Inspection on 19/05/05 for Old Ford Road (69-71)

This inspection was carried out on 19th May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Old Ford Road (69-71) 14/10/08

Old Ford Road (69-71) 02/07/07

Old Ford Road (69-71) 27/04/06

Old Ford Road (69-71) 21/10/05

Old Ford Road (69-71) 17/11/04

Old Ford Road (69-71) 21/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 69-71 Old Ford Road Bethnal Green London E2 9QD Lead Inspector Anne Chamberlain Announced Inspection 19th May 2005 10:00am 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 69-71 Old Ford Road Version 1.10 Page 3 SERVICE INFORMATION Name of service Old Ford road (69-71) Address 69-71 Old Ford Road, Bethnal Green, London E2 9QD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8980 5631 020 8980 5631 h3055@mencap.org.uk Mencap Mr Mikkel Togsverd Care Home 7 Category(ies) of Learning Disability (7) registration, with number of places 69-71 Old Ford Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 2004 Brief Description of the Service: Old Ford Road is a residential care home registered for seven service users with learning disabilities. Currently there are two vacancies. The home is situated in the Bethnal Green area close to central London. It is comprised of two terraced houses interlinked through a shared conservatory and with a shared garden. Parking in the area is restricted but there good are public transport links. The registered provider of the service is Mencap. 69-71 Old Ford Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Unfortunately the pre-inspection paperwork was not received by the Commission for Social Care Inspection (CSCI). The inspection was carried out on one day between 10a.m. and 6p.m. The inspector met briefly with four of the service users and spoke with three of them. She also interviewed two staff members in addition to the manager. The inspector viewed the files of three service users and three staff as well as various documents and records. The inspector viewed the premises and the garden. The inspector would like to take this opportunity to thank the service users, manager and staff for their co-operation and assistance with the inspection. What the service does well: What has improved since the last inspection? Since the previous inspection there have been improvements in the environment of the home. The laundry room is free of mould and newly decorated. The downstairs shower no longer leaks water on to the floor. There were no offensive odours noticed in the home. Person in control visits have been resumed and have been undertaken regularly. 69-71 Old Ford Road Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 69-71 Old Ford Road Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 69-71 Old Ford Road Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,4 and 5. The home provides prospective service users with sound information and an opportunity to visit the home and meet other service users. There is an adequate system in place for assessing the needs of individuals. Service users have a contract with terms and conditions. EVIDENCE: The home has produced a statement of purpose and a service user guide. These documents between them cover almost all the necessary information. However there are a few omissions and some of the information in one document should be in the other, in order to meet the standard. The manager must review the documents to ensure that they are fully compliant with the legislation. This is a restated requirement. The home has not had any new admissions since the last inspection. However in discussion with the manager, and after viewing the needs assessment form, the inspector was satisfied that the procedure for assessing the needs of a prospective service user would be adequate and that the manager understood and would follow it. 69-71 Old Ford Road Version 1.10 Page 9 The manager advised that prospective service users would be offered the opportunity to visit the home. It would be arranged that they also have an opportunity to meet the other service users, see their room and be assured that they would choose their own decoration etc. The file of the most recently admitted service user evidenced a statement of terms and conditions. This included the room number and rent and was signed by both parties and dated. The inspector saw letters addressed to service users on file, which advised them of the breakdown of the component parts of the rent i.e. social services contribution and their own. The home keeps a rent file where details of rents paid are documented. 69-71 Old Ford Road Version 1.10 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8 and 9. Service users changing needs are assessed and addressed. However the documentation which supports this is not being used effectively and the manager has been required to make some changes. Service users are encouraged and supported to make decisions about their lives. They are consulted and participate in the running of the home. Risk taking within the context of an independent lifestyle is supported and staff take a sound commonsense approach to reduce risks. EVIDENCE: The inspector was not able to evidence in service users files care needs assessment, even in the file of the most recently arrived service user. She evidenced in service user files ‘statement of support’ which is the individual plan. However although these contained a lot of information they sometimes petered our and were not signed or dated. In the case of the most recently admitted service user the service user plan could not be located on file. There was evidence of frequent reviewing activity by the organisation. There was a lack of evidence of annual reviews by social services and the manager 69-71 Old Ford Road Version 1.10 Page 11 explained that when minutes are the responsibility of the social worker they are often not received. In discussion with the manager it was established that, reviews should not review the previous review. They should review the service user’s plan and it should then be updated and amended to show the new objectives. The manager therefore must:Ensure that all service user have a care needs assessment on file. (It would not be unrealistic to undertake this afresh with existing service users). Ensure that plans (statements of support) are fully completed, signed and dated and present on the service user file. That reviews, review the service user plan and it is updated and amended accordingly. Annual reviews which take place are documented in the file and the actions recorded even if the official minutes from social services are not received. This is a requirement. There was evidence that service users are supported to make decisions about their lives. The inspector saw person centred plans which are small user friendly books which service users work on with their keyworker. They show goals achieved and new plans. One service user chooses to buy tickets for football matches so that he can watch his team, Arsenal, play. Service users choose holidays and short breaks. They choose what they would like to buy, cook and eat. Service users have regular house meetings where they make decisions about the running of the house. The inspector viewed a record of these meetings. The inspector saw the photograph system. This is a chart with velcro and photographs of everyone in the house. This chart is updated by a service user each day and shows who is on duty, at home, etc. The chart supports communication, particularly with service users who are non-verbal. One service user told the inspector how she does jobs like laundry and food shopping with her keyworker. She also empties and fills the dishwasher. The inspector viewed risk assessments. An example of risk addressed would be that one service user likes to get her errands done on a particular weekday. If she has to wait around she gets anxious and this can bring on an epileptic seizure. An additional staff member is rota’d for that day to escort the service user promptly when she is ready to go out, and therefore reduce this risk. 69-71 Old Ford Road Version 1.10 Page 12 One service user has a behaviour which renders him very vulnerable. The staff have worked hard with the input of other professionals, to try to modify it. The service user chooses to go walking the streets, very late at night. His return is quite unpredictable. He also tends to collect the possessions of others as well as quantities of rubbish which he wants to keep in his room. These risks are constantly reassessed and there is a procedure for reporting this individual missing to the police, specific to him. 69-71 Old Ford Road Version 1.10 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) No standards in this section were inspected. The standards in this section were not inspected. Standards 14 and 15 were met at the previous inspection in November 2004. EVIDENCE: 69-71 Old Ford Road Version 1.10 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 only The arrangements for the administration of medication are sound but there were some errors found during the inspection and a requirement has been made. EVIDENCE: The arrangements for the administration of medication were inspected. The inspector was satisfied that the policies, procedures and system which are in place are effective and if followed perfectly will safeguard service users, whilst supporting those who are able to administer their own medication. There was evidence that staff regularly count and balance the medication stock held. Notwithstanding the above a number of errors were noted :Some old cream and surplus medication needed to be disposed of by being returned to the pharmacist, who should sign for receipt. Pharmacist has not been routinely signing for receipt of returned medication. A signature was missing from a medication sheet for paracetamol which had been given to a service user. 69-71 Old Ford Road Version 1.10 Page 15 The manager must ensure that the signature of the pharmacist is obtained for returned medication and drug errors are eliminated as far as possible. This is a requirement. 69-71 Old Ford Road Version 1.10 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23. The home’s adult protection procedures protect service users from abuse neglect and self-harm. EVIDENCE: Mencap produces an organisational policy and procedure for adult protection. It is comprehensive and is followed by the home. The inspector and manager had a discussion regarding the previous requirement made which referred to some confusion in the terminology of the documentation. The inspector was satisfied following this discussion that the manager and staff are clear about when to use the policy. The manager advised that ‘minor incidents’ for example one service user pushing another, are dealt with under the complaints procedures but any allegation or suspicion of abuse must be reported directly to the manager and the adult protection procedures followed. The manager stated that the staff are clear on the above. 69-71 Old Ford Road Version 1.10 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29 and 30. From the outside the home looks just like other houses on the street. The environment inside is homely and comfortable. Service users bedrooms reflect their needs and lifestyles and promote their independence. The toilets and bathrooms facilities are adequate for the needs of the service users. The house is clean and safe and the garden is tidy. EVIDENCE: The inspector viewed the premises, including the garden. The premises appeared safe and well maintained. The garden is small but privateand sheltered, with table and chairs. The manager stated that service users get a lot of pleasure out of the garden. The inspector was able to meet one service user in his room and another service user showed the inspector her room. Both rooms were pleasant and reflected the tastes of the individuals. The slipping hazard in the downstairs shower room has been remedied. The shower now has half-doors and curtaining to prevent water from leaking onto 69-71 Old Ford Road Version 1.10 Page 18 the floor. The laundry room has been fitted with a new tumble drier which has solved the condensation problem. The walls are mould free and redecorated. The communal areas of the home are homely and comfortable, especially the shared conservatory which is light and cheerful and is where service users eat. There are some nice pieces of service users’ craftwork in evidence. Most of the service users have full mobility and few adaptations are needed at present. There are rails in the shower room for a service user who is epileptic but she actually prefers a bath. This activity is risk assessed for her. One service user has an acquisitive behaviour and for this reason the service users have been given small refrigerators for their rooms so that they can store their snack food there. The bedrooms all lock and service users have their own keys. The inspector detected no offensive odours in the house. The manager advised that there is an ongoing issue with the service user who brings rubbish home to store in his room. This obsessive behaviour is managed by staff, as part of the service users support by clearing the room every day of rubbish. This leads to tension with the service user who wishes to hoard all the rubbish. However, it is acknowledged that the service user himself and the other service users need to be protected from this negative behaviour. To allow the rubbish to accumulate would be to fail in the duty of care to the service user. 69-71 Old Ford Road Version 1.10 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34, 35 and 36. Staff recruitment practice is safe. Staff are well trained and are clear about their roles and responsibilities. They are competent and qualified. Staff morale is low and this will impact on their effectiveness. The staff are well supervised but feel do not feel fully supported by their senior managers. EVIDENCE: The inspector viewed staff personnel files and also saw a list of numbered Criminal Records Bureau checks. The files evidenced a safe recruitment procedure with application form, interview notes, references, contract and training. The manager keeps the training profile on the wall of her office. The manager stated that this is an area of strength in the organisation. All staff have NVQ 2, two staff have NVQ 3 and the rest are working towards it. The manager stated that relief staff undertake the same training as permanent staff and the whole staff train on any specialism which is needed like working with epilepsy. The inspector was satisfied that staff understand their roles and responsibilities. There was evidence of regular supervision but not of appraisals. This is to to come on line this summer now that the manager has had the training in delivering appraisal. The inspector viewed a from called Performance Review which will be used. 69-71 Old Ford Road Version 1.10 Page 20 The manager must ensure that staff have an annual appraisal. This is a requirement. In discussion with members of staff the inspector was concerned to hear of their anxieties regarding their working patterns. The inspector was advised that the whole staff team is concered about weekend working. The staff have contracts which state they may be asked to work ‘extra hours’. Historically the staff working pattern has been working one weekend a month. However they have been told by their managers that they are to work most weekends for the foreseeable future. This has led to a serious deterioration in staff morale which the inspector feels will impact negatively on service users. The inspector recommends that this change in custom and practice is not brought in without full consultation with the staff at the home. This is a recommendation. The inspector was also told that the home is fully staffed. However the deputy manager is off on long term sick leave. The manager advised that the waking night staff time is counted as day time which has the effect of draining daytime contact time. The level of staffing is such that a staff member is being forced to take a group of four vulnerable service users out into the community, on his own. One of the service users is epileptic and accident prone and needs one to one working. The staff member does not feel safe in being responsible for this large group and in the view of the inspector the practice is quite unacceptable. The manager must stop this unsafe practice and bring the concerns of the inspector regarding staffing levels to the attention of her senior managers. She must provide to the CSCI a staffing establishment list. This is a requirement. 69-71 Old Ford Road Version 1.10 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38,39,41 and 42. The home is well run in many respects and the ethos is good. However the manager is not registered and this reflects negatively on the organisation. Staff demonstrate a high level of commitment and service users can rely on them. Service user views are taken into account Their health and welfare is promoted and protected. EVIDENCE: The manager of the home has NVQ 3 and is working towards NVQ 4, the registered manager award. She is qualified to train in NVQ. She was appointed in November 2004 and was acting in the post before that. The manager stated that she has applied to the CSCI for registration and expects to be registered very shortly. The inspector has checked with the registration team and an application has been received but was lacking medical consent form and had no proof of Criminal Records Bureau (CRB) check. There is therefore is no application currently being processed by the commission. 69-71 Old Ford Road Version 1.10 Page 22 The manager must be registered and must have a current CRB check. This is a requirement. The inspector was favourably impressed with the general ethos of the home. She felt she felt the manager and staff demonstrated a high level of skill and commitment. The staff were supportive of their manager and she of them. The inspector observed relaxed interaction between service users and staff. Monthly person in control visits have been resumed and the inspector viewed evidence of their regularity. Mencap sends a form out to the families of service users for their views, annually. There is a monthly forum for service users and occasional conferences. Staff and service users receive feedback and news through the organisation’s intra-net news which is discussed at house meetings, every first Friday in the month. The inspector viewed the minutes which were in a user friendly format. The inspector viewed various examples of recording, medication records, risk assessments, staff and service user records, risk assessments, person in control visit reports and an accident report. The records all appeared reasonably well kept and were secure and up to date. Service users work with keyworkers on the person centred plans. The inspector viewed the recording of accidents, focussing particularly on a recent accident of which the commission had been advised. She discussed this with the service user concerned. The inspector felt the report was sufficiently detailed and the actions identified to prevent a recurrence were reasonable. She saw the accident file which was satisfactorily kept. The risk from slipping in the downstairs shower room has been satisfactorily addressed. The inspector was advised that service users are risk assessed individually for the use of areas of the home, for example the garden. On entering the home the inspector had been advised of where the fire exits are located and where the assembley point is. She was advised that there was no fire drill planned for that that day so if the fire alarm went off it would be in earnest. The manager stated that all cleaning materials etc. are locked away. The inspector viewed the Control of Substances Hazardous to Health (COSHH) file which was in order. 69-71 Old Ford Road Version 1.10 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 69-71 Old Ford Road x x x x x Standard No 31 32 33 34 35 36 Score 3 3 2 3 3 2 Version 1.10 Page 24 16 17 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 3 x 3 3 x 69-71 Old Ford Road Version 1.10 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4 and 5 Requirement The manager must review the statement of purpose and service user guide to ensure that they are fully compliant with the legislation (previous timescales of 31/8/04 and 31/01/05 not met. The manager must ensure that annual reviews which take place are documented on file and the actions recorded (even if the official minutes are not received). The manager must ensure that staff have annual appraisal. The manager must stop the unsafe practice which is described body of the report, and bring the concern of the inspector regarding this to the attention of her senior managers. She must provide to the CSCI a staffing establishement list. The manager of the home must be registered with the commission and must have a current CRB check. The manager must ensure that the signature of the pharmacist is obtained for returned Version 1.10 Timescale for action 01 September 2005 2. 6 15 01 July 2005 3. 4. 36 33 18 18 01 August 2005 01 July 2005 5. 37 8 01 August 2005 01 July 2005 6. 20 13 69-71 Old Ford Road Page 26 medication and drug errors are eliminated as far as possible. 7. 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 33 Good Practice Recommendations The senior management are urged to engage in full consultation with staff before changing their working practices. 69-71 Old Ford Road Version 1.10 Page 27 Commission for Social Care Inspection 4th Floor, Gredley House 1-11 Broadway, Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 69-71 Old Ford Road Version 1.10 Page 28 - 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!