Inspection on 26/05/06 for Sunrise Care Home

This inspection was carried out on 26th May 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 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

Sunrise Care Home 11/09/07

Sunrise Care Home 12/01/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Sunrise Care Home 10 Amen Place Little Addington Kettering Northants NN14 4AU Lead Inspector Mrs Kathy Jones Unannounced Inspection 26th May 2006 12:00 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 Sunrise Care Home DS0000065878.V294090.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 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. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sunrise Care Home Address 10 Amen Place Little Addington Kettering Northants NN14 4AU 01933 650794 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) Le Flamboyant Limited Vacant Care Home 20 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (10) of places Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The total number of residents must not exceed 20 No residents within the category of DE(E) (dementia) may be admitted to the home where there are already 10 such residents. No residents within the category of OP (Older People) may be admitted to the home where there are already 10 such residents. The 4 existing residents within the category of PD(E) (physical disability) may remain in the home. The 1 existing resident within the category of MD (mental disorder) may remain in the home. 12th January 2006 Date of last inspection Brief Description of the Service: Sunrise is a residential home registered to provide care for twenty older people over the age of 65 including up to ten older people with dementia. Four residents with a physical disability and one with a mental disorder living in the home at the time of registration are able to continue living in the home while their needs can be met. The home is owned by Le Flamboyant Ltd and situated in the village of Little Addington in East Northamptonshire. The premises consist of a detached house which has had an extension built on. There are eighteen single bedrooms and one double. All bedrooms except one are located on the ground floor and eight have en-suite toilets. Access to the first floor bedroom is via the stairs and would require good mobility. The home has a garden, which is accessible to residents’, with views over the local countryside. The home is easily accessible by car; however there is no public transport to the village and access, without a car would be by public transport to Irthlingborough followed by a taxi to the village. The following information about fees was provided as being current at the time of completion of the pre-inspection questionnaire on 3 May 2006: Fees per week range between £319 and £ 375 dependent on the needs of the resident. The fees include personal care, accommodation and meals. Chiropody and hairdressing services can be arranged and are charged separately. Other costs would include clothing and toiletries. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 5 Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. All standards identified as ‘key’ standards and highlighted through the report were inspected with the exception of standard 31, which relates to the qualifications and experience of the registered manager. This standard was not assessed, as there is no registered manager in post however the adequacy of the current management arrangements has been commented on. The key standards are those considered by the Commission to have a particular impact on outcomes for residents. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered. The review of evidence and pre-inspection planning was carried out over the period of one day and involved reviewing the report of the inspection carried out in January 2006, reviewing the service history which details all contact with the home including notifications of events reported by the home and telephone calls received. A pre-inspection questionnaire submitted by the home and five comment cards from residents’ and eight from relatives’ were also reviewed. The information gathered assisted with planning the particular areas to be inspected during the visit. The unannounced inspection visit covered the lunch time period and the afternoon of weekday. The inspection consisted of talking to residents, staff, the responsible individual and the deputy manager. Observations were made of residents’ general well being, daily routines and interactions between staff and residents. A sample of residents care records were reviewed to check how residents’ care and health needs were being assessed and how their care was planned and supported. The management of residents’ medication and monies were reviewed. Staff training was discussed with staff and two files for newly recruited staff were reviewed to check the adequacy of the recruitment process. Communal areas and a sample of residents’ bedrooms were viewed and plans for improvements to the premises were discussed with the responsible individual. Feedback on the inspection findings was given to the responsible individual and the deputy manager throughout the inspection visit. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 7 What the service does well: What has improved since the last inspection? Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 8 The last inspection was carried out just a few weeks after the new owners had taken over the home. At that time they had identified some areas for development, which included improved records to assess and plan residents care, staff training and supervision and some redecoration and refurbishment of the premises. A marked improvement in the assessment and planning of residents’ care was found. Staff training needs have been reviewed and training provided. Five staff have been enrolled on a National Vocational Qualification course and a new recruit is being supported to complete the qualification. Some re-decoration has been carried out. As advised at the last inspection all staff employed including family members are now recorded on the staff rota. 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. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 9 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 Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, Std 6 is not applicable, as the home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The admission process provides assurances that the needs of Residents entering the home can be met. EVIDENCE: The home has a statement of purpose, which provides prospective residents, and their families with information about the home, the services they provide and the people they are able to care for. Prospective residents’ are encouraged to visit the home prior to admission in order that they can make an informed choice about moving in. There is an initial trial period of one month, which allows time for the resident and their families and the home to decide if it is the right home for the resident. Residents’ needs are assessed prior to being offered a place in the home to ensure as far as possible that their needs can be met. Review of the Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 11 assessment documentation for a recently admitted resident confirmed that this is a thorough process, which provides a good basis for the provision of care. The assessment consists of gathering detailed information from residents’, their families, and where applicable placing authorities and relevant health professionals regarding the residents’ needs and preferences. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Residents receive a good standard of care and support, they are treated with respect and their care and health needs are closely monitored. EVIDENCE: Comments received during the inspection and in comment cards from residents’ and relatives are very complimentary about the care provided by the new owners and staff with one relative rating the emotional and physical care as 10 out of 10. There is a comprehensive assessment in place for each resident, which identifies his or her past and present care and health needs. This document provides a good basis for planning residents’ care. Care plans provide staff with a good level of information about the actions they need to take to meet residents’ care needs. For example there were details of a residents’ preferred morning routine which included the time they liked to Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 13 get up and what assistance they needed with personal care. The care plans are reviewed regularly and relatives are kept informed of residents’ changing needs. This was confirmed in comment cards received from relatives. Advice was given to ensure instructions in care plans give specific instruction to staff to avoid the risk of error and to avoid the use of words such as ‘regular’. This had been used in connection with the monitoring of residents’ blood sugar levels. In spite of this ambiguity the record of checks on blood sugar levels confirmed that they were monitored sufficiently to maintain stability and staff were clear about the expectations. Residents’ are treated very much as individuals and their care and support needs are carefully assessed and monitored. The emphasis is on helping residents’ to retain as much independence as possible. For example some temporary signage had been put in place to assist a new resident with finding there way independently to their bedroom. Residents’ health is carefully monitored and health care services such as general practitioner, district nurse, diabetic nurse, community psychiatric nurse and chiropody services are accessed appropriately on behalf of residents’. Discussion with staff and observations confirmed that they have a good understanding of residents’ individual needs and personalities. Staff were calm, friendly and very caring in their approach and spoke of and treated residents with respect. A sample check of the medication system confirmed that medication is generally well managed however a discrepancy was found which was immediately investigated and addressed. Discussion about the recent death of a resident highlighted that where a residents needs can continue to be met in the home every effort is made to allow a resident who becomes ill to remain in the home. Families are kept fully informed, and are supported and encouraged to spend as much time as they wish with the resident. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. 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 all the available evidence including a visit to the service. The routines of the home provide Residents with choice, flexibility and stimulation. EVIDENCE: The routines of the home are flexible and take account of individual preferences. One resident said she has always been an early riser and continues with these routines. There is a plan of activities, which is flexible and altered according to preferences on the day. On the afternoon of the inspection some residents’ were involved in playing a large snakes and ladders game. There was some discussion about the music that was playing and this was changed at the request of a resident. Later in the afternoon residents’ were taking up the offer of staff painting their nails which also provided opportunities for one to one conversations. Throughout the inspection it was noted that staff were talking to residents rather than just to each other. A staff member also commented that there was more interaction between residents’ since some new residents’ had been admitted. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 15 Two residents talked about trips out where they had been out with one of the directors. One resident had been to the local pub and played pool. A member of staff said that they had identified that a new resident liked to be involved in some of the household tasks such as clearing tables and polishing, so small tasks were arranged for her. There is a Church of England service in the home once a month and residents’ choose whether to join in. At the present time there are no residents’ with other religions and all residents’ are White British. Visiting arrangements are flexible and eight comment cards from relatives all confirm that they are welcomed into the home and can visit their relative in private if wished. Residents are able to bring personal possessions into the home. Their rights are respected and contact with advocacy services made where necessary. Of the five comment cards received from residents’ two always like the meals, two usually do and one does sometimes. One comment card said the food had improved. The meal on the day of the inspection was fish, chips and mushy peas. It was freshly cooked and nicely presented and those spoken to had enjoyed it. Sample menus seen identify variety and choice. A two course meal is provided at lunch time with a choice of main course. On most days there is a choice of hot snacks at tea time and a resident said that you can have supper if you want it. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 16 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 inspected at least once during a 12 month period. 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 all the available evidence including a visit to the service. The home has procedures for dealing with concerns and complaints which residents and relatives are aware of and staff are aware of their responsibilities for protecting the people in their care. EVIDENCE: The Commission for Social Care Inspection have received no complaints about the service since the last inspection. The pre-inspection questionnaire identifies that no complaints have been received by the home. The home has a complaints procedure, which six out of eight relatives confirmed they are aware of. Residents were aware of who they could speak to if they were unhappy. Staff have received training in the protection of vulnerable adults. Discussion with staff confirmed that they were aware of their responsibilities in reporting any concerns that they may have. Staff spoken to had no concerns about how residents’ were being cared for or treated. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 26 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Residents have a clean and comfortable home to live in and appropriate action is being taken by the new owners in considering required improvements. EVIDENCE: The home is located in a residential area and backs onto open fields. The premises consist of a detached house which has had an extension built on. Communal areas consist of a large lounge with a dining area. Re-decoration of these areas has taken place in consultation with residents’ regarding the colour scheme. Rooms were clean and comfortable. There was a ridge in the lounge carpet where it appeared to have stretched following recent cleaning. The responsible individual confirmed that he would address this to minimise the risk to residents’ of tripping. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 18 All bedrooms except one are located on the ground floor and eight have ensuite toilets. 18 bedrooms are single and one a double. Access to the first floor bedroom is via the stairs and would therefore require good mobility. A sample check of residents’ rooms confirmed that they are comfortable and clean and residents’ are able to bring their personal possessions into the home. The pre-inspection questionnaire identifies that relevant checks and servicing of equipment has been carried out. Since the last inspection radiator covers have been fitted to radiators where a risk to residents’ of burning has been identified. Since the current owners of the home took over in December 2005 they have reviewed the requirements of the home and are considering various improvements in order to improve the facilities for residents’. Improvements discussed were the possible provision of another lounge and the conversion of a bathroom, which does not meet the needs of current residents’ into a walk in shower room and toilet. A cleaner is employed in the home and a good standard of cleanliness was found in all areas of the home inspected. There were no unpleasant odours in the home and comments received from residents’ confirm that this is always the case. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. 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 all the available evidence including a visit to the service. Staffing levels, recruitment procedures and the commitment to staff training, provide good care and protection for residents’. EVIDENCE: Observations and discussions with residents’ and staff confirmed that there are enough staff to meet the needs of the residents’. Comment cards from residents indicate that this is usually the case. Staff on duty appeared competent and to have a good understanding of residents’ needs. The home has recently admitted residents’ with dementia and a staff member confirmed that training and support has been provided to assist with meeting these additional needs. A programme of staff training has been implemented and a member of staff who has wanted to start a National Vocational Qualification (NVQ) for some time was pleased that the new owners have arranged this. Although no staff have an NVQ at present six staff are undertaking the course. Training to meet the needs of residents’ has included induction and foundation training, first aid, movement and handling, protection of vulnerable adults and Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 20 dementia. The deputy manager is arranging for certificates to confirm attendance at the recent courses to be added to staff files. A sample check of staff records confirmed that references and criminal record bureau clearances are taken up as part of the recruitment process and interviews are held. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 38 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The home is managed in the best interests of the residents’. EVIDENCE: Standard 31, which is one of the key standards, has not been assessed, as the home does not currently have a registered manager. At the present time the responsible individual who is a registered manager for a care home in Northampton is undertaking the management responsibilities with support from a deputy. The deputy manager is currently working towards a National Vocational Qualification at level 4 in Management. The home is being managed in a way that promotes residents’ interests and there is no evidence Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 22 that the temporary management arrangements are having any adverse impact on them. Elements of a quality assurance system are in place. The responsible individual carries out a monthly review of various aspects of the service and produces a report. From discussion it is clear that a lot of positive feedback has been received from relatives (this has been confirmed by comments forwarded to CSCI). The responsible individual also said that positive comments have been received from health professionals. Questionnaires are sent out to relatives periodically requesting feedback on the quality of care. At the time of inspection the home had only been in operation under the present owners for six months. However there was evidence of ongoing review and monitoring of the service and the responsible individual intends to have for both of his homes an annual development plan based on review and feedback received. Where residents’ are not able to manage their money, a small amount is held on their behalf to pay for items such as chiropody and hairdressing. Records are kept of all transactions and can be cross referenced to receipts. At the time of the inspection all of the money was held in one ‘pot’ however following discussion this is being changed to ensure all individual residents’ monies are held and can be accounted for separately. Action is taken to protect the health and safety of residents’ for example staff training, review and monitoring of the premises and staff training. Sunrise Care Home DS0000065878.V294090.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP21 OP28 Good Practice Recommendations Planned improvements to the bathroom and toilet facilities should be implemented to meet resident’s needs. The staff training programme should be completed to ensure staff have at least a basic knowledge of the needs of the resident group. Sunrise Care Home DS0000065878.V294090.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Aylesbury Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury Buckinghamshire HP19 8JR 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 Sunrise Care Home DS0000065878.V294090.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!