Inspection on 03/05/07 for Savile House

This inspection was carried out on 3rd May 2007.

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

The inspector 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

Savile House 29/12/05

Savile House 19/08/05

Savile House 20/10/04

Savile House 18/06/04

Savile House 01/03/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Savile House 25 Savile Road Halifax West Yorkshire HX1 2BA Lead Inspector Karen Westhead Key Unannounced Inspection 3rd May 2007 09:45a 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 Savile House DS0000049290.V328944.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 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. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Savile House Address 25 Savile Road Halifax West Yorkshire HX1 2BA 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) 01422 359649 Chestnut Care Ltd Mrs Ruth Syme Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th December 2005 Brief Description of the Service: Savile House is a care home providing personal care and accommodation for up to twenty-four older people. It is in the Savile Park area of Halifax, which is not far from the town centre. It is easy to reach using public transport. The home is privately owned by a limited company, Chestnut Care. Residents have a choice of sitting areas on the ground floor. There are fourteen single bedrooms, two of which have an en suite, and four double rooms. Communal toilets and bathrooms are within easy access of all bedrooms. There is storage for wheelchairs and other equipment. There is a passenger lift to all floors. The fee charged is between £323 to £359 per week. This information was provided on 16th February 2007 and confirmed during the inspection. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was done by one inspector and had not been prearranged with the Manager. The inspector arrived at 9.45am and left at teatime. At the end of the visit the manager was told how well the home was being run and what, if anything needed to be done to make sure the home meets the standards. The reason for the visit was to make sure the home was being run for the benefit and well being of the residents and in line with requirements. The home was last inspected on 29th December 2005. Before the inspection information received about the home was reviewed. This included looking at the number of reported incidents and accidents, the action plan provided following the last inspection and reports from other agencies such as the fire safety officer’s report. This information was used to plan the inspection visit. A number of records were looked at; all areas of the home were seen. Most of the day was spent talking to residents, visitors, staff and the manager, to find out what it is like to live and work at Savile House. Commission for Social Care Inspection questionnaires and post-paid envelopes were left for residents and visitors to complete at a later date. At the time of writing this report nine questionnaires had been returned to CSCI. Some had been filled in by residents or visitors. On the whole comments were positive. Seven suggestions were noted and these are included in the report. What the service does well: The home is well run. Paperwork is comprehensive and staff are able to complete these competently and know what they need to do to meet residents needs. The residents, their families and friends are actively encouraged to share their views about the home and how it should be run to make sure the focus is always the well being of those living there. Health and personal needs are met by a skilled group of staff who are given support and guidance by the manager. Health and safety is seen as important and comprehensive risk assessments have been completed to make sure the home is fit for purpose and safe. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 6 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. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 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 Savile House DS0000049290.V328944.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 (Standard 6 - N/A, the home does not provide intermediate care) People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents have enough information about the home to decide if it will meet their needs. EVIDENCE: Five residents told the inspector that they had been given support or had been encouraged by their relatives to move into Savile House when they couldn’t look after themselves at home. A few said they had visited the home prior to moving in and felt the information available was useful. The home does not routinely accept emergency admissions. Six plans of care were looked at. All of them included a pre admission assessment. Assessments are carried out by the manager and a senior member of staff. If possible they visit the resident in their own home. This means staff can get a good idea about the type of care needed. The Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 9 prospective resident can also ask the staff questions about the home and what moving in will mean to them. A judgement is then made about whether the home can provide appropriate care. The admissions process gives prospective residents the opportunity to spend time in the home before moving in. On admission, where possible, an individual member of staff is allocated to give the resident information, special attention, help them to feel welcome and comfortable in their surroundings and ask any questions about the home. Four residents plans of care were looked at and cross referenced with other records. These included the most recently admitted person, a resident who’s first language isn’t English, a resident with poor mobility and a resident who has high dependency needs. All residents receive a contract of terms and conditions on admission. Those residents case tracked were having their fees paid by the local authority and contracts were held in the home to show this. The Statement of Purpose and Service User Guide provides enough information for residents and their relatives about the home and what they can expect. The staff on duty said they had read through the information with those residents who have sensory impairment or needed help with documentation. All but four bedrooms are single. This means most of the residents can have privacy whilst being attended to in their own bedrooms and can have time alone if they choose without being disturbed. Those in double rooms have a privacy screen between the beds and curtains around the sink in the bedroom. The staff team are qualified and experienced to work with the resident group. Staff understand the cultural and diverse expectations of the residents and work within these. Residents have access to the advocacy service to make sure they have a representative if they are not able to make their own wishes known or do not have a relative or friend. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 People who use the service experience excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Health, personal and social care needs are fully met. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Residents at Savile House receive effective personal and healthcare support, which is determined by a ‘person centred approach’. The Statement of Purpose and Service User Guide explains the type of care the home offers. The staff working in the home are skilled and knowledgeable about the needs of the residents and deliver care in a professional and competent way. Plans of care show the personal and healthcare needs of each resident and how staff will meet these. In many instances other professionals work in partnership with staff in the home to make sure residents are receiving the best possible care. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 11 There are some aids and equipment in bathrooms to encourage residents to retain their independence. The manager reviews this regularly to make sure the home can accommodate any changing needs. Staff have received training in the use of equipment. Residents who have a doctor in the locality can choose to stay on the practice list. However, most are registered with a local surgery. There is a team of district nurses who know the residents and the residents trust. Regular reviews and health appointments are seen as important and systems are in place to make sure these happen. Staff are alert to any changes in mood, behaviour and general wellbeing of each resident. Plans around health are in place and records are carefully updated to give an accurate account of what is required and done. There is a good medication policy in place. Staff understand the procedures and work within their responsibilities. Quality assurance systems confirm that this policy is practiced. None of the current group of residents take care of their own medication and have agreed for the home to oversee this on their behalf. Savile House does not provide nursing care, however admissions are seen as long term whilst ever the staff team can provide the care required. The wishes of each resident about terminal care and the arrangements they want after death are openly and sensitively discussed with all residents. Their wishes are recorded. This includes specific details including information to be passed to family or friends. Staff routinely receive training in this area and have support and guidance from senior staff to discuss any areas of anxiety or concern. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents at Savile House make choices about their lifestyle. Social, cultural and recreational activities meet the resident’s expectations. EVIDENCE: Staff focus on each residents right to live the life they choose. Staff do not impose their views on residents but support them in ways, which might improve their quality of life. Staff make sure residents rights are protected. For example residents have access to a range of community resources and staff are proactive in their efforts to make sure residents feel part of the community. Residents said they are able to do what they wish, when they wish. There are regular residents meetings, which are used to seek the views of residents about the running of the home. Routines are very flexible and residents make choices about their lives. For example residents have full control about when they get up and go to bed, who Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 13 they spend time with and when to eat. A main meal is provided at lunchtime. But it was clear that if residents did not want to eat at that time, or wanted a different meal this was catered for. Meals are served in the main dining room, however if residents wish they can sit else where in the home to dine. All residents said they enjoyed the meals provided. There is a varied menu available and residents have a choice at each mealtime. Snacks and drinks are provided throughout the day and night. Staff try to encourage residents to eat a healthy diet and monitor weight loss and gain. The inspector sampled the main meal; this was tasty, hot, well presented and attractively plated. Residents were seen to be given ample time to enjoy their meals and the few needing assistance, were helped from a carer who was sitting beside them and who dealt with this in a discrete and gentle way. Visiting is open, however visitors are asked not to come at meal times as this can be distracting for the person they are visiting. In conversation with residents they said they didn’t think this was bad but that their relatives tended to prefer evening visiting anyway when the meal was a snack. Activities and recreation vary on a daily basis. The manager asks about resident’s preferences on admission and this is regularly reviewed with the resident. All activities are recorded and monitored to make sure residents are having access to thing they enjoy and can take part in. An entertainer is booked on a monthly basis and residents said they really enjoyed these sessions. The comments received on the questionnaires suggested that activities could be ‘limited and boring’ and that there wasn’t much to do apart from ‘watch television’. One resident said it was difficult to see and hear the television in the conservatory, particularly when the sun shone through the blinds. This was discussed with the manager. It is acknowledged that it can be difficult to engage some people in activities and to suit all of the different personalities. There is a system in place to monitor this aspect of the home and it would seem that the majority of residents are happy with what is on offer. The television in the conservatory has been replaced since the questionnaire was completed and the manager said residents have another communal area they can watch television. She also said that most of the residents who watch television have a set in their bedroom. She was committed to making sure this was still the case and said she would discuss this with the residents at their next meeting. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents are able to raise complaints and have access to a complaints procedure. Their rights are protected and they feel safe. EVIDENCE: There had been one complaint over the last twelve months. This had been dealt with by the provider and investigated by Social Services and the Adult Protection Unit. The complaint was not upheld. Residents said they knew who to complain to if they were unhappy and the complaints procedure was displayed for them to refer to. All the residents spoken with or who completed a questionnaire said they had not had reason to make a complaint so far. Staff spoken to said they had received training on adult protection. Copies of the adult protection procedures and the local authority adult protection procedures are kept in the office, and are available for staff to read. Staff showed a good awareness of what they should do if they thought residents might have been subject to any form of abuse and were able to identify the different types of abuse possible. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The design and layout of Savile House allows residents to live in a safe, well maintained and comfortable home. EVIDENCE: Savile House is on a main road. There is limited parking in the driveway. Since the last inspection two new single bedrooms have been provided which have en suite facilities. This has not increased the number of people living at the home. Residents said they liked the home and thought it was well kept with many of the ‘old fashioned features’ adding to the overall appearance of the home. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 16 Depending on the weather conditions the manager needs to monitor the temperature in the conservatory. On the day of the visit the conservatory was warm but the blinds had been used to shield residents from the sun and air conditioning units were being used to make sure residents were not too hot. The home is well maintained. Bedrooms seen had been personalised to differing levels and reflected the tastes of the resident using it. The layout of the building means groups of residents can meet together in one of two lounges or the conservatory; which has seating for ten residents. Residents can also meet with friends and relatives in their bedrooms. There are three bathrooms, two of which have a mechanical hoist. One is currently being redecorated and was out of use at the time of the visit. There are locks on the doors and residents can use the facilities in private. Residents said there is enough hot water. Water temperatures are monitored and records kept. The home is well lit, clean and tidy. One or two areas, which the manager was aware of, had a slight unpleasant odour. This was discussed and a plan had already been made to replace carpets and maintain standards. The manager is hoping to secure funding from the Local Authority to enhance the grounds, improve parking and add extra security to fire doors. The manager agreed to take advise from the local fire safety officer to make sure all bedroom doors met with fire safety regulations. Some bedroom doors had slight gaps under them, which might compromise fire safety. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Staff are trained, skilled and enough staff are on duty to support the residents who live there. EVIDENCE: All the residents, who talked with the inspector, spoke in positive terms about the manager and staff team. They said staff made them feel safe and that they had confidence in the care being provided. There are enough staff on duty throughout the day and night. The questionnaires received gave an account of ‘caring, helpful, friendly and approachable staff’. One person said ‘I wish to thank all the staff for being helpful and kind to us Ancient Brits!’ One person said their relative had lived a the home ‘six years and is treated with love, care and most importantly is allowed to keep his dignity.’ ‘Staff interact well with the residents, they take time to get to know each one and this is not always easy’, said another relative. Staff have been trained beyond the basic requirements meaning they have the skills and knowledge to deal with the needs of the resident group. Staff are entitled to paid absence to attend courses out of the home. All staff have an Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 18 accurate job description, which sets out their roles and responsibilities. Residents knew the names of staff and who their key worker (nominated carer) is and valued the relationships they had with the manager and staff team. Two residents said this is ‘my home’, and that they were made to feel they belonged. One resident, who was returning to the home after a hospital check up, said as she was getting out of the taxi, ‘Oh I’m glad I’m home.’ The staff team is made up of a manager, carers, domestics and a catering/household manager. The catering manager also has dedicated hours to carry out routine maintenance in the house. The staffing structure is based around delivering outcomes for the residents and not led by staff requirements. There is a good recruitment procedure that makes sure only staff who are suitable to work with vulnerable people are appointed. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38 People who use the service experience excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The management of the home is based on openness, respect and commitment. The manager is competent and has the necessary skills and qualifications to oversee the home properly. EVIDENCE: The manager is properly qualified and has a significant amount of experience of working with older people. The manager is supported well by a team of dedicated staff. The owner of the home visits regularly to review the service and plan for the future. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 20 The manager has a clear vision of what the home provides and has plans for further developments. Policies and procedures are written in a way, which follow ‘best practice’. Equality and diversity issues are considered when staff are working with residents. The organisation carries out an annual quality assurance survey. The results are gathered and if necessary new policies and procedures are introduced. Staff work practices and performance is discussed during their supervision sessions with the manager. The views of residents and staff are listened to, valued and acted upon. There are safeguards in place for the correct management of resident’s money. Record keeping is good so staff know what they are doing. These are kept securely and staff know what they have to do to comply with the requirements of the Data Protection Act. The plans of care had been written with involvement of residents and their relatives as appropriate. The manager and staff team have a good understanding of the risk assessment process and this is taken into account in the running of the home. A common sense approach is used to minimise risk without restricting the movements of residents. Health and safety systems are regularly reviewed and are kept up to date. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 21 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 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 3 3 4 3 Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 22 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. 1 2 Refer to Standard OP26 OP19 Good Practice Recommendations It is recommended that carpets are replaced where cleaning is not effective and does not remove unpleasant odours. It is recommended that the manager take advice from the local fire safety officer to make sure all bedroom doors meet the fire safety regulations. Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Savile House DS0000049290.V328944.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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