Inspection on 20/04/06 for Southfield

This inspection was carried out on 20th April 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Southfield Harp Hill Charlton Kings Cheltenham Glos GL52 6PX Lead Inspector Nick Jones Key Unannounced Inspection 20th April 2006 11:00 Southfield DS0000067087.V291315.R01.S.doc Version 5.1 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 Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Southfield Address Harp Hill Charlton Kings Cheltenham Glos GL52 6PX 01242 250053 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.brandontrust.org The Brandon Trust Miss Kathryn Helen Northfield Care Home 5 Category(ies) of Learning disability (5), Sensory impairment (2) registration, with number of places Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To reduce numbers to four (4) places when a vacancy occurs in the shared bedroom. 18/01/06 Date of last inspection Brief Description of the Service: Southfield is a registered Care Home and is registered to accommodate five adults who have a learning disability. The home is an adapted detached house about one mile from the centre of Cheltenham town. The accommodation is on two floors and consists of two lounges and a dining room on the ground floor. On the first floor there are four single bedrooms and one twin bedroom.There are two bathrooms; one of which is an assisted bath, the other a walk-in shower with seat. There is a raised sitting area in the garden and pleasant gardens. The outside area is accessible and provides a pleasant alternative for the service users. The Registered Provider of the home is now the Brandon Trust as of the 1st April 2006. They are a social care organisation based in Bristol and were chosen by the Gloucestershire Partnership Trust in the re-provision of the MEND/Mayfield Trust homes in Gloucestershire. The home and the Brandon Trust are reviewing how best to provide information about the home to prospective service users. The monthly fees charged by the home are £1359.15 Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Key Inspection and was completed during one day and a morning the following week over a total period of nine hours. Staff, including the Registered Manager, on duty were seen and spoken to individually. All of the service users were met and whilst their ability to offer comment was limited it was evident that they were happy in the home and had a positive relationship with the staff. All staff were helpful and well informed during the inspection. A number of records were seen and they were generally well maintained and contained the required information. A tour of the home and garden was completed. The home was seen as comfortable and stimulating environment where staff are totally committed to meet the varied and complex needs and wishes of the service users. The home has maintained the continuity of service during the change over to the new Registered Provider, The Brandon Trust. There are some requirements and recommendations detailed in the report which are partially related to these recent circumstances. What the service does well: What has improved since the last inspection? The ground floor toilet has been re-tiled and fitted with new flooring. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Southfield DS0000067087.V291315.R01.S.doc Version 5.1 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 the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information provided by the home enables prospective service users/relatives/sponsors to make an informed choice. EVIDENCE: The registered manager of the home would formally assess any prospective service user. The home has an appropriate assessment tool available for use. The home has a Statement of Purpose and a guide for service users. This provides considerable information about the home and would assist someone who was considering living there. An insert sheet has been produced which provides details about the Brandon Trust. The Manager stated that the Statement of Purpose and Service User Guide would be reviewed over the coming year. The home has not had any new admissions during the year since the previous annual inspection. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of the service users are on the whole clearly identified and wherever possible met. The records of care plans and risk assessments of service users must be reviewed and updated to ensure consistency in staff support. Service users have been imaginatively supported to enable them to make decisions and choices about their lives. EVIDENCE: The care plans of three service users were viewed which clearly indicated the needs, interventions and desired outcomes for service users. The assessment of need is based on the model ‘activities for daily living’, and the plan of care indicated the relevant issues under each section. The care plans and risk Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 10 assessments reflect issues discussed at IPP reviews held on an annual basis for each service user. The system of review appears to be informal, and a number of the plans had no evidence of review since 2004. Others have been reviewed in recent months. The previous report required that all care plans must be reviewed. The registered manager and inspector discussed circumstances at the home in recent months. The registered manager is nearing a phased return to work after a period of absence from work. The home is also in the middle of the process of adjusting to the new Brandon Trust processes and systems. These circumstances were acknowledged by the inspector but the requirement is restated. The registered manager stated new care plan formats are to be introduced. Discussions with staff and observations of staff interactions with service users over the two days demonstrated that staff have a detailed understanding of the support and communication needs of service users. An entry in the staff message book was recently made indicating an element of a persons care plan was to be reviewed at a team meeting. Viewing care plans and risk assessments and spending time with service users demonstrated they are imaginatively supported to make choices and decisions in their day to day lives. Any limitations to choice are documented. The staff team are to be commended in their support of the complex and varied needs of the service users. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users day time activities, social and leisure needs are identified and met. Service users’ choice and freedom of movement are respected so promoting the rights of service users. The home provides meals which the service users enjoy and promotes their health and wellbeing. EVIDENCE: Each service user has a weekly programme and this indicated the activities, times and venues. Considerable care has been taken by staff to ensure the Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 12 wishes and needs of the individuals are, wherever possible, met. The programmes include attendance at a variety of day centres and colleges, hydrotherapy sessions, rambling and swimming. Service users also attend some social clubs in the evening during the week. One service user told the inspector that they enjoyed the things they did and that they are consulted over how they spend their time. Service users are supported to use a variety of community facilities. Records of this were viewed in the diary of the home and daily notes. Service users are offered holidays that meet their individual needs and wishes. This included a holiday cottage in Devon and a visit to a Centerparcs facility. Social and family relationships are encouraged and supported and everyone has contact with family/friends. Every Sunday a number of relatives visit and staff stated the service users look forward to this contact. Daily notes viewed recorded the regularity of the visits. The rights of the service users are respected and the staff were seen to provide a flexible response to the many and varied needs of each service user. The home has produced creative solutions to enable freedom of movement and choice of service users utilising remote door opening technology and objects of reference. Everyone in the home is involved in menu planning and staff place great emphasis on ensuring likes/dislikes are known and responded to. On the day of the inspection the tea consisted of chips, beans, eggs and sausages. Staff had a clear understanding of the needs of service users at mealtimes. The menus provide a varied, nutritious and balanced diet. Mealtimes are seen as an important social occasion. Staff and service users sit together in the dining room for the main meals. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The support and guidance offered to service users by staff and health professionals ensure personal care and health care is adequately provided. The procedures for the prescribing, storage and administration of medicines ensures the health and welfare of service users is maintained. EVIDENCE: Staff on duty were seen to respond to needs in a sensitive and competent manner. It was clear the staff offer a flexible service which accommodates individual preferences, and ensures service users are seen and treated as individuals. Care plans viewed contained clear guidelines as to how service users should be supported to maintain dignity and control over their lives. Records viewed and observation of staff practice showed the home is aware of and meets the needs of service users with sensory impairment. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 14 Health care records seen were comprehensive and showed that all health needs are met through a range of community health services. They also showed that the prescribed medicines are appropriately reviewed. Staff administer medicines and there was a record of the receipt, administration and disposal of prescribed medicines. Medicines were being stored appropriately. Staff have received training in the safe handling of medicines. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practices in the home ensures that service users have an active voice and are protected from any abuse. EVIDENCE: The home has a complaints procedure and there is a copy for service users in a “symbols” form. The manager informed the inspector that not all service users would be able to understand the current formats, however, in such cases there is a relative/friend who would act on their behalf. The manager stated relatives/friends are encouraged to express any thoughts or concerns when visiting the home. The home has not received any formal complaints. All staff have recently had training in adult protection and ‘Whistleblowing’ procedures. The inspector saw examples of the records of personal monies, which are held and managed by staff on behalf of the service users. They were detailed and up to date. The service users will be having their personal savings and benefit payments transferred from the MEND account to individual bank/savings accounts. The details are yet to emerge in Brandon Trust’s review of procedures as the new provider and will be assessed at the next inspection. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 16 Staff talk to service users about what happens in the home and every opportunity is given to ensure that they have as much choice as possible over what they do, what they eat and when they get up and go to bed. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, clean, hygenic and safe environment which meets the needs of service users. EVIDENCE: All areas of the home were viewed including all bedrooms. Décor and furnishings are of a good quality with bedrooms personalised to the tastes and preferences of service users. Fixtures and fittings were well maintained and appropriate to the needs of service users. The home has one bathroom with a Neptune bath lift and the other with a walk-in shower. The radiator in the bathroom does not function properly and the manager stated the bathroom was often cold during the winter. This must be repaired or an alternative source of heat installed. The lounges and dining room have been maintained to a good standard and provide comfortable and pleasant surroundings. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 18 The ground floor toilet has been re-tiled and a new floor fitted. The recommendations from the previous report to replace damaged curtains in the back lounge and dining room and repair or replace one settee in the back lounge have not been acted upon and are re-stated. The humidifier in a one bedroom on the first floor remains in place. It is housed in a metal cage, which appears to be inappropriate in a bedroom setting. The home should investigate a quieter and less visible form of air conditioning to assist in maintaining a comfortable temperature during the summer months. The home was found to be clean and hygienic. Staff have access to disposable gloves, aprons and laundry bags. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by committed staff who demonstrate care and interest in providing the right care. The home has a staff team with sufficient numbers and suitable qualities to meet the needs of service users. A suitable recruitment process supports and safeguards service users. The training, development and supervision of staff, in the main, ensures service user’s needs are met by a well trained and supervised staff team. EVIDENCE: At the time of the inspection there were two carers (one of whom was a locum worker) on duty and this included the deputy manager of the home. A further carer was completing LDAF Induction documents. The manager and a carer were on duty during the morning of the following week. The inspector was able to watch many interactions between staff and service users, and the view was that staff were attentive, competent and caring and placed the needs of the service users as paramount. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 20 There have not been any staff changes or recruitment since the last inspection. There has been a relatively high rate of staff sickness which has been covered largely by locum and some agency staff. The locum member of staff on duty had a good knowledge of the needs of service users and stated that the managers and staff were always willing to answer queries. Staff rotas were viewed which showed that two staff are on duty during the day. Additional staff are available some evenings and occasional weekends. There is one waking night staff on duty during the night. The home has a lone-working risk assessment/procedure. The manager stated there is a clear procedure for staff to follow to locate additional staff if a member of staff phones in sick. A team meeting was being planned and staff discussed issues at a shift handover that would be on the agenda at that meeting. There has not been any staff recruitment during the last year but staff files viewed showed that appropriate recruitment procedures are followed. The manager was aware of the POVA/CRB checks and other procedures required. The deputy manager is undertaking the Registered Managers Award (RMA) at Stroud College. Two staff have NVQs 3 in Care and two staff are due to start their NVQs. Brandon Trust are reviewing the training requirements of their homes across Gloucestershire including mandatory and NVQ training requirements. Training records at the home showed that staff access a range of training including mandatory training. However some staff are over due for refresher courses. Staff booked on courses have had these cancelled as Brandon Trust plan to set up their own in-house mandatory training programme. This must be introduced within a timescale that ensures staff are suitably trained to meet the needs of service users. Staff files viewed showed staff receive recorded supervision sessions; these however have not occurred regularly in recent months for all staff. The manager stated that this has occurred due to her period of absence, and initial part-time return to work, as well as the need to cover shifts on a regular basis. Discussions with staff indicated that they receive sufficient support and supervision to carry out their jobs. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home benefits from a dedicated and committed manager who promotes good care practices and person centred service. Service user’s and their relative’s views and preferences inform the aims of the home and staff practice. The home does not have a formal quality assurance system to evidence some of their consultative work with service users and their relatives. Health and safety monitoring is taken seriously in the home to ensure service users live in a safe environment. EVIDENCE: Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 22 The manager has gained the necessary management qualification (RMA). She has promoted an inclusive style of management which has enabled the staff team to develop in their roles and develop a service user focused approach. The manager was nearing the end of a phased return to full-time time work following a period of sick leave. Management of the home was continued by the deputy manager. It was evident during the inspection that service users have continued to benefit from a well run home during the manager’s absence. The manager acknowledged that issues such as recorded staff supervisions and reviews of care plans have been affected by her absence. Discussions with staff, observation of staff practice and viewing of records showed the home ensure service users’ individual wishes are considered and wherever possible met. Service user’s relatives visit most weekends and the manager ensures to meet with them every two months. The manager stated she will be discussing with the Brandon Trust an appropriate quality assurance/monitoring system to be used at the home. Health and safety aspects of service provision are being maintained and monitored. Records viewed included fire safety checks, water temperatures and servicing of equipment. On the day of the visit a fire safety equipment firm was replacing an emergency lighting bulb. The manager and staff were observed to be continually aware of the specific needs of service users with sensory impairment. Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 24 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 YA9YA6 Regulation 15 12(1)(a) Requirement Timescale for action 31/07/06 2 3 YA35 YA24 Care plans and risk assessments must be reviewed and updated.(timescale of 30/03/06 not met) 18(1)(c)(i) Mandatory staff training must be provided and a plan for this to be produced 23(2)(p) The radiator in the bathroom must be made to function or an alternative heat supply to be supplied in the bathroom 31/07/06 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA26 YA24 YA24 Good Practice Recommendations Review the arrangements for the humidifier in service users bedroom Replace curtains as indicated in this report Replace/repair settee in back lounge Southfield DS0000067087.V291315.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Southfield DS0000067087.V291315.R01.S.doc Version 5.1 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. 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!