Inspection on 04/07/05 for St George`s Care Centre

This inspection was carried out on 4th 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

St George`s Care Centre 18/03/09

St George`s Care Centre 06/12/06

St George`s Care Centre 07/11/05

St George`s Care Centre 23/09/04

St George`s Care Centre 22/04/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Stoneygate Ashlands Ratcliffe Road Leicester Leicestershire LE2 3TE Lead Inspector Fiona Stephenson Unannounced 4th July 2005 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 Older People and 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. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stoneygate Ashlands Address Ratcliffe Road, Leicester, LE2 3TE 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) 0116 244 8624 Prime Life Limited Mrs Diane Smith Care Home 40 Category(ies) of OP Old Age(40) registration, with number PD Physical Disability(40) of places PD(E) Physical Disability - over 65(40) Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23/09/2004 Brief Description of the Service: Stoneygate Ashlands is a 40-bedded home for up to forty older people, some of whom have physical disabilities. The home is a two-storey, purpose-built building and is situated in a quiet residential area of Stoneygate, Leicester. It is set in extensive grounds, surrounded by lawns and mature trees. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on Monday 4th July 2005. The inspection lasted 6.5 hours and was conducted by one inspector. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for residents and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they received through looking at their records, talking with them and their relatives where possible, talking to care staff, and observing parts of the home they use. Nine service user comment cards, three relatives comment cards, and one general practitioner comment card were also checked. The requirements and recommendations requested are a direct result of the evidence gathered from the four residents who were case tracked, and observations of the inspector. What the service does well: What has improved since the last inspection? Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 6 The lunch menu 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 Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 7 contacting your local CSCI office. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 There are good needs assessments in place. EVIDENCE: The inspector checked the assessments and care plans of 4 people living in the home. The records showed that the needs of residents are well documented on arrival at the home. The care records demonstrate that their basic care needs are being met. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The health and personal care of residents are on the whole, met sufficiently. EVIDENCE: Care records have an individual plan of care that is updated monthly. The dental and optical needs of residents are also being routinely checked. The new resident who was ‘case tracked’ informed the Inspector that he had already had his dentures checked because he reported them as being ill fitting. The inspector noted that staff are using the same pot of cream when supporting Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 11 different residents with personal care, instead of using cream specifically prescribed to the individual resident. Staff were observed to knock on residents doors before entering their bedrooms, and to talk to residents in a courteous manner. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with asssistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Generally, residents have sufficient choice in their daily life and social activities. EVIDENCE: Residents informed the inspector of the trips available to them. One resident said she had been on a trip to Anstey and had a pub meal there which she enjoyed, she also said she was going on a holiday to Butlins which had been organised by staff at Prime Life. She said she would like to have more Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 13 activities in the home ‘there’s not much inside the home, the reason being, not enough staff’. She said she would like more bingo; sing songs and quizzes and spoke of a time where a member of staff had done some memory work with them, which she enjoyed. The inspector was also informed that about four trips a month are available to residents, and this was supported by an information leaflet on the wall, and photos of residents who have been on the trips. Another resident spoken with whose care plan indicated he wanted to stay in bed every day, supported the care plan informing me that he was quite happy in his room ‘ I have my own independence in my own room here, better than if I were in hospital’. Of the nine service user comment cards received, four said they did not like the food, or only liked it sometimes. At the time of inspection the food sent by the company’s central kitchen arrived burned, and there was no choice available. Whilst waiting for the staff to make alternative provisions for residents, two residents said that whilst the food was improving, it still was sometimes not warm enough. Two of the residents case tracked were satisfied with the food one saying ‘Lunch was magnificent today, despite it being late…the food is excellent, more than you need. such variety and well cooked’. Residents informed the inspector that visitors could come to the home at any time during the day and evening. Residents with lower dependency needs were observed to exercise choice and control, and one, for example, was spoken with on his return from seeing friends at the pub. The choice and control for residents with higher dependency needs is more limited. Through observation and discussion with staff and management, it was noted that staff have to organise residents around their tasks to enable care to be given; for example, the inspector was informed by residents and the manager that there is limited choice regarding bedtimes because the staff do not have time to support residents in going to bed at the time of their choosing, due to the number of tasks they have to do. One case tracked resident said ‘at 8.30pm they give you tablets, and from then on you wait to be taken to bed, last night we waited over an hour before we got taken, and then sometimes you have to wait again to get ready for bed’. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) not checked EVIDENCE: Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,23,24,25,26 Residents live in a homely environment, which generally has satisfactory standards of safety, cleanliness and hygiene EVIDENCE: The inspector checked the individual bedrooms of residents who were being case tracked, and the areas of the home they would use. The bedrooms were found to be on the whole in a clean and pleasant condition, with the personal possessions of residents within. However, in one bedroom the inspector found Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 16 a lot of clutter and dust had accumulated behind a dressing table, and in the same room there were three bedside tables. On asking the resident who lived in the room, she said she didn’t know why she had three. These reduced the amount of space available to her, and one was not being used. The wheelchair used by this resident was also found to be in need of repair. The shower room, bathrooms and toilets used by residents case tracked were also checked. These were not sufficiently clean. The manager, who was with the inspector at the time of checking these areas, was in agreement that they were not cleaned to a sufficient standard. The ground floor shower room had two shower chairs, one that was in poor condition, this was taken away at the time of inspection leaving the newer one in the room. The manager informed the inspector that contract cleaners were responsible for areas identified, and asked a member of staff on duty the day of inspection to clean areas identified. The inspector also noted in another room that there were two wheelchair pedals when the resident living in the room did not use a wheelchair. In another bedroom of a resident case tracked, the inspector found the sheets to have faeces stains on them. The manager said that the resident made her own bed, but that staff had not checked the bed to ensure sheets were clean. The communal living and dining areas were in a good state of cleanliness. The second floor shower room is very rarely used as it is a step-in shower cubicle and not suitable for the majority of residents living at Ashlands. It is recommended that a walk in shower replace the shower cubicle located on the first floor, which is not used due to it’s unsuitability for the service user Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 Staff work hard and are aware of their roles and responsibilities, however there are insufficient staff to support the needs of all residents in the home. EVIDENCE: The inspector observed staff to be working hard to cover the general duties expected of them, this included bed making, laundry duty, and meal times. The inspector was also informed that from 8.00am to 8.45 four of the five members of staff are needed to cover breakfast time, with the fifth member of staff undertaking medication. At 10.00 two members of staff are on bed duty and tidying rooms, and this can take between one to one and a half hours. One staff member will put clothes away and the inspector was informed that this can take an hour. Two residents case tracked were not happy with the level of staffing, one resident case tracked was satisfied with staffing, however his dependency on staff is lower, and the fourth resident was not able to be spoken with on the day of inspection. One who was unhappy with staffing said ‘by the end of the Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 18 day, staff can get a bit irritable because they are so overworked’; the other said ‘there should be more staff on duty both on nights and days’. He said that although he didn’t want to use his wheelchair, he would be concerned about falling out of it, as he would need to members of staff to get him back in it, and would be concerned about the length of time it would take for staff to get to him. All residents spoken with who were case tracked knew who their key worker was and had good things to say about them. ‘I get on very well with Saul…Saul knows my needs’; ‘Sharon is lovely..she’s a special one’. The inspector checked the records for a new member of staff and found the recruitment practices to be compliant with the standards. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s polies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 33, 35 and 38 (Older People) and Standards 23, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,38 The home is satisfactorily managed, with the manager promoting the well being of residents to the best of her ability and resources. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 20 EVIDENCE: The manager acknowledged the concerns expressed by staff and residents regarding staffing. She informed the inspector that concerns about the level of, and deployment of staff had been discussed with senior management of the organisation. Her staff team demonstrated satisfaction with her management ‘ I feel very supported by Diane’…I get supervision when she has the chance, and regular supervision from a senior’. All staff spoken to were in agreement that they have good training opportunities. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 3 4 x 5 x 6 x HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 3 3 2 3 3 3 2 Score Standard No 7 8 9 10 11 Score 3 x 2 3 x Standard No 27 28 29 30 2 3 3 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score x x x MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 x 34 x 35 x 36 x 37 x 38 x Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 22 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 27,14 Regulation 18 Requirement The organisation is to review the current levels of staff, and the deployment of staff to ensure the needs of higher dependency residents are sufficiently supported during the day and night. Ensure that when staff administer creams to residents, they are creams prescribed specifically for the individual resident concerned. Timescale for action 04/09/05 2. 9 13 13/07/052 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. Refer to Standard 12 26 21 22 Good Practice Recommendations Support staff in giving them sufficient time to engage with residents in social and recreational activities within the home. Monitor the cleanliness of the communal bathrooms, shower room and toilet areas, and discuss issues addressed at the inspection with the contract cleaners. Consider converting the first floor shower room from a step-in shower facility to a walk-in shower room. Monitor the condition of wheelchairs used by residents to C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 23 Stoneygate Ashlands ensure they continue to be in safe working conditions. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 Page 24 Commission for Social Care Inspection The Pavilions 5 Smith Way, Grove Park Enderby, Leicestershire LE19 1SX 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. Stoneygate Ashlands C51 C01 S6446 Stoneygate Ashlands V230091 070705 STAGE 4.doc Version 1.40 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. 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