Inspection on 22/07/05 for Scope - Coronation Drive

This inspection was carried out on 22nd July 2005.

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

Scope - Coronation Drive 19/01/07

Scope - Coronation Drive 12/01/06

Scope - Coronation Drive 02/03/05

Scope - Coronation Drive 29/09/04

Similar services:

Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

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

CARE HOME ADULTS 18-65 Scope 10 Coronation Drive Ditton Widnes WA8 8AY Lead Inspector Maureen Brown Unannounced 22 July 2005 09:45 nd 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Scope 10 Coronation Drive Address 10 Coronation Drive Ditton Widnes WA8 8AY 0151 424 2737 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Scope/Rita McCormack Mrs Amanda Sankey Care home 8 Category(ies) of Physical disability - 8 registration, with number of places Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 8 service users in the category of PD (physical disability) 2. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with The Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance issued through The Commission for Social Care Inspection 3. Date of last inspection 2nd March 2005 Brief Description of the Service: Coronation Drive is a purpose built house designed for eight adults with physical disabilities. The home is managed by Scope which is a national organisation for people with cerebral palsy. All of the service users have their own individual tenancy agreements. The home is near to Widnes town centre close to local amenities. Service users’ accommodation is on the ground floor and comprises eight single rooms, a kitchen/dining area, a kitchen and a laundry room, two bathrooms and two shower rooms, all of which are have toilets. The manager’s office, staff room, staff toilets, and the bedroom for the ‘sleeping‘ night duty staff are located on the first floor of the home. There is a patio and garden area, which is easily accessible. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out during the morning of 22nd July 2005. The total time on site was five and a half hours. The inspector spent an hour planning the inspection by reviewing previous inspection reports and the service history. The inspection included a full tour of the home, inspection of records and discussions with six residents, the registered manager, the care assistants and the housekeeper on duty. Twenty-two out of forty-three standards were assessed and all were met. Feedback from this inspection was given to the registered manager at the end of the inspection. What the service does well: What has improved since the last inspection? The shower rooms have been retiled and the flooring had been replaced. This has significantly improved the facilities available for the residents. A new washing machine had been purchased with a sluice facility programme. This will ensure that residents laundry will be cleaned appropriately and that cross-infection will not occur. This is in line with current Health and Safety guidelines. A gardener had been employed and a new raised flowerbed had been developed and planted with herbs and scented flowers. Residents said they enjoyed having the raised bed. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 6 A new cook had been employed and the menus had improved. manager and residents confirmed this. Both the 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. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 2 Sufficient information is provided for residents to make a decision about moving into the home but needs to be reviewed and updated. Full assessments of needs are carried out to ensure that the home can meet the residents’ needs. EVIDENCE: Each resident had a copy of the home’s statement of purpose and function and the service users guide and they were kept with the resident’s plan of care in their own bedrooms. A copy of the most recent inspection report was available in the office and staff were aware of this. The statement of purpose and service users guide needed updating and reviewing. For example, information regarding the National Care Standards Commission needs to be updated to reflect the Commission for Social Care Inspection details. (See requirement No.1). Care plans examined showed that assessments had been carried out with each person before moving into the home. Residents had visited the home prior to admission and trial overnight visits were encouraged. Admissions were planned and ranged from a short visit to overnight stays, dependent on the needs and wishes of the person. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: Four residents’ care records were seen during this inspection. These were comprehensive and well presented in individual folders. Each contained care plan monitoring sheets, personal information, 24-hour summary sheets, visiting professionals sheet, risk assessments, statement of purpose and function, service delivery agreement and service users guide. The care plans seen were drawn up in consultation with the residents and family and were based on their assessed needs and risks. The care plans were reviewed on an annual basis by social service and in conjunction with the residents. Staff reviewed the care plans on a monthly basis. Although paperwork for goals to be identified was filed in each plan, none were completed. The manager said that this was only used for planning for the annual review. It was suggested that this be removed until needed. One of the residents had a personal profile which gave a good indication of that person’s history. It was suggested it would be useful if these were Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 10 completed with the residents and their families for everyone so that staff would know each person’s history. Some residents had a record of their food intake. The manager stated that these were only used if required for dietary purposes. However for some meals entries were not completed. These records should be kept up to date so that an accurate record is available to assess an individual’s need. This is particularly important when looking at a persons weight loss and useful information for the GP, consultant or dietician. One of the four files seen had a monthly summary sheet, which detailed what had happened with that resident over the last month. This was a useful document to use as a quick reference guide to an individual resident. It was suggested that these be completed for each resident. Daily record sheets seen showed that day-to-day activities were recorded. This enabled staff and family members to see what a particular resident was undertaking during the day. They were written clearly, easy to follow and were signed by carers. Residents confirmed they had chosen the décor and furniture with some assistance from the staff team. It reflected residents’ personality and preferred taste of décor. The staff said that all residents had been involved in choosing the décor of the shared rooms. See recommendations 1, 2, 3 & 4 for the above issues. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 14, 16 & 17 Residents’ were able to take part in a range of activities of their choosing. Personal and family relationships were encouraged by the home and the staff team supported people with this. Residents’ dietary needs were well catered for with a balanced and varied selection of food that met peoples’ tastes and choices. EVIDENCE: The residents’ plans reflect the range of activities undertaken which included attending “lifestyles” day centre where a programme of crafts, music, information technology, working on an allotment, cooking or flower arranging is available. Each resident has three or four sessions a week at the day centre. Activities take place twice a week in the evenings at the home. These vary from DVD nights, men’s and women’s nights, aromatherapy sessions, pool, darts, massages and manicures. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 12 Residents spoken to said they enjoy going out and about in the community, to local shops, out for lunch, to the pub or cinema. The home has a wheelchairadapted vehicle for transport, which all residents can access. It was seen that educational needs were not fully met. It is suggested that this situation be reassessed. On discussions with residents and from reading care plans it was seen that educational needs were not being met. By having access to the local college and courses this could improve the residents skills in areas such as social interactions, Information Technology and day-to-day living skills. (See recommendation No 5). Visits from family and friends were recorded in the care plans and case notes. Residents shared with the inspector the contact they had with family members and said they could choose to see visitors within their own room or in the shared lounge/dining area. During the inspection staff spoke to residents in a friendly manner, using residents preferred names. Residents can pursue their own religious preferences. Some residents liked to go to church regularly and staff assisted them in this area. Some of the residents had been on holiday with the Winged Fellowship, and some had visited family members. The menus were seen and these reflected people’s personal choices. These were planned between the residents and the cook and an alternative was always available. Fresh fruit was available and mixtures of fresh and frozen vegetables were used. The menus seen gave a good balanced diet. It was noted that some Friday and Saturday night menus was kept free, so that the residents could choose to have a Chinese or Indian takeaway. Some residents have food intake charts to record their food intake. Meal times were varied depending on the needs of each resident. The kitchen was maintained in a clean and tidy condition and fridge, freezer and hot food temperatures were recorded. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 20 Residents received support from the staff for personal care in accordance with their stated preference. Administration and control of medications were appropriate for the needs of the residents. EVIDENCE: The sample 24-hour summary records seen described how the residents preferred to be supported in their daily routines. Times for rising and resting preferred moving and handling techniques and personal care preferences were recorded, as was choice of clothing, hairstyle and makeup. All residents were dressed differently according to their own choice. During the inspection personal care was given in residents own bedrooms. Staff were observed to be respectful, knocking on bedroom and bathroom doors before entering. The home was equipped with hoists, wheelchairs, shower chairs and cradle. This equipment enabled residents to remain as independent as possible. Specialist services used such as physiotherapists, dietician, continence advisors, occupational therapist and speech and language therapists were available via referrals through each residents GP. Records of visits were noted within each resident’s plan of care. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 14 A locked steel cupboard was available for storage of medication. This was located within the bathroom. A monitored dosage system was used and all medication was stored appropriately. The medication administration sheets seen were signed and up to date. It was seen that directions for use of medications were not clear for some medication and that clear instructions should be printed on both the medication and Medication Administration Record sheets. (See recommendation No. 6). No controlled drugs were used at this time, however appropriate facilities were available if required. The home had a medication policy and the Royal Pharmaceutical Society guide to administration of medicines for care homes and children’s homes was also available for reference purposes. The manager said that she had on-line access to the British National Formulary. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Clear policies and procedure were in place to ensure that residents’ views were listened to and acted upon. Residents were satisfied with the support they received from the manager and staff. No complaints had been made since the last inspection. EVIDENCE: The home’s policy on complaints was seen and also the full complaints procedure produced by Scope. The complaints procedure included timescales for response to the complainant and who to complain to. Residents said that they would speak to the staff or manager if they had a complaint. Staff confirmed that they were aware of the procedure and would pass concerns onto the manager. No complaints had been received since the previous inspection and a complaint book and relevant paperwork was available in the event of a complaint being received. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 The home provided a clean and comfortable environment for the people to live in. EVIDENCE: The home was furnished in a domestic style with additional equipment such as hoists and tracking provided as necessary to meet the residents’ needs. Residents said that bedrooms were decorated to their preferred style and staff stated that shared lounge and dining areas were decorated with residents’ involvement in the colour scheme chosen. The corridors were showing recommendation No. 7). signs of damage to the décor. (See The home was clean, tidy and free from any unpleasant smells. There was a separate laundry room with a new washing machine with a sluice facility. A drier was also available. The manager said that these machines met the residents’ needs. Cleaning materials stored in a locked area. Control of Substances Hazardous to Health data sheets was available to the staff team. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 17 The garden was accessible to the residents and a new raised bed had been built for the residents to use. It had been planted with herbs and scented plants and the residents said that they liked the raised beds. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 & 36 The manager provided clear leadership. Records were well maintained. Staff received support to enable them to meet residents’ needs. EVIDENCE: At the time of this inspection the agreed staffing levels were met. Three support workers, the housekeeper and the home’s manager were on duty. Observed day-to-day supervision of staff was good and the staff team confirmed that they were supported by the manager in their delivery of care to residents. The manager said that formal supervision was not up to date. A new system had been introduced and is due to be started over the next month. Records were kept of previous sessions. Staff appraisals were due to be undertaken. With the new supervision sessions starting the manager anticipated that appraisals would be completed by September 2005. (See recommendations Nos. 8 & 9). During this inspection staff were seen providing care for residents in a dignified manner. Whilst assisting with mealtime food was offered to residents at their particular pace and staff were seen to interact well with residents. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 19 Nine staff had obtained NVQ level II in Care and five staff were currently undertaking NVQ level II in Care. Two senior support workers were undertaking the NVQ assessor training. Mandatory training included moving and handling, first aid, fire awareness, food hygiene and medication training. All staff had completed mandatory training. Health and Safety and Adult Protection were other courses most staff had undertaken. One of the staff team is a Moving and Handling trainer. The manager had a training plan, which was up to date and showed when refresher training was due. The manager said that the staff team was stable with very little change over the last two years. On occasion agency staff had been used, but the same staff were used each time. The manager said that the agency was reliable. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 40 & 41 Residents’ records were kept safe and secure. The manager is competent, experienced and able to meet the homes stated purpose aims and objectives. EVIDENCE: Records seen were kept in good order. These were in line with the Data Protection requirements. The manager said that residents had access to information stored about them. Residents said they were aware of information kept about them. Residents care plans were kept in their own bedrooms. The manager said that the A - Z file of policies and procedures had been reviewed recently. Policies and procedures are reviewed and updated as necessary for example, in line with changes in legislation. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 21 During discussions with staff members they said that they were aware of the policies and procedures relating to the home and the care of the residents. Staff explained that they had access to the policy file. The registered manager has only one unit to complete for her NVQ level IV Registered Managers Award, the recognised qualification for home managers. She said she expected to complete this by August 2005. The manager has seventeen years experience with Scope and has been a manager for four years. During discussions she demonstrated her awareness of residents needs and her knowledge and understanding of Scope’s policies and procedures. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Scope Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x 3 3 x x F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 23 No Are there any outstanding requirements from the last inspection? 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 1 Regulation 4,5 Requirement The registered person must ensure that the statement of purpose and function and serivce users guide are updated and reviewed in line with Standard 1. Timescale for action 15.9.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard 1 7 7 7 12 20 Good Practice Recommendations The registered person should complete the paperwork for goals to be identified. The registered person should ensure that each service user has a personal profile which would then assist the staff in understanding of that person’s life history. The registered person should ensure that the service users who had a record of their food intake have this completed regularly for each meal taken. The registered person should ensure that monthly summary sheets are completed for each service user. The registered person should reassess each service user in respect of their educational needs. The registered person should ensure that directions for use of medication is clear both on the bottle or pack and on the Medication Administration Record Sheets. F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 24 Scope 7. 8. 9. 30 36 36 The registered person should have the corridors redecorated where signs of damage were noted. The registered person should ensure that the new formal supervision system is put into practice and records kept. The registered person should ensure that annual staff appraisals are undertaken. Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Scope F51 F01 S5180 10 Coronation Drive V239494 220705 Stage 4.doc Version 1.40 Page 26 - 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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