Inspection on 17/04/07 for Orchard (The) - Leonard Cheshire Disability

This inspection was carried out on 17th April 2007.

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

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

Other inspections for this house

Orchard (The) - Leonard Cheshire... 17/05/06

Orchard (The) - Leonard Cheshire... 04/01/06

Orchard (The) - Leonard Cheshire... 27/04/05

Orchard (The) - Leonard Cheshire... 01/09/04

Orchard (The) - Leonard Cheshire... 12/05/04

Orchard (The) - Leonard Cheshire... 03/02/04

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

CARE HOME ADULTS 18-65 Orchard (The) Woolton Road Liverpool Merseyside L25 7UL Lead Inspector Peter Cresswell Key Unannounced Inspection 17th April 2007 09:00 Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard (The) Address Woolton Road Liverpool Merseyside L25 7UL 0151 428 8671 0151 421 1356 sheli.maxwell@lc-uk.org www.leonard-cheshire.org.uk Leonard Cheshire 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) Michelle Maxwell Care Home 26 Category(ies) of Physical disability (20), Physical disability over registration, with number 65 years of age (6) of places Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 2006 Brief Description of the Service: The Orchard is a care home for 26 disabled adults, owned by ‘Leonard Cheshire’, a charity that provides a variety of services for disabled people in the United Kingdom and Europe. The home is in a suburb of south Liverpool, a short drive from Woolton Village, where there is a range of shops, pubs, banks, a post office, cinema and many other amenities. The Orchard is purpose built, standing in its own well-maintained and accessible grounds. All service residents’ accommodation and facilities are on the ground floor. Residents have single bedrooms though one bedroom can be shared if required. Four bedrooms have en-suite facilities. There are three lounges, one of which has a wide range of games, activities, and a computer with internet access. The breakfast/coffee bar, where residents make drinks and snacks, is linked to the dining room. The home employs a full time activities co-ordinator/volunteer organiser who - with the support of residents, volunteers and staff - plans and supports a varied range of activities and entertainment within and outside The Orchard. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced site visit. On that visit the inspector spoke to eight residents, a relative and a number of staff, including the manager, deputy manager (care services manager), a support worker, a volunteer and the volunteer organiser/activities co-ordinator. He toured the building, including a number of bedrooms and the grounds. The inspector checked the home’s medication procedures and examined a number of records, including care plans for three residents, safety records, recruitment records for new staff, and the home’s quality assurance processes. The Registered Manager completed a detailed pre-inspection questionnaire before the site visit. Questionnaires were sent to a number of residents and associated professionals but none were returned before this report was written. The visit on 17 April lasted over six hours. What the service does well: What has improved since the last inspection? What they could do better: The Orchard is adequately decorated and receives a lot of wear and tear. It would benefit from some modernisation and refurbishment. Although medication is on the whole well organised there were still some minor shortcomings. Quarterly internal reviews need to be held even if the resident declines to attend. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 6 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. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4. Quality in this outcome area is good. Material is available to ensure that prospective residents have information about the home. People are thoroughly assessed before admission, using nationally agreed procedures, thus ensuring that The Orchard can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide was on display by the signing in table at the main entrance. One new person had been admitted since the last inspection. She had been assessed by a local authority social worker, the Registered Manager and the Care Services Manager. They had visited the proposed resident and completed an assessment document that is used nationally by the Leonard Cheshire organisation, though it was not signed or dated. The social work assessment was two years old. The resident’s family had been involved in the assessment and the move and her closest relative said that she was very pleased with the care that The Orchard was providing. She had no complaints of any description. The resident knew the home before she came to live there as she had spent several respite breaks there in the past. Fees for The Orchard are negotiated individually with commissioning bodies and depend on the needs of each particular person. The lowest current fee is £512 a week. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. Quality in this outcome area is good. Care plans provide staff with the information they need to care for the residents, who are involved as far as possible in every aspect of the home’s life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector looked in detail at three individual case files. Each had a detailed Individual Service Plan (ISP) and a care plan summary drawn up from it. The owner’s policy is for ISPs/care plans to be reviewed every three months, with a major review once a year. Some of the quarterly reviews are not held if the service user decides not to attend. It is, of course, good practice (and Leonard Cheshire’s national policy) for residents to attend all reviews but if they decide not to attend, staff should still review the care plan and then discuss any possible changes with the resident. The files also contain pen pictures that give a useful overall impression of the person concerned. These are usually drawn up with the residents and, where they wish, their families. The daily reports file is kept separately. Residents make their own decisions unless there is good reason for any limitations, which are then carefully recorded on the ISP. Residents have regular meetings and also take part in staff interviews. One Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 10 resident said that he felt that the meetings were ‘all talk’ but in fact the issue he had identified at the last such meeting was in fact being addressed by the manager. Residents are also invited to complete questionnaires on how the home is running. The most recent report was published only last month. There was a very high response rate and nearly all residents were satisfied with the care and service they receive. 4 were ‘dissatisfied’ with most things, and given the size of the return that amounts to one resident. The surveys are anonymised so it is not possible to say who this was. Residents are encouraged to take appropriate and proportionate risks and risk assessments are in place. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is excellent. The Orchard has good links with the community and residents are enabled and supported to pursue activities and pastimes of their choice. Several residents assist in this as volunteers, increasing their capacity for personal development. Residents receive a balanced diet which most of them enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Orchard has a full time activities organiser/volunteer co-ordinator who, with the support of other staff, residents and volunteers, arranges a wide range of activities, both inside the home and externally. Two full time overseas volunteers are staying at The Orchard during a ‘gap year’. Some of the residents are also volunteers and told the inspector that they very much enjoy this role. The manager has arranged for them to take part in the same training as external volunteers. Since the last inspection the home has bought a large greenhouse - with a charitable donation from a bank - so that the residents can take part in Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 12 growing their own crops and flowers. During the site visit a volunteer from a local horticultural group (part of a small team) was getting the greenhouse ready. There are also raised plant beds in the central courtyard for wheelchair users to plant and care for plants. Teaching and support staff from Hugh Baird Further Education College provide courses on the premises, including local history and IT. Some residents go to external courses. Staff (usually key workers) accompany individual residents on individual social days, which are activities chosen by themselves. This includes shopping and several of the residents talked to the inspector about shopping trips, both to local shops and further afield. The home has a vehicle with a hoist which can cope with all of the residents’ wheelchairs. Some residents were looking forward to a trip to the Anglican cathedral the following day; others had been to New Brighton for the day but said it had been a bit cold. There are also trips further afield such as North Wales or Chester Zoo. The system for recording activities still did not give the full picture of the activities in which residents take part. Activities within the home include crafts, baking, board games, movies (large screen in the lounge) and coffee mornings. The activities room has computers installed and many residents also have their own computers in their rooms as well as televisions and radios. One resident was planning to watch a World Cup cricket match later that day. The manager said that there are plans to redevelop the existing OT room as a life skills centre, again using external sponsorship. Many residents prepare their own breakfast at the breakfast/drinks bar, though cooked, all day breakfasts are often available. The main meal is served at lunchtime, which the residents say they prefer. On the day of the site visit the main lunch was meatloaf, with an alternative of cheese and/or ham salad. Most residents eat in the main dining room and are helped discreetly if necessary. Once a month the home gets a takeaway meal and some residents said that they occasionally order individual takeaways to be delivered to the home. Other residents choose to eat in their rooms. The questionnaire results indicated that 58 were ‘always’ satisfied with the food, and 33 ‘usually’ satisfied. This was an increase on the previous year and may reflect the fact that the menu had been revised after consultation with the residents during the year. The residents who spoke to the inspector said that on the whole they did enjoy the food and felt they could make choices. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. Residents receive personal care in the way that they prefer and their physical and emotional needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans set out residents’ views on how they wish to be supported, including whether they have a preference for male or female staff to provide personal care. Visits by health care professionals are recorded on the files and any concerns about skin integrity are reported promptly to the district nurse. Four residents look after their own medication and they have secure, accessible facilities. Most medication is securely stored in residents’ own rooms in facilities that are not accessible to the resident. The Monitored Dosage System is now provided by a new pharmacist who also provides training for staff. On the whole, medication was in order and its administration was properly recorded on the Medication Administration Record (MAR) sheets. However, there were still some minor shortcomings in the way that the administration of medication had been recorded. In one case an Ascorbic Acid tablet could not be accounted for; some prescribed painkillers were not on the MAR sheets and it was not clear if they were still to be taken; there was no written guidance for some medication which was to be taken ‘as Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 14 required’ (PRN). In such cases trained staff should record the circumstances in which PRN medication is to be given. These are not major shortcomings in themselves but could of course have serious consequences if made with more powerful medication. Staff need to be reminded of the importance of accurate recording of medication. Medication requiring refrigeration is kept in a lockable, dedicated fridge in the staff office. The fridge temperature is checked each day and recorded. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. The home has satisfactory complaints and adult abuse procedures to protect the interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The organisation has clear procedures for dealing with complaints and allegations of abuse. One complaint was received in the last year and was dealt with appropriately. Staff receive training in adult abuse procedures. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. Quality in this outcome area is good. The home is spacious, clean, well maintained, and on the whole well decorated, providing a comfortable environment for the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Orchard is purpose built and has a range of comfortable communal spaces. These include a spacious dining room/coffee bar and a large, attractive internal courtyard. Corridors are wide, allowing independent wheelchair users to move around the home freely. Residents have spacious single bedrooms, four of them with en suite facilities, all with built in electric ceiling hoists. Most bedrooms are highly personalised, with individual signs outside the doors and on the whole they are adequately decorated and furnished. There is one bedroom that can be shared if two people choose to do so. Door surrounds receive very heavy wear from the wheelchairs and some of the décor on the doors and corridors is a bit unsightly and a bit difficult to keep in pristine condition. The Orchard has sufficient baths, assisted bathing facilities and toilets. Some of the toilets have been modernised but others still look a bit old Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 17 fashioned and would benefit from modernisation. The home was clean and odour free. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36. Quality in this outcome area is good. Staff recruitment and training procedures help to ensure that well trained care, support and ancillary staff are available to meet the needs of the residents. Staff are supported by volunteers who are fully checked before recruitment, providing additional support for residents especially with activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is adequately staffed. In addition to the Registered Manager the home is staffed at all times by a Team Leader and between four and six care staff. In addition there is a Care Supervisor (in effect the deputy manager), Activities Organiser/Volunteer Co-ordinator, domestic staff, kitchen staff and administrative staff, ensuring that the care workers are able to concentrate on care and support. At the moment there are 16 volunteers working with the residents for over 232 hours a week. Volunteers help with activities such as driving, befriending, escorting, gardening, assisting with meals and fundraising. Some funding authorities (Social Services Departments and Primary Care Trusts) pay for additional hours for particular residents. In some cases this pays for staff from specialist agencies to help to provide one-to-one support for Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 19 activities and one resident told the inspector how much she valued this additional support. All but two of the care staff now have at least NVQ2 and the others have the opportunity of achieving it. Leonard Cheshire has an extensive training programme. In the last two months training has included POVA awareness, Disability Equality, Food Hygiene, Moving and Handling (refresher). Other training in the regional plan for the year includes Risk Assessment, ‘Managing Difficult Situations’ and ‘Diversity Complaints and Whistleblowing’. Staff receive regular supervision and records are kept though they were not scrutinised on this site visit. Leonard Cheshire’s General Manager for the area is also based in the home and provides supervision for the Registered Manager. Five new staff had been employed since the last inspection. All of the necessary checks had been carried out before they were able to start work. Records of the interviews are kept on file. Residents attend all staff interviews. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42. Quality in this outcome area is good. The owners have quality assurance procedures in place to ensure that the residents’ views are taken into account in reviewing and improving the service provided. The home takes steps to ensure that residents’ safety is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager is qualified and experienced. Leonard Cheshire carries out an annual quality assurance audit on The Orchard. In addition the manager completed a Self Assessment report on the service last year. The national organisation carries out an annual survey of residents/service users in all of its services and the findings are broken down for individual homes. This represents a powerful combination of quality assurance tools in addition to the normal line management procedures. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 21 Fire safety procedures were up to date and the owners have fitted door closers with an automatic release on service users’ doors to provide additional protection. This has proved to be rather controversial with the residents and they told the inspector that they find them hard to open. The manager is planning to fit automatic switches so the residents can open the doors themselves. If this does not meet the residents’ needs it may be worth asking the Merseyside Fire and Rescue Service if they feel that the closers are necessary. The home has adequate fire safety precautions as it is split into four self-contained fire zones, each protected by automatically closing fire doors. Accidents are properly recorded and the temperatures of all fridges and freezers, including the medication fridge, are regularly taken and recorded. The bed rail risk assessment for one resident was not quite complete and needed to be completed. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 4 X X 3 X Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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. 3. Refer to Standard YA6 YA20 YA26 Good Practice Recommendations Internal reviews should still take place even if the service user does not want to attend. The Registered Manager needs to again remind staff who administer medication of the importance of accurate recording. Some toilets are rather old fashioned and institutional in appearance and it is suggested that the Registered Person continues its programme of replacement. Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Orchard (The) DS0000025360.V331642.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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