Please wait

Please note that the information on this website is now out of date.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

Inspection on 26/06/07 for St Andrews Residential Care Home

Also see our care home review for St Andrews Residential Care Home for more information

This inspection was carried out on 26th June 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.

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

What the care home does well

Encourages service users to participate in the running of the home. Provides a good standard of care for service users. Treats service users with dignity and respect. Provides a safe and homely environment for service users. Has a consistent and dedicated staff team. The service is well managed.

What has improved since the last inspection?

The overall organisation of the care provided and supporting documentation has improved. Staff participation and team cohesion. Encouraging involvement of relatives. Have increased opportunities for service users to participate in activities. Introduction of individualised care plans. Introduction of key worker system. Introduction of one to one staff supervision.

What the care home could do better:

To further improve communal environment. To introduce more activities. To further improve individual care plans. To expand individual risk assessments.

CARE HOMES FOR OLDER PEOPLE St Andrews Residential Care Home 184 London Road Headington Oxford Oxfordshire OX3 9EE Lead Inspector Sally Newman Unannounced Inspection 26th June 2007 10:45 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 St Andrews Residential Care Home DS0000013138.V342971.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. St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Andrews Residential Care Home Address 184 London Road Headington Oxford Oxfordshire OX3 9EE 01865 741752 01865 452705 stephen.longthorp1@btinternet.com 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) St Andrews Residential Care Home Limited Mrs Barbara Dixey Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (23), Old age, not falling within any other category (23) St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 23. 18th May 2006 Date of last inspection Brief Description of the Service: St Andrews is a residential home providing care, support, and accommodation to its residents. The home is registered for 23 residents over the age of 65. The home has 19 single rooms and two double rooms. Eleven bedrooms have the benefit of en suite facilities. The home is situated on the outskirts of Oxford city centre. The home is set back in its own grounds on a busy main route into Oxford. Local shopping and leisure facilities are available and the home has easy access to the city and beyond. The original home has been added to and extended. The garden has recently been landscaped and provides wheelchair access to all parts of the garden. The home is family run and has a homely atmosphere. The home’s fees range from £653.13 to £685.81 per week. St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection that was conducted over the course of three days and included a visit to the home of 4 ½ hours duration. Information provided by the service prior to the visit and data held by the Commission has been used to evaluate this service. In addition, time was spent with the two managers who are currently being considered for registration. Staff on duty were spoken to and three service users were seen by the inspector in private. Surveys were distributed by the service to a range of individuals. Two General Practitioners’ returned surveys, one District Nurse, one Care Manager and three relatives surveys were completed and returned to the Commission. All were very positive and included several comments of praise for the new manager and individual members of staff. Service users spoken to were happy living in home and could not think of any areas that could be improved. A range of records were sampled whilst at the home, a tour of the premises was undertaken and observation of interactions between staff and service users was occurred throughout the course of the visit. The two managers are job sharing and have been in post since January 2007. They have made improvements in a wide range of areas most noticeably with paperwork and supporting documentation. In discussion it was apparent that they are aware of areas still to be addressed and have clear plans to make improvements. Three requirements made at the last inspection have been complied with. One requirement has been made as a result of this inspection that relates to the storage of hazardous chemicals. The provider has a range of polices and procedures relating to equality and diversity. Care plans have been designed to take account of individual needs and cultural and religious choices. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service that meets the needs of individuals of various religious, racial or cultural needs. The Commission has received no complaints about the service since the last inspection and concerns or allegations have come to the notice of the Commission. What the service does well: Encourages service users to participate in the running of the home. Provides a good standard of care for service users. Treats service users with dignity and respect. St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 6 Provides a safe and homely environment for service users. Has a consistent and dedicated staff team. The service is well managed. 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. St Andrews Residential Care Home DS0000013138.V342971.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 St Andrews Residential Care Home DS0000013138.V342971.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): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All service users have their needs appropriately assessed prior to a place being offered. Assessments should be supported by written documentation. EVIDENCE: The files and care plans were seen for the last three service users to have moved into the home. There was evidence of discharge information from hospitals. In discussion with the managers they confirmed that they always visit prospective service users in order to undertaken a full assessment of needs. Currently they do not complete documentation to support these assessments but agreed that this important information should be in written form and available in the home. The information obtained at assessments is used as the basis of the care plans that are currently drawn up by one of either of the managers. There are plans St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 9 to compile comprehensive histories where possible for all service users to include details of previous interests, occupations and hobbies. St Andrews Residential Care Home DS0000013138.V342971.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are set out in an individual care plan and their health needs are fully met. Service users are protected by the home’s policies and procedures for medication and they are treated with respect. EVIDENCE: Individual care plans have been developing under the guidance of the new management. The managers acknowledge that further work is still required, however, the current level of information held is sufficient to provide appropriate care to meet the needs of individual service users. A key worker system has now been introduced and staff are being supported to become more involved with the completion of documentation. Care tasks are allocated on a daily basis and for those staff spoken to this represents an improvement in the overall organisation of the care provided. The health care needs of service users’ is closely monitored. It was apparent from talking to the managers and staff that the health needs of individual St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 11 service users is well understood. Health care appointments could be better recorded in care plans. Surveys from two GP’s and a District Nurse were very positive and included comments such as “an excellent home with bright, friendly staff who are dedicated to the well being of their residents”, “Excellent caring environment” and “Provides a homely environment, good food and individualised care. One of the best residential homes we see as a District Nursing Team”. In addition a Care Manager responded by stating, “Meets individual needs, responds to relatives and mental health team and senior team are helpful and keep me informed. The deputy manager provided an overview of the arrangements for medication. Checking and signing processes were robust and no errors were identified in those MARs sheets seen. Information on each service users medication including condition prescribed for and possible side effects was in the process of being introduced for all service users. One service user currently self medicates two over the counter medicines. It was noted that this service user did not have a lockable space in her room in which to keep this medication. A lockable storage box was identified and made available during the course of the visit. The home enjoys a positive and supportive relationship with the local Pharmacist who visits the home regularly and provides advice. This Pharmacist had recently provided training for staff in the home and there are plans to repeat this on a periodic basis. In discussion with the managers and from information supplied by them they confirmed that service users are treated with respect and dignity and their right to privacy is safeguarded. Staff were observed to knock on service users bedroom doors before entering and interactions seen were warm, friendly and caring. A District Nurse commented in a survey that “privacy and dignity are given a high priority” and a visitor to the home stated in a survey that “residents are treated with respect and are spoken to politely”. St Andrews Residential Care Home DS0000013138.V342971.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ lifestyle in the home mostly matches their expectations and preferences. They are supported to maintain contact with significant others and are encouraged to exercise choice and control over their lives. The meals are wholesome and enjoyed by service users. EVIDENCE: Evidence was obtained from discussion with the managers, staff and service users, from feedback from surveys and from information provided by the service prior to the visit. The service under the guidance of the new managers is improving the lifestyle of service users by gathering more information about their social histories and identifying past interests and hobbies. There is now a dedicated activities organiser who has introduced regular activities such as music and exercise sessions, arts and crafts and growing seeds. This is a developing role and the post holder informed the inspector that there are plans for her to meet with other activity leaders to provide education and ideas. Where possible service users are taken to local shops and for walks with staff support. The service St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 13 plans to introduce more entertainment in the home and to arrange some summer outings. A large screen television will be purchased when funds allow. Two service users spoken to said they preferred to stay in their rooms and were not really interested in going out of the home. There are no restrictions on times for visitors to go to the home. Service users spoken to described visits from their relatives that they looked forward to. Relatives’ surveys indicated that they are made to feel welcome when visiting the home. The service promotes contact with relatives and since in post the managers have written to all relatives to inform them of the changes to management and to reinforce their commitment to work with relatives and to welcome their involvement. The cook confirmed that the meals are prepared freshly with a good range of fresh vegetables being provided at each meal. Fresh fruit is always available and was in evidence in the lounge. Service users can choose what breakfast they would like and whether it is served in their rooms. This was confirmed by one service user who stated that she almost always enjoyed a fried egg for breakfast, which was served in her room. One main meal is prepared each day but any service user can choose an alternative. The cook confirmed that the likes and dislikes of individual service users’ are well known but suggestions for meals, is actively and regularly sought. Fridge and freezer temperature checks are regularly taken and recorded. The service must ensure that this continues when the cook is on holiday. The food safety practices in the home were inspected by the Environment Health dept in February 2007 and were found to be of a high standard. St Andrews Residential Care Home DS0000013138.V342971.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are listened to and acted upon and service users are protected from abuse. EVIDENCE: The new managers have welcomed comments and concerns from staff, service users and relatives. They have written to all interested parties in an attempt to obtain feedback about the home and have demonstrated a willingness to address issues promptly. There have been no formal complaints made to the home since the last inspection and no complaints or concerns has been received by the Commission. Relatives’ surveys indicated that all concerns raised had been dealt with appropriately although one survey did indicate that the formal complaints procedure was not known. A copy of the complaints procedure has been made available in the reception together with a comments book for all visitors to home. The management have introduced guidance notes for relatives and service users should they become concerned about protection matters. In discussion with management and staff there was clarity about the action to be taken should a concern or allegation of abuse be made. Both managers are in the process of identifying protection of vulnerable adults training for themselves and of the 16 care staff employed 7 have achieved at least NVQ 2 St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 15 qualifications where POVA issues are addressed and a further 3 are currently undertaking training. St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 16 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and well-maintained environment that is kept clean, pleasant and hygienic. EVIDENCE: All areas seen of the home were clean and hygienic. The home uses a regular maintenance man who makes repairs and improvements when required. There are plans for refurbishment of the lounge if a grant application from the Local Council proves to be successful. The home benefits from dedicated cleaning staff who were observed about the home during the course of the visit. The managers informed the inspector that there are plans to improve the facilities in the home to provide a wet room for those service users unable to use a bath. Some new furniture has been purchased and provision for storage in some bedrooms has been improved. St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 17 It was noted that one bedroom door was not closing properly and should be subject to maintenance without delay. Laundry facilities were seen and although small were functional with separate storage of each service users’ clothes. It was noted that this room is not locked although cleaning chemicals are stored within the area. The security of the room must be reviewed in consultation with the Environmental Health Dept to ensure that service users cannot access the room and expose themselves to risk. Hot water outlets are checked on a weekly basis. St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 18 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are met by appropriate numbers of staff, who are trained and competent and their jobs. Service users are in safe hands and are protected by the home’s recruitment policy and practices. EVIDENCE: Staff were observed going about their duties in a calm and professional manner. There were sufficient staff on duty to meet the needs of service users. The home has a low staff turnover with low rates of sickness. The service does not use agency staff and covers any shortfalls by the use of overtime. At night there is one waking night staff with one member of staff sleeping in. This was considered by the manager to be currently sufficient to meet the needs of service users. All staff are encouraged to undertaken training including NVQ qualifications. 7 staff have already achieved at least an NVQ 2 and a further 3 are working towards an NVQ 2 qualification. The home has not employed any new staff since the last inspection. Three files were seen, two of which were for very longstanding staff. There were required documents missing from these files but it was not practical to obtain this information considering the passage of time. The application form does St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 19 not ask for a full employment history and the health declaration is insufficient. The managers undertook to review the current application form to ensure that it is compliant with the regulations and obtains appropriate information in sufficient detail. The inspector was informed that future practice will include a follow up telephone call to references to ensure authenticity of referees and to obtain additional information. The current management have introduced formal one to one supervision and they intend providing annual appraisals for all staff. In addition, regular staff meetings have been introduced and have resulted in lively discussions and the sharing of views. It is the intention of the managers to develop individual staff and to encourage attendance at training identified with the Social Service dept. All staff have been allocated a particular area of responsibility within the home and this was reported as working well. Survey results indicated that staff are well regarded and were described as bright, friendly and dedicated. In addition a health care professional considered staff to have good communication skills and considerable patience. One relative name several staff with whom he was particularly impressed. St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 20 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, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and is run in the best interests of service users. Service users’ financial interests are safeguarded and their health, safety and welfare and that of the staff are promoted and protected. EVIDENCE: The two managers job share and are currently in the process of registration. They are both qualified nurses with considerable experience. There were clear indications that they had made a positive impact on the running of the home and the arrangement was working well. The organisation of the home including record keeping has improved and is continuing to develop. There are plans to maintain records electronically and make them accessible to all staff. All policies and procedures have been reviewed and the majority have been St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 21 implemented in final form. There has been a concerted effort to involve staff and service users in the running of the home and communication was described as good by those staff spoken to. Survey results indicated that the managers were professional and well regarded. The management have already undertaken a wide scale exercise to seek the views of a range of professionals, service users, relatives and staff. The results have been acted upon and consideration should be given to incorporating the outcome and conclusion of surveys into an annual development plan for the home. The home does not hold money for any service users. Petty cash is used to purchase small items should service users need them and they are then invoiced directly. A range of health and safety records and checks were seen. A fire risk assessment is in place and regular testing of the fire warning system is undertaken. Portable appliance testing is undertaken and the electrical installation has been checked. Equipment servicing is undertaken according to manufacturers instructions. Risk assessments for the home were not seen but should be undertaken for all hazards identified throughout the home. St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 22 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 X X 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 3 X 3 X 3 X X 3 St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23 (4) Requirement To seek the advice of the Fire Authority as to the appropriateness of the fire safety systems in the home. Timescale for action 16/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 St Andrews Residential Care Home DS0000013138.V342971.R01.S.doc Version 5.2 Page 25 - 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!