Inspection on 29/06/07 for Phylward House

This inspection was carried out on 29th June 2007.

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

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

Other inspections for this house

Phylward House 07/12/05

Phylward House 05/07/05

Phylward House 05/10/04

Phylward House 11/05/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Phylward House 9 Cavendish Avenue Harrogate North Yorkshire HG2 8HX Lead Inspector Pauline O`Rourke Key Unannounced Inspection 29th June 2007 09:30 Phylward House DS0000007838.V333236.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 Phylward House DS0000007838.V333236.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. Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Phylward House Address 9 Cavendish Avenue Harrogate North Yorkshire HG2 8HX 01423 502644 01423 522810 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) www.wilfward.org.uk The Wilf Ward Family Trust Miss Nicola Mary Spencer Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 9 Service Users with Learning Disability some or all of whom may also have a Physical Disability Date of last inspection 7th December 2005 Brief Description of the Service: Phylward House is registered to provide long-term accommodation to 9 younger adults who have a learning disability and/or a physical disability. Miss Nicola Mary Spencer is the Registered Manager and it is owned by the Wilf Ward Family Trust a registered charity. Phylward House is a large detached building standing in its own grounds. It is situated in a residential area of the town. A former private dwelling house it has been extended and adapted to provide accommodation for a maximum of nine service users. It occupies three floors. The lower two provide the accommodation and facilities for the service users. The upper floor is used for staff accommodation and administrative purposes. A day care unit is housed within the main building. This is separately staffed and managed. Information about the service is available on request and it can be provided in a variety of formats. On the 29th June 2007 the cost to the residents was between £108.95 and £143.60 per week, this is determined through a financial assessment. This covers the accommodation costs, the local health authority and social services departments meet the cost of the personal care. They and their carer are informed of this cost prior to their admission. . Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on a pre inspection questionnaire; Comment cards returned from all people living in Phylward House, health and social care professionals and relatives. A visit to the home carried out by one inspector that lasted for five and a half hours. During the visit to the home interactions were observed between people who live in the home and five members of staff. Care records relating to three people, two staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Phylward House for the people living there. The manager was available to assist throughout the visit for feedback at the close. What the service does well: All the people who use, or want to use the service at Phylward House would have to tell someone of the help they need. This information is used to make a care plan. The care plans used are detailed and tell the carers everything from how people like to get up, go to bed, what they like to do during the day and how it is best to communicate with them. These care plans are reviewed every two months, and people who are important to the resident are involved if they want to be. Those people who live at Phylward House have a full programme of activities and they enjoy going out shopping, going on holiday, museums, and trips to the seaside, and local pubs. There are enough staff on duty to help the people who use the service to get out and about either individually or as a group. Everyone who lives at Phylward House has a key worker. This member of staff keeps in touch with the family and makes sure that birthdays and Christmas cards are sent to the family. They also make sure that the person they help has enough clothes and personal items. They also make sure that everything goes along according to the resident’s diary. Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 6 The staff are well trained and have been thoroughly checked before they started working for the Wilf Ward Family Trust at Phylward House. The staff have regular training to make sure they have the skills needed to ensure the needs of the residents are met. The service is well managed and the staff like having a manager who listens to them and asks for their opinion. The manager makes sure that any work needed on the building is carried out and she makes sure it is a safe place to live and work. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Phylward House DS0000007838.V333236.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 Phylward House DS0000007838.V333236.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): 2. People who use the service experience excellent quality outcomes in this area. People who are admitted to the home can be assured their needs will be fully met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There have been no admissions to the home since 2005, but a discussion was held with the staff how new admissions would take place. The Wilf Ward Family Trust has a proven admissions policy and this ensures that a multi disciplinary assessment is undertaken prior to any admission. The home receives an assessment and makes as initial decision about suitability before the person who requires support and their family are contacted. The process then becomes a series of visits and short stays to determine whether the placement is suitable. A trial period is then planned and the length of this trial is dependent on the needs of the individual. As part of the assessment process the wishes of the people already established in the home are taken in to account. The case files seen of current residents contained comprehensive assessments and evidence of regular reviews of the care plans. Phylward House DS0000007838.V333236.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 and 9. People who use the service experience excellent quality outcomes in this area. The people who use the service are able to make decisions on a day-to-day basis about their lives and this enables them to remain as independent as possible. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: All the people in the home have a comprehensive care plan and there is evidence to show these are reviewed when necessary. The staff spoken with were knowledgeable about the care plans and they involve the residents relatives, where appropriate, in all reviews. People were seen during the visit making their own choices about what they wanted staff to do for them. All of the service users have different methods of communication and the staff have developed an understanding of these Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 10 methods and they are clearly identified in the care plans. Occasions when how people may refuse to do something were highlighted. A daily diary is maintained for each person and this informs the staff and the home and the review process. Everyone had an up to date risk assessment in place in relation to their individual needs and their differing daily living abilities. These documents are reviewed regularly incorporating specialist assistance when necessary. People have complex needs and the staff were seen to treat each one as an individual at all times during the visit. Feedback received from relatives included: ‘Treat the people as individuals and demonstrates constantly that they care about these vulnerable people’. And ‘health and safety regulations have gone mad and they are missing many experiences they would otherwise have’. Staff spoken with during the visit confirmed that where occupational and physical therapist assessments had been carried out the result was sometimes action that limited the independence of people in the home. Phylward House DS0000007838.V333236.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): 12, 13, 15, 16 and 17. People who use the service experience excellent quality outcomes in this area. People are encouraged to make decisions about their daily life and staff provide appropriate support and encouragement for them to remain independent. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: On the day of the visit several people had gone out to attend day centres one person was going home to see their mother for the weekend. The people remaining in the home were able to go out with staff for short periods and one person went to the day room, which, is separately staffed. The day prior to the visit everyone had gone out bowling followed by a meal in a local fish and chips restaurant. When this was mentioned to the people they expressed their enjoyment of the day. People have access to a range of activities throughout Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 12 the county of North Yorkshire and include bowling, creative art sessions, swimming, visits to local attractions and in-house activities. People have an individual activity plan and they are supported by staff to do those activities. Activities are not limited to the daytime and several evenings are planned. Interactions observed with staff and the people who live at Phylward House were respectful and appropriate. Feedback received from a care manager said ‘the service user known to me has lived here for some years. They are involved in various activities having structure to their day/week. At weekends they are transported home to spend time with their mother –staff provide transport to and from home’. A relative said in feedback ‘Cater for a wide range of needs while maintaining group spirit in the residents’ The visit started at breakfast time and whilst several people had had their meal several were still having their breakfast. Staff said that mealtimes were flexible and people did not have to come to the dinning room for any of their meals if they did not want to. People can choose what they like for breakfast, whilst there is a menu for lunch and teatime. Meals are planned on a weekly basis and allergies, diabetic needs and likes and dislikes are taken in to account. One person has a specialist feeding tube in place and staff have received training and continue to receive support from the local district nurses. Staff are aware of the differing dietary needs of all of the people who live at Phylward House and they make appropriate arrangements for meals when they go out for the day. Advice is sought from dieticians to ensure that people are receiving a healthy and balanced diet. Phylward House DS0000007838.V333236.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 and 20. People who use the service experience excellent quality outcomes in this area. Peoples’ health and personal care needs are met on an individual basis. The staff employ the principles of respect, dignity and privacy in all interactions with the people who live at Phylward House. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The case files for the four people were seen and they contained detailed information for the individual concerned about how they like or need to be approached and assisted with all their personal care tasks. The staff spoken with during the visit had a clear understanding of these instructions and the reasons why they were so detailed. Evidence was available in the case files that advice has been sought from the local Learning Disability Support team in relation to equipment and changes in the care plans. Each person has a key worker and they work closely with any family members and the residents to ensure their routine and care plan remain up to date and appropriate. Staff Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 14 were observed treating the residents with respect and in accordance with their care plan. The people are all registered with the local surgery and one of the GP’s who responded to the questionnaires said ‘Doing a good job managing a very difficult patient’. Another said ‘I am only involved at the surgery and have been satisfied with the attending carers. A consultant who is closely involved with someone at the home said ‘Carers attending hospital with my patient show respect for her needs and ensure her dignity is maintained. Where possible involve the patient in the consultation. They encourage her to answer for herself. Promote her quality of life. Skilled staff attended training to improve their own understanding of Myeloma, very impressive’ There was evidence in the case files that people can access specialist health support when necessary. This included, a learning disability nurse, dentist, physiotherapist, vagal nerve specialist, speech therapist, chiropodist, and a dietician. The case records reflect the level of input required by the person. People are unable to self medicate so the manager and staff administer their medication. The storage and administration was appropriate and all staff have completed a BOOTS training course in the monitored dosage system as well as practical observations during their working time. At the time of the visit the manager had identified a fault with the auditing of the household medication and she was implementing a system that allows for mistakes and losses of medication to be identified quickly. Phylward House DS0000007838.V333236.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 and 23. People who use the service experience excellent quality outcomes in this area. People are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected. We have made this judgement using a range of evidence, including a visit to this service. People who live at Phylward House and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected. EVIDENCE: There is a robust complaints procedure in place, a copy of which is available in the residents file. They are in large print and picture format. The Wilf Ward Family Trust also has a resident Group, which meets to discuss how residents might like to improve the services available. A representative is named and contact details are displayed in the hallway of the home. The Wilf Ward Family Trust or the Commission has received no complaints. An Adult Protection protocol is in place and staff were aware of their responsibilities under this procedure. Staff have received training through Nation Vocational Qualification and their induction and foundation training. The manager also reinforces the training in the monthly staff meetings. Phylward House DS0000007838.V333236.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 and 30. People who use the service experience good quality outcomes in this area. The people who live at Phylward House live in a well-maintained, clean property that allows them to maintain their independence. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is a detached property situated in the suburbs of Harrogate. It has three floors, the ground and first floor and used by the people who live there and the top floor is used by staff. Everyone has their own bedroom and they had been equipped to allow people to be safe in their own room. All the rooms are personalised to represent the occupant’s likes and dislikes. The people who live upstairs have to be mobile as there is no passenger lift. The environment is maintained regularly and the health and risk assessments are in place for all areas of the home. Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 17 The laundry is situated upstairs in the property and is suitable for its intended purpose. All of the cleaning materials were stored securely and staff have had appropriate training in their use Phylward House DS0000007838.V333236.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 and 35. Quality in this outcome area is excellent People are supported by well trained staff in sufficient numbers that they are seen as individuals and the care provided is pertinent to their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Wilf Ward Family Trust has a well established and robust recruitment process and all necessary checks would be carried out prior to anyone being deployed in the home. Two of the staff files have been previously checked during a visit to the head office of the organisation. The rota’s received prior to the inspection indicated that the home is staffed appropriately. During the site visit peoples care plans were seen to provide the staff with clear instruction including where two members of staff were required to assist one person. The staff spoken with said that they felt the staffing was adequate and that they had time to spend with people on a one-to-one basis. The whole routine during the visit was relaxed and staff were seen interacting positively with the people who live at Phylward House. Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 19 The pre-inspection questionnaire showed that the staff have received training in fire safety, first aid, food hygiene, prevention of ulcers and pressure sores, LDAF and how to manage a specialist feeding tube. Future planned training includes safe handling of medicines, first aid and fire training. Staff spoken with said that they had access to training on a regular basis. Staff have monthly supervision where they are expected to set their own learning goals and identify training needs. Team meetings are an opportunity to ensure everyone is aware of any changes to peoples’ plans and to put forward ideas for future activity plans. Feedback received from a doctor ‘Skilled staff attended training to improve their own understanding of Myeloma, very impressive’ Phylward House DS0000007838.V333236.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, 39 and 42. People who use the service experience excellent quality outcomes in this area. People live in a well managed home where the administration of the home is based on openness and respect. This allows them to retain their individuality and independence We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People in the home were seen to easily approach the manager throughout the visit. Observations were made throughout the visit of interactions between the manager, people who live in the home and staff and it was clear that these interactions were relaxed and obviously familiar to everyone concerned. Staff spoken with during the inspection said that the manager was always Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 21 approachable and would deal with issues raised or direct staff to someone who could deal with those issues. Regular staff meetings are held and these allow for an exchange of ideas and information. The Trust had a sound Quality Assurance Monitoring procedure that ‘linked’ all levels of the organisation. The members of staff as well as the manager of the home had to submit monthly ‘objectives or aims’ to the their line management to ensure that progress and achievement was adequately monitored. This process also incorporated elements of equality and diversity with regards to meeting the needs of the service users. The records available in the home and the Trust’s headquarters confirmed this. Overall relatives of the people who live at Phylward House were very complementary regarding the service provided by the home and in particular the attitude and helpfulness of the staff. The pre-inspection questionnaire provided all the dates for the testing of equipment in the home. Those checked were accurate. There were risk assessments in place and these covered the environment as well as for people. The fire procedures were well highlighted and all the relevant testing was carried out in accordance with guidance. Accidents are recorded and stored in the person’s own file, this information is used to help determine the need for extra support or a change in the care plan. All staff have health and safety training covering first aid, manual handling, food hygiene, and infection control. Phylward House DS0000007838.V333236.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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Phylward House DS0000007838.V333236.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Phylward House DS0000007838.V333236.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. 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!