Residents were calm and relaxed in the presence of staff during the inspection visit. During the inspection visit residents, staff, family members and care plans indicated that personal choice is given high priority at the home. For example, one resident chose to sleep in, another to stay in their room for a meal, another to go out, and another was collected by family members. Two relatives present were very pleased with their family member’s life at the home.
Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 14 Residents wear their own clothes which are labelled and laundered by a person employed specifically for these important duties. In conversation the laundry lady demonstrated a high level of commitment and care. A staff member at the home said that residents enjoy music, sing-a-longs, reminiscing and watching old films on video. A lovely party had been held for residents at Christmas time. A care plan advised staff to encourage a resident to express herself with activities she may enjoy, but any such activities were not specified. A conversation with one gentleman indicated that he would benefit from increased meaningful occupation, and the manager and staff confirmed that this area of life at the home needs to be improved. There are plans to provide more opportunities including gardening for a resident who is a keen gardener. The manager is also currently gathering biographical information about residents with dementia so that any ways of enhancing the well being of residents with dementia can be identified and introduced. A couple of residents already enjoy helping with cleaning tasks. At the time of the inspection visit the home had advertised for a full time activities coordinator, this post being currently vacant. A resident and two relatives confirmed that visitors are welcome at the home at any time. The relatives visit the home every weekend and they always find the staff friendly and supportive. All of the residents have relatives to support them in the handling of their financial affairs. The chef on duty during the inspection visit demonstrated sound knowledge of residents’ likes and dislikes, and was able to discuss the specific needs of individual residents. An Indian gentleman said that he gets the food he wants, and in conversation other residents and relatives complemented the meals provided and they said that they enjoy the food at the home. There are links with a dietician who can be contacted when necessary. Oasis House DS0000070190.V357379.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): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner, manager and staff want residents to be happy. There is a proper procedure for complaints and staff have had training about protecting vulnerable people. Therefore people living at the home feel safe and are sure they will be listened to. EVIDENCE: The Commission has received no complaints about this home since the current owners took over in July 2007. Neither have there been any referrals to the Adult Protection Team since then. Notifications to the Commission have been made in line with the regulations. The home has a complaints procedure a copy of which is kept in the files of information in each bedroom. Residents seen during the inspection visit had an open and friendly relationship with staff, and two residents were able to say what they would do if they have a problem at the home. The relatives visiting the home had no cause for complaint but felt happy about what to do should this be necessary. Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 16 Staff at the home have received training about the protection of vulnerable adults. The deputy manager was able to discuss the action she would take if she is concerned about the welfare of a resident. Oasis House DS0000070190.V357379.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): 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is gradually being redecorated, and the owners want to make it a comfortable and safe place to live. Therefore people at the home know that they will be living in a safe and maintained environment. EVIDENCE: During the inspection visit all parts of the home seen were clean and there were no unpleasant odours. Designated cleaning staff were busy with their duties which included carpet cleaning. Cleaning staff were well motivated, trained, and had all the equipment and products they required. There were personal items on display in the bedrooms seen, and a gentleman said that he is happy with his room and the accommodation provided. One shared bedroom was seen and this was equipped with privacy screening.
Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 18 The home has been and is in need of some decorative work. The current owners of the home have begun a carpet replacement programme and some ground floor carpets had been replaced by the time of the inspection visit. The carpet fitters were expected back to refit a section of carpet in the conservatory that had become loose. A redecoration programme is also underway, and bathrooms have been refitted and made good. There are plans to further modify one of the bathrooms to make the bath more accessible for some residents. Although quite serviceable, the bathrooms seen could be made more homely in appearance and some ideas for achieving this were discussed with the deputy manager. Some new chairs for the home had been ordered at the time of the inspection visit. The home has a contract in place for pest control so that if there is any infestation professional help can quickly be secured. Oasis House DS0000070190.V357379.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): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The support and training of staff is given high priority, and the owners make sure that the right procedures are followed before allowing anyone to work at the home. Therefore people living at the home can be sure that they are in safe hands. EVIDENCE: Staff on duty at the time of the inspection visit were caring and attentive in approach and professional in manner. Residents were relaxed in their company and each staff member spoken to knew about the needs of the residents and was familiar with the running of the home. A key worker system is in operation. Key workers have specific duties such as making sure that residents have what they need and liaising with relatives. The manager may further develop the role of key workers. Most of the care staff at the home have undertaken National Vocational Qualification training at level 2, and one person spoken to is currently being supported to undertake training at level 3. New staff receive induction training and are supervised for at least 2 weeks after appointment. A sample of staff files showed that organised recruitment
Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 20 procedures are in place, and that proper checks are made. Equal opportunities are monitored. Photographs of staff were on file in line with the regulations. At the time of the inspection visit a recruitment drive was underway, and interviews were scheduled for the following week. In conversation staff described undertaking essential training such as moving and handling, fire, and protection of vulnerable adults. Cleaners had received training about their duties and infection control. Staff have also received training about dementia care. There is a contract in place to provide training for staff and the operational manager supports the manager to ensure that training is tracked and well organised. A poster displaying training received by staff was also displayed. The managers are currently reviewing training needs to make sure that staff are well prepared for their roles. The manager is also giving consideration as to how to make sure that the dementia training already received is used to potential, and how to build on that training. Separate staff are employed for kitchen, laundry and cleaning duties. At the start of the inspection visit on duty were two senior care and two care assistants (another was expected late due to unforeseen circumstances). Four additional staff were on duty covering cleaning, kitchen and laundry. There were 27 residents present. Staff feel very well supported by the management at the home and by the owners. They are pleased with the training given, staff meetings are held, and supervision for staff is established. Oasis House DS0000070190.V357379.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): 31, 32, 33, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner and manager try hard to make staff and residents feel well supported, they check to make sure that things are done properly and they listen and try to improve things. People living at the home are therefore assured that the home is run with their best interests at heart. EVIDENCE: During the inspection visit staff, residents and family members described very friendly and approachable manager and owners, and they indicated that they see a lot of them. Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 22 The manager feels well supported by the owner and is also well supported by a senior manager who acts on behalf of the owners. For example she helps with the management of training and human resources. The systems in place for quality assurance are being developed. For example monitoring visits are undertaken in line with the regulations, and the senior manager does regular quality checks at the home looking at aspects such as the cleaning. The owners are also often present and residents and staff alluded to their frequent visits. In addition, the manager makes checks on areas such as medicines management, and she reviews accidents so that any trends will be identified and preventative action taken as necessary. Questionnaires were distributed by the owners to residents or family members in August 2007 and the results were considered and acted upon. For example the information made available to residents was reviewed in the light of feedback received, and the services of pest control experts were employed through a contract. Residents are sometimes involved in the recruitment of new staff by sharing a cup of tea with them, and residents opinions are informally asked regarding the meals provided and the choice of décor. Such involvement could become better established and developed further for the benefit of residents. Meetings with residents/families have not yet been started. There are maintenance contracts at the home for the servicing of equipment, and health and safety checks of fire equipment and hot water are undertaken. Oasis House DS0000070190.V357379.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 3 x 2 n/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 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 3 2 x x 3 x 3 Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No. This is the first inspection visit since new ownership. 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 2 Refer to Standard OP7 OP8 Good Practice Recommendations The organisation of the assessment and care planning documentation should be reviewed in the light of comments made in this report. The use of a recognised nutritional screening tool for all residents should be introduced to support the work being done in this area. “As needed” prescriptions should be reviewed and avoided where possible. The reason for administration of an “as needed” medicine should be recorded on the medicine administration record sheet. 3 OP9 Oasis House DS0000070190.V357379.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 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 Oasis House DS0000070190.V357379.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!
