Inspection on 24/09/08 for Rosemount Care Home Limited

This inspection was carried out on 24th September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosemount Care Home Limited 10/10/07

Rosemount Care Home Limited 19/06/07

Rosemount Care Home Limited 07/11/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rosemount Care Home Limited 133 Cheadle Old Road Edgeley Stockport Cheshire SK3 9RH     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Geraldine Blow     Date: 2 4 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Rosemount Care Home Limited 133 Cheadle Old Road Edgeley Stockport Cheshire SK3 9RH 01614771572 01614803320 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Komal Nagjee Coorjee Type of registration: Number of places registered: Rosemount Care Home Ltd care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home is registered for a maximum of 17 service users to include: *up to 17 service users in the category of OP (Old age not falling within any other category). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home Rosemount Care Home is a detached residence in its own grounds, situated in Edgeley, Stockport. Rosemount is registered to provide accommodation for up to 17 older people. Rosemount has a lounge, which adjoins a smaller lounge. There are four steps leading from the lounge to the dining room. Handrails are provided to both sides of the steps. Care Homes for Older People Page 4 of 29 Over 65 17 0 Brief description of the care home Due to the design of the care home it is not practicable for people who have difficulty walking up and down steps or who need to use a wheelchair. There is a stair lift for residents to access the first floor of the home. Bedroom accommodation is provided on two floors. The home offers single and shared bedrooms. En-suite facilities are not provided. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report is based on information gathered by the Commission for Social Care Inspection (CSCI) since the last inspection on 10 October 2007 and supporting information received in the Annual Quality Assurance Assessment (AQAA) submitted by the manager prior to this visit. Residents and staff were sent comment cards. At the time of this visit 8 staff comment cards were received by CSCI. Some of their comments are included in the body of the report. This visit was unannounced, which means that the manager and staff were not told that we would be visiting. The visit forms part of the overall inspection process and took place on Wednesday 24 September 2008. The opportunity was taken to look at all the core standards of the National Minimum Standards (NMS). This report is an Care Homes for Older People Page 6 of 29 overview of what the inspector found during the inspection. As part of the visit we (the commission) spent time examining relevant documents and files. We also spent time talking with the manager, the deputy manger, several people living at the home, members of staff and a tour of the building was undertaken. Feedback was given to the manager during the course of this visit. The fees at the time of this visit ranged from 326 to 350 pounds. Additiional charges may also be made for hairdressing and other personal requirements. What the care home does well: What has improved since the last inspection? What they could do better: It is recommended that the plans of care are further developed on a more person Care Homes for Older People Page 8 of 29 centred approach and contain more details of peoples personal needs and preferences. Some areas of the medication administration need some improvements to ensure that residents are not put at risk and receive their medication as intended by their GP. Polices and procedures relating to residents finances should be reviewed and updated. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to make sure that peoples needs are assessed before admission Evidence: The manager stated that prior to a resident being admitted to the home a pre assessment of their needs is always undertaken. A documented pre-admission assessment form is in use to ensure residents assessed needs can be met prior to admission and a care managers assessment is always obtained prior to any admission if the care is funded by social services. All of the files looked at contained a care managers assessment and the homes own pre admission assessment, with the exception of one, which the manager confirmed was an emergency admission. The process of assessment was also confirmed in the completed AQAA. Care Homes for Older People Page 11 of 29 Evidence: An intermediate care service is not provided at Rosemount. The manager confirmed that prospective residents and or their relatives are encouraged to visit the home before making a decision to move in. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some shortfalls were identified in ensuring that the health care needs of residents were being met. Evidence: A sample of care plans were seen and two people were case tracked. The care files examined all contained a plan of care, which were periodically reviewed and the files were organised and easy to use. The manager, who is a Registered General Nurse, confirmed that he developed and reviewed all of the plans of care himself. There was a comprehensive Assessment of capabilities, which was competed on admission in addition to the residents assessment of needs. Some parts of the care plans contained person centred information. For example one file detailed that the resident had poor vision and was deaf in their left ear. The file Care Homes for Older People Page 13 of 29 Evidence: detailed that the resident needed discreet supervision while eating and needed their cutlery arranged directly in front of her. However other plans were vague and did not give specific details of how care needs or personal preferences could be met. For example in relation to hygiene needs the care plan did not give any details of exactly what help was needed to maintain personal hygiene or any details of the residents personal preferences, it just stated to assist with daily wash and maintain good oral hygiene. Both files looked at stated to assist with daily wash and weekly bath. This was discussed with the manager as the wording insinuates that the resident can only have a bath once a week. There was no evidence of resident choice or personal preferences in relation to baths or showers. It is recommended that that all residents care plans are developed using a person centred approach and contain sufficient detail for staff to meet all resident’s identified needs and personal preferences. Appropriate risk assessments had been included in the care files e.g. nutrition, moving and handling, falls, and assessments for pressure area care. A daily log was completed, usually twice a day for each resident. Some entries were detailed and informative. However some were quite vague and from discussions with the manager it was clear that some of entries did not always accurately reflect the care given over a 24-hour period. A recommendation has been made. Residents spoken to stated that they felt they were very well looked after and staff helped them when they needed assistance. The records regarding medication were examined. It was day three of week one of the recording. Medication had been signed into the home. The manager confirmed that only care staff who had received appropriate training have the responsibility for administering medication. It was noted that one particular medication, eye drops, were prescribed as use into affected eye. It did not give details as to which eye and it had not been signed as given. It was also of concern that the eye drops had a limited life of one month after opening. The date of opening was recorded was 27-7-08 and the day of this visit was 24-9-08 and therefore the drops were out of date. To ensure that residents are not placed at risk and receive medication as intended by the General Practitioner (GP) confirmation of the prescribers intentions must be sought and documented and all medication must be signed for on the record sheets. In addition to ensure that residents are not placed at any unnecessary risk out of date medication must not be given. Care Homes for Older People Page 14 of 29 Evidence: A tablet count was undertaken on 2 boxed medication. Both counts identified that too many tablets were left and a check of liquid medication also identified that there was too much medication. From the excess found it would appear the medication administration sheet had been signed and the medication had not been given. In addition medication had not been recorded on the record sheets as being carried over from the previous month. For one resident the bottle of medication in the medication trolley was dated 21-5-08 and there were four other bottles of the same medication. Excess stocks of medication should be returned to the pharmacy. The manager confirmed that at the time of this visit there was no formal system of auditing medication. To ensure that residents are receiving medication as prescribed by the GP, medication should be accounted for at all times by means of an audit trail. The manager confirmed that a copy of the GPs original prescription is not kept in the home. It is recommended that there is a copy of the GPs original prescription so that the medication received into the home can be checked against medication prescribed. Residents, a visiting professional and staff spoken to confirmed that privacy and dignity was respected during day-to-day interactions and residents are encouraged to exercise choice in their daily lives. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are provided and residents are able to maintain contact with family and friends. Evidence: Activities are provided every afternoon and there was a list of activities on display. Some of the activities provided include outside entertainers, some pub lunches, trips to the local shops bingo, music, manicures, films and card games. On the day of this visit residents were seen playing magnetic darts. Residents spoken to confirmed that there are daily activities and those spoken to said they had particularly enjoyed a recent trip to Blackpool. To ensure that the activities provided are what the people living at the home want to do, a social history is taken on admission, which includes spiritual fulfilment. There is a specific plan of care relating to social activities. There is a weekly church service held in the home for those residents wishing to attend. Copies of the menus were seen and there was a menu on display in the dining room. The meals were varied and nutritionally balanced. There were 3 choices at each Care Homes for Older People Page 16 of 29 Evidence: mealtime and residents spoken to were complementary about the food. One resident said the food is very nice and there is always a good choice Residents and staff spoken to confirmed that there is open visiting and visitors are made welcome. One visiting professional said she noticed that visitors were always offered a cup of tea when they arrived. Residents and staff spoken to confirmed that residents are encouraged to have freedom of choice around their day to day lives. For example residents are able to go to bed and get up when they choose and they can freely use any of the communal facilitate or their own rooms whenever they wish. One resident talked about how nice it was to have a glass of wine or whisky in the lounge before going to bed. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to enable people to raise concerns and policies and procedures are in place to protect people from abuse. Evidence: The complaint procedure was on display in the main reception area and the manager said that it was also on display on the back of residents bedroom doors and is included in the Service User Guide which is also in all residents bedrooms. Residents spoken to said they would be happy to make a complaint but had never wanted to. All of the returned comment cards from staff indicated that they knew what to do if somebody wanted to raise a concern. There was record of complaints made and a separate record of informal queries/concerns. Evidence was seen that action had been taken in response to any issues raised. The manager stated that he has an open door policy and encourages people to raise any concerns or complaints they may have. There was a copy of the local authorities All agencies Safeguarding Adults Policy and the No Secrets Guidance available in the home, which all staff could access. The manager was able to clearly describe the events to be taken in the event of an Care Homes for Older People Page 18 of 29 Evidence: allegation of abuse being made. The manager confirmed that all staff had received training in Safeguarding Adults. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clean and comfortable environment is provided. Evidence: A clean and comfortable environment is provided. During this visit a tour of the building was undertaken which included the communal areas and residents bedrooms. It was clean and tidy and residents spoken to confirmed that that was usually the case. As already stated in this report since the last inspection visit there has been ongoing improvements to the décor and furnishings of the home. It was noted that there were no window restrictors in the first floor bedrooms. This was discussed with the manager and it was recommended that a risk assessment be completed. However the manager later confirmed that he would be fitting window restrictors to ensure that residents are not placed at any unnecessary risk. It was noted that the hairdresser was using a residents bedroom to cut peoples hair. The bedroom was next to the bathroom and the manager said that they did have his verbal permission to use his room. However it is recommended that rather than using one residents bedroom alternative arrangements are made. Care Homes for Older People Page 20 of 29 Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The number and deployment of staff available appeared sufficient to meet the needs of the residents. Evidence: At the time of the site visit 12 residents were accommodated and the staff rota showed that during the day there was one senior carer and two care assistants in addition to the manager and deputy manager. There was one senior carer and one care assistant up to 10pm and then from 10pm to 8am there was one senior carer on duty and the manager and deputy manager who sleep in the building are on call. The manager confirmed that 10 care staff are employed. Three care staff have successfully completed NVQ Level 2 or above, one member of staff is currently working towards NVQ Level 2 and a further two members of staff are due to undertake the training. A sample of staff files were seen to see whether the required documentation was in place and the necessary checks had been made. One application form had not been accurately completed as it stated that Rosemount was their current-most recent employer and the manager confirmed that this was inaccurate. In another file both references were character references and both stated that they had only known the Care Homes for Older People Page 22 of 29 Evidence: applicant for 2 months. It is recommended that one reference is obtained from the applicant’s current or most recent employer or if not, the reason is recorded. The files looked at contained photocopied documents and there was no evidence that the original documents had been seen. It is recommended that all photocopied documents are signed and dated to indicate that the original has been seen. There was a structured induction in place, obtained from Skills for Care and the manager stated that all new employees must complete induction. Copies of the General Social Care Councils Code of Practice were available for staff. There was a training matrix available for inspection and certificates were seen on the staff files looked at. The manager confirmed that the training programme for care staff relied on the training events offered to care homes by the City Councils Adult Social Care Service. Members of staff were nominated for a range of core training events. If the home were offered places on these events then staff would attend. In addition to this the home had a programme of mandatory training. Training DVDs had been purchased and the manager, who is a Registered General Nurse, undertook the training with staff. On completion of the DVD staff complete a competency questionnaire that are returned to the company the DVDs were purchased from for marking and then certificates are issued if appropriate. Evidence of recent training included Fire Safety and Infection Control. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of the people who live there. Evidence: The manager has the experience and knowledge to effectively manage the home. From discussions he knew all of the residents and their individual care needs and personalities. From observations during the visit the manager had good relationships with the residents living at the home and residents spoken to knew who the manager was and felt they could speak to him if they had a problem. He continued to sometimes cover shifts and work alongside the staff, enabling him to monitor staff practice and be aware of residents individual needs and personalities. There is a suggestion box in the main reception, although the manager stated that it is rarely used. The manager confirmed that there are quality questionnaires for residents and relatives although relatives have not been sent one this year. He stated that it was his intention to send Care Homes for Older People Page 24 of 29 Evidence: relatives and visiting professionals a questionnaire and then collate the results and display them. There was a policies and procedures folder that was available for staff to access and the manager confirmed that he reviews and updates them as required. The systems in place for the recording of residents finances were in order with income and outgoings being recorded. Where residents received visits, for example, from the hairdresser receipts showed which residents had received the services. Some relatives give money to the manager for safekeeping. It is recommended that the policies and procedures relating to finances are reviewed and updated to clearly set out the systems to be followed. The manager confirmed that, on occasions, staff do purchase items on behalf of a resident. However, there was no record of agreement that people had given their permission for staff to make purchases on their behalf. It is recommended that written agreements be developed between people and the home setting out permission for the staff to purchase personal items for that person and the receipt be signed by the person purchasing items. The information provided in the AQAA demonstrated that the homes maintenance certificates and records were up to date. Fire safety checks were looked at and found to be up to date. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 There must be sufficient 21/10/2008 information to enable nurses to administer medication as intended by the General Practitioner (GP) and therefore the doctors’ instructions must be recorded. To ensure that residents are not placed at risk and receive thier medication as intended by the GP. 2 9 13 All medication must be appropriately signed for on the recording sheet To ensure residents have received medication as prescribed by the GP 21/10/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 1. It is recommended that that all resident’s care plans are developed using a person centred approach and contain Page 27 of 29 Care Homes for Older People sufficient detail for staff to meet all resident’s identified needs and personal preferences. 2. It is recommended that the daily reports are written in sufficient detail to accurately reflect the care given over a 24 hour period. 2 9 1. It is recommended that there is a copy of the GP’s original prescription so that the medication received can be checked against medication prescribed. 2. To ensure residents are receiving medication as prescribed by the GP medication should be accounted for at all times by means of an audit trail. 3. Excess or out of date medication sould be returned to the pharmacy. 3 4 19 29 1. It is recommended that alternative arrangements are made when residents are having their hair cut. It is recommended that if a reference is not obtained by the applicant’s last/current employer the reason is clearly recorded. and that written evidence is maintained that the original documentation had been seen, the date and by whom. Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!