Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 15/02/06 for Queensway House Residential Care Home

Also see our care home review for Queensway House Residential Care Home for more information

This inspection was carried out on 15th February 2006.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Manager was praised by staff and service users for the current smooth running of the home. Staff commented that they now work as a team and moral is very high. There are separate activities provided for those on the dementia unit and for the remaining residents and this separation is benefiting both groups. Service user independence is promoted by the staff and residents are involved in the day to day running of the home through regular meetings and quality assurance procedures. There are clear policies for maintaining Health and Safety in the home and these were successfully actioned when residents had to be evacuated after the explosion at the Buncefield Depot. Residents praised staff support and action at this time.

What has improved since the last inspection?

The separation of service users with different needs was welcomed by some residents spoken with, who also said that they now enjoyed the activities more. Training records are now computerised and the new Deputy Manager will have responsibility for training staff. All residents said the meals were now very good. The Manager said that there were good relations with the local G.P. and that there was now a named Psychiatric Nurse who was linked to the home. The quality system in the home is now back in action and the Manager has updated some of the monitoring procedures in the home.

What the care home could do better:

There were some small shortfalls in the system for administering medication which staff have already noted. The manager is also aware that more training courses are needed , including Adult Abuse training for staff who have not yet had this. It may be that some additional staffing is needed on the dementia unit, and the manager will monitor this situation. There are also areas of the dementia unit still to be developed, but as it has only been open for one week this improvement will no doubt happen.

CARE HOMES FOR OLDER PEOPLE Queensway House Residential Home Jupiter Drive Hemel Hempstead Hertfordshire HP2 5NP Lead Inspector Pat House Unannounced Inspection 15th February 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Queensway House Residential Home Address Jupiter Drive Hemel Hempstead Hertfordshire HP2 5NP 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) 01442 266088 01442 261818 GCH (Queensway) Limited Mrs Marie Shouler Care Home 60 Category(ies) of Past or present alcohol dependence (1), registration, with number Dementia - over 65 years of age (60), Mental of places disorder, excluding learning disability or dementia (1), Old age, not falling within any other category (60), Physical disability over 65 years of age (60) Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The category MD will be conditional on the continued occupation of a (named) service user. 30th November 2005 Date of last inspection Brief Description of the Service: Queensway House is a sixty-bedded care home for older people, who may also have a physical disability or dementia. The home does not provide nursing services. The building is two-storey, and has a passenger lift and all service users have access to the gardens. A separation of facilities has just been implemented and there is now an eleven-bedded dementia unit on the first floor of the home. This unit has its own dining and lounge areas and a dedicated staff group and provides care for those individuals whose levels of confusion are more advanced. All bedrooms in the home are single occupancy and have en-suite facilities. The main dining room and kitchen is on the ground floor. There is a large, secure garden to the rear of the home and a parking area at the front. The home is situated in a residential area, near to the town of Hemel Hempstead, which has extensive shopping areas, leisure facilities and good transport links. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one day with two inspectors. All areas of the home were visited and service users, care staff and visitors were spoken with. Records were examined and care plans were checked on the dementia unit. The new dementia unit had been opened for one week at the time of the visit. The Manager was present during the visit and the newly appointed deputy Manager was introduced. Since the last inspection visit, an anonymous complaint had been received by the CSCI and this was investigated during the inspection. What the service does well: What has improved since the last inspection? The separation of service users with different needs was welcomed by some residents spoken with, who also said that they now enjoyed the activities more. Training records are now computerised and the new Deputy Manager will have responsibility for training staff. All residents said the meals were now very good. The Manager said that there were good relations with the local G.P. and that there was now a named Psychiatric Nurse who was linked to the home. The quality system in the home is now back in action and the Manager has updated some of the monitoring procedures in the home. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 6 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. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 and 5. Standard 3 was assessed and met at a previous visit. Service users are able to visit the home and are given adequate information to enable them to decide if Queensway will meet their needs. Terms and responsibilities are clearly set out in the contract provided for all service users. The separation of service provision in the home enables the differing needs of service users to be met. EVIDENCE: The home’s Statement of Purpose and Service User’s Guide are currently being updated to include the recently implemented changes. A copy will be provided for the CSCI when it is completed. All prospective service users and their families are able to visit the home before moving in. All residents agree and sign a contract when they take up a permanent place and copies are available on file. Standard 6 does not apply to this home. A separate unit on the first floor of the home has recently opened and will provide services for those with more advanced dementia. There is a dedicated staff team attached to this unit and it has its own dining and lounge areas. As a result of this separate provision, services for the different resident groups can be more appropriately targeted. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,10 and 11. Standard 8 was assessed and met at the previous inspection. Policies and procedures in the home ensure that service users are treated with respect at all times and especially at times of terminal illness. Detailed individual care plans enable care staff to provide the appropriate care for service users. Some small improvements are needed to ensure the home’s procedures for administering medication protect service users at all times. EVIDENCE: Service users and visitors spoken with confirmed that staff always treat them with respect and that residents always wear their own clothes and receive their mail unopened. During the inspection, care staff were seen knocking on bedroom doors and waiting before entering rooms. One resident said he had regularly used the shower unaided until recently, but had now asked staff for assistance with bathing. One relative said that her sister could get up and go to bed at any time she wanted and that she was aware of the advocacy services available. Leaflets about advocacy were displayed on the notice board. Each resident has a named key-worker, and the relevant care workers’ photographs are pinned on the back of bedroom doors. Quite a few residents have their own telephone in their rooms and are able to use a phone in private in the office if they wish. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 10 One service user spoken with manages his own finances, and has lockable space for his money. This resident also has a car, which is parked outside the home. Several residents said they had their own bedroom door key and all rooms have Yale locks fitted. Service users and relatives spoken with confirmed that visitors were welcomed in the home at all times. The home has a written policy on death and dying, which staff were aware of. Some care plans were tracked on the dementia unit and these were well documented. However, the Manager is planning to make further changes to the care plan format and intends to include more details and more information regarding “life histories”. The Manager said that at a recent residents’ meeting, the use of care plans was discussed and service users were encouraged to discuss these and any changes they would like, with their key worker. One resident said he manages his own medication and keeps this in a locked drawer in his room. This gentleman also manages his own insulin injections and this medication is kept in the home’s medication fridge. Risk assessments were seen for these procedures and for the resident’s use of Warfarin. The storage of controlled medication was checked and was in order, although staff were reminded to record detailed addresses when these drugs were transferred. Two staff signatures should also be recorded when any hand written instructions were added to the medication records. The home also needs proper equipment to count tablets and to cut tablets. There were one or two gaps on the medication records checked and not all packets were dated on opening, making audits more difficult. There were two instances where amounts of tablets did not tally with records and the temperature of the medication store on the dementia unit should be monitored for safety. However, the system for administering medication was basically sound, although a requirement has been made to resolve theses small shortfalls. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14 and 15. Standard 13 was assessed and met at the last inspection. Service users benefit from and enjoy the meals and activities provided in the home and are supported by staff to make choices about their daily life and thus maintain their independence for as long as possible. EVIDENCE: During the visit, activities were provided for service users on both floors. On the dementia unit service users were playing a ball game in the lounge and one care worker was playing a board game with two of the residents. In the main lounge, there were two distinct areas. One area had music playing and the residents were watching the television in the other area. Later a quiz was provided in this lounge and a large number of residents took part in this. The week’s activities were displayed on the notice board and these covered every day except Sundays when Church services take place. One resident enjoys sewing tapestries and said that the activity co-ordinator provides him with the wool for this. Residents also said that care staff assist the activity co-ordinator to provide the events and said they often go on outings in the home’s vehicle. There is a large “pillar box” in the hall where residents can “post” suggestions for the day to day running of the home and new activities equipment has been provided for the specialist activities needed for the dementia unit. The minutes of residents’ meetings seen showed that residents were asked what additional events they would like and the co-ordinator said she holds weekly planning meetings to consult with service users. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 12 The co-ordinator has completed courses in activity planning and dementia care and has no care duties now. Records are kept of attendance at events and the co-ordinator is completing “life stories” for every resident with relatives help where possible. Service users spoken with confirmed that newspapers were delivered if requested and that there is a “trolley shop” in the home from which they can purchase essential items. As already stated, details of advocacy services are displayed around the home and some residents handle their own financial affairs. Most of the bedrooms have been personalised with the possessions and furniture of residents and one service user has his own tea/coffee maker, small ring cooker and fridge, amongst other things. Service users spoken with confirmed they could have meals provided in their rooms if they wished and said they chose both their main meal and tea, from two options the day before it was provided. Residents said the food was now very good and that drinks were provided all through the day. Supplies of drinks and snacks are left in the small kitchenette when the main kitchen closes and service users and visitors can use these at will. The kitchen was very clean and tables in the dining room were laid with coloured cloths, napkins and with a printed menu on each table. Meals are taken up to the dementia unit in a heated trolley. Currently the cook is providing one liquid diet and is keeping records of the actual food provided for service users. These records are monitored by the Manager. Records of fridge and freezer temperature checks were seen and there are appropriate risk assessments in place for kitchen equipment. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17. Standard 18 was assessed and met at the last inspection. Service users in the home have their rights protected and can be confident that procedures in the home encourage them to raise any concerns they might have and to know that these will be listened to and acted on. EVIDENCE: As already stated, the availability of advocacy services is promoted in the home. The Manager confirmed that all residents are registered to vote in elections. Service users and relatives who were spoken to, confirmed that they would feel comfortable discussing any concerns with staff and would make a complaint if necessary. Minutes of a recent residents’ meeting also recorded that service users were reminded what to do if they had a complaint. An anonymous complaint about the home had been received by the CSCI since the last inspection. The issues in this complaint were investigated during the inspection. None of the issues raised in the complaint were substantiated and the complaint was not upheld. However, the Manager acknowledged that some of the concerns raised had been a problem in the past, and some had been highlighted in previous inspection reports. It was very encouraging that all the issues had already been dealt with. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,24 and 26. Standards 20,21,23 and 25 were met previously. The home is clean, well decorated and maintained and provides a comfortable and homely environment for service users which promotes their well being. EVIDENCE: The new dementia unit has been redecorated and the flooring in the dining area here is due to be changed to vinyl flooring soon. Murals are to be painted on the corridor walls of this unit and a “quiet” room is going to be developed. There are pictorial signs on doors throughout the home to guide service users to the facilities, as well as all areas having names on bedroom doors. There are grab rails and other aids in appropriate places throughout the home. There is a shower room and assisted baths for service user choice and a separately labelled disabled toilet for wheelchair users. Redecoration has taken place throughout the home and there are ongoing maintenance programmes. There is currently a serious water leak behind the washing machines in the laundry, but the Manager said that repair work has been booked. There are two new washing machines in the laundry and a new automatic system has been installed, which assists infection control. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 15 The home was generally very clean and liquid soap and paper towels were being used in all communal areas to promote infection control. The room previously used as a second dining room has now returned to being a quiet room where books are available. Those bedrooms seen were all very clean, had good bedding and had been personalised. All bedroom doors have Yale locks fitted and some service users were seen using their keys to open their doors. Many residents have their own telephone lines, but are able to use the home’s telephones in private when they need to. All rooms have call alarms and service users said these were always answered when activated. CCTV is not used at the home. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 29. Standards 27 and 30 were assessed and met at the previous visit. Policies for staff training and staff recruitment in the home ensure that service users are protected and supported by competent staff at all times. EVIDENCE: At the last visit to the home evidence was seen that staff training was being reviewed and new courses booked. Overviews of training completed and training still needed were seen and the newly appointed Deputy Manager will now have responsibility for staff training. There is still a lot of mandatory training to be updated but courses are already booked and the Manager is aware that all staff must attend Adult Abuse training as soon as possible. This area will be checked again at the next inspection. Currently there are eight staff with NVQ qualifications and five more care workers have started this training. The Manager confirmed that NVQ training for staff will be ongoing. Recruitment records for six of the newer staff were checked and all contained evidence that appropriate checks had been made prior to employment commencing and all files were well documented. Service users spoken to felt there were generally enough staff on duty. However, only two care workers are allocated to work on the dementia unit and it was not clear if this number was adequate, especially at peak times. The Manager will be monitoring this provision and it will be checked at the next inspection. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 37 and 38. Effective management in the home has benefited both staff and residents and service users’ interests are protected by the procedures now in operation in the home. EVIDENCE: Comments from service users and staff confirmed that the running of the home has vastly improved since the registered Manager has returned. The recent appointment of a deputy Manager should also ensure that all areas of the home’s management can continue to function effectively. Care workers spoken with said they now felt they were “working as a team.” The registered Manager has completed both the Registered Manager’s Award and NVQ 5 training. Dates of residents’ meetings were advertised on notice boards and some service users confirmed they attended these. Minutes show that the Manager has been promoting service user involvement in care planning and in accessing their records. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 18 Discussion also took place at one of these meetings about the content of the next residents’ questionnaires, which will soon be sent out. Before the opening of the dementia unit, residents were also informed about the proposed separation of services and the minutes showed there was general approval for this change. As a result of requests made at one residents’ meeting, staff photographs and names are going to be displayed in the home. There is a comment book for visitors to record their views in, kept in the entrance hall and a good system of Quality Assurance already in operation in the home. The Manager has amended the system of accident monitoring in the home to include the time, place and frequency of events. The date of the next Relatives’ Meeting was also displayed in the home and one visitor spoken with confirmed she attended these meetings when she could. An appropriate certificate of insurance is displayed in the home and there is a good system for dealing with service users’ monies, which was examined at a previous inspection. Care staff spoken with confirmed they now have regular formal supervision, and this includes a signed contract and dates booked in advance. Some spoken with said they were having supervision every six weeks at present. Staff also confirmed there are regular fire drills in the home and equipment checked had been recently serviced. There is a comprehensive Health and Safety statement and file in the home with extensive general risk assessments completed. The laundry also has COSHH risk assessments displayed on the wall. Accident recording is thorough and the CSCI is regularly informed of accidents and incidents in the home. Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 3 x x 3 x 3 x 3 STAFFING Standard No Score 27 x 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 20 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. 1 Standard OP9 Regulation 13(2) Requirement The Registered Provider must ensure that accurate records are maintained for the administration of medication in the home with two signatures recorded for hand written instructions and dates of opening recorded on packaged drugs. Timescale for action 15/02/06 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 Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Queensway House Residential Home DS0000063303.V283907.R01.S.doc Version 5.1 Page 22 - 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!