Inspection on 04/10/07 for The Grange Rest Home

This inspection was carried out on 4th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Grange Rest Home 24/05/06

The Grange Rest Home 15/09/05

The Grange Rest Home 21/04/05

The Grange Rest Home 19/10/04

The Grange Rest Home 22/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Grange Rest Home 11 Sackville Gardens Hove East Sussex BN3 4GJ Lead Inspector Nigel Thompson Key Unannounced Inspection 4th October 2007 09:30 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 The Grange Rest Home DS0000014251.V348819.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. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Rest Home Address 11 Sackville Gardens Hove East Sussex BN3 4GJ 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) 01273 298746 suzanne.leahy@ntlbusiness.com The Grange Rest Home Limited Mrs Suzanne Leahy Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of residents to be accommodated is 26. The residents will be aged 65 years or over on admission. 24th May 2006 Date of last inspection Brief Description of the Service: The Grange Rest home is situated in a residential road close to Hove seafront. It is registered for twenty six residents who are older people aged over sixtyfive years. Since 1989 the home has been privately owned. The building is Victorian and has been extended. There is a small garden at the rear that has a conservatory and paved area for residents and their visitors to use. Internally the building is spread over three floors with a passenger lift servicing each level. The first floor is split levelled with a few steps linking the residents’ accommodation. There are twenty -five single bedrooms, eleven of which have full en suite facilities. On the ground floor is a shared dining room close to the kitchen, and two sitting rooms. The front of the home is paved to enable visitors to park, however there is onstreet parking and meter parking on the seafront. The pavements are suitable for residents who require a wheelchair. The home is close to the shopping area of Hove and all amenities including Hove Museum that has a teashop, the local library and Sussex County Cricket Ground. Information about the service, including the recently updated Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective residents or their relatives, on request, as part of the admission process. The current range of fees at The Grange, as of 4 October 2007, is £305 - £450 per week. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five and a half hours in October 2007. It found that the majority of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was satisfactory. Residents spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were twenty six residents living at the home. The inspection involved a tour of the premises, examination of the homes records and discussion with seven residents, three relatives, the manager and three members of staff. The focus of the inspection was on the quality of life for people who live at the home. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. What the service does well: The relaxed, homely and welcoming environment has evolved over many years and reflects the stability and commitment within the staff team and the open and inclusive management style. Through working closely, sensitively and consistently with the residents, staff have developed a sound understanding of their individual care and support needs. Residents are encouraged and supported to maintain links with their family and make decisions about their lives. Where appropriate and practicable, they are involved and regularly consulted on many aspects of life in the home, including menu planning, colour schemes and activities. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 6 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 Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 7 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. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 8 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 The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The thorough admission policy and procedure ensures that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents have the opportunity to visit the home and know that it is able to meet their individual care and support needs. EVIDENCE: Information for prospective residents, including the Statement of Purpose and the Service User Guide has been thoughtfully and imaginatively produced to a high standard and both documents were found to be comprehensive and informative. It was noted that details had been most recently reviewed and updated in March 2007, so as to accurately reflect the services provided and the current situation within the home. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 10 Documentation, including comprehensive Social Care Assessments and full care needs assessments, relating to two most recent admissions to the home was inspected and found to be generally up to date and well maintained. As part of the admission procedure, the manager confirmed that prospective residents are invited to visit the home, to look around and meet with staff and existing residents. They also have the opportunity to stay overnight before moving in. A four week trial period enables both ‘parties’ to establish suitability and the level of compatibility with other residents A formal written contract has been developed and implemented and is routinely provided to each new resident or their representative, incorporating a statement of terms and conditions of residency. The manager confirmed that Intermediate Care is not provided at The Grange. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 11 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. Care plans are in place enabling staff to meet the assessed needs of residents in a structured and consistent manner. Residents are protected by the home’s medication policies and procedures. They are treated with respect and encouraged to make decisions about their day-to-day living. EVIDENCE: The home operates an effective key-worker system. Personal care plans are in place for the majority of residents and are clearly and directly linked to the individual’s assessed needs. However it was noted that no care plan had been developed for one resident, admitted to the home more than a week previously. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 12 The manager confirmed that residents or their relatives are involved or have the opportunity to be involved, in developing or reviewing their personal care plan. However, this was not supported in plans that were examined, where there was no documentary evidence that residents, or their representative, have been involved in developing their individual care plan or in the reviewing process. This was further supported by residents’ relatives, spoken with during the inspection: ‘To be honest we don’t know what’s in the care plan but we couldn’t be happier with the care that she receives.’ All residents are registered with local GPs and have access to other health care professionals, including District Nurses and physiotherapists, as required, via the surgeries. All appointments with, or visits by, health care professionals are appropriately recorded. Policies and procedures are in place for the control, storage, safe administering and recording of medication. The manager confirmed that all staff involved in administering medicines receive appropriate training. This was supported by documentary evidence and through discussions with care staff. As part of their induction programme, all staff receive instruction on the principles of dignity and respect. This was evident, through discussion during the inspection, and from direct observation of staff interacting with residents in a sensitive and professional manner. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 13 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. Residents are enabled and supported to maintain contact with family and friends as they wish. They benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: Residents’ social and recreational interests and preferences are identified and recorded in their individual care plan, as part of the pre admission assessment process. This information evidently forms the basis of a weekly programme of recreational and leisure activities that has been developed, since the previous inspection, and is displayed in the dining room. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 14 Independence continues to be promoted and encouraged within the home and the manager confirmed that, wherever possible, residents are enabled and supported to make choices and take decisions affecting their life and daily routines. The manager confirmed that family links are actively encouraged and supported. Visiting in the home is unrestricted and residents may see friends or relatives in the lounge or in the privacy of their own room. This was evidenced through discussion with residents’ relatives, spoken with during he inspection: ‘We are always made to feel so welcome whenever we come to see mum and usually we are offered a cup of tea as soon as we arrive.’ Residents continue to be provided with a varied, wholesome and nutritious diet. At lunchtime a choice of meals is available and special diets are catered for. A four-week rolling menu has been developed, reflecting individual preferences and including seasonal variations. The cook has worked at the home for just under a year and is clearly very popular with residents. Positive comments received during an enjoyable lunchtime, in good company, indicated a high degree of satisfaction with the standard of meals provided: ‘The food is always good here and he (the cook) is excellent.’ ‘We are all very satisfied with the food’. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 15 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. The open and inclusive atmosphere within the home enables residents, staff and visitors to express any concerns, confident that they will be listened to and acted upon. Residents are safeguarded from abuse through relevant staff training and satisfactory policies and procedures. EVIDENCE: The manager continues to operate an ‘open door’ policy and is clearly considered to be very approachable and understanding. Residents and members of staff spoken to during the inspection confirmed that, should they have a concern or complaint, they would have no hesitation in speaking to the manager and each person was confident that they would be listened to. The home’s complaints policy and procedure were examined and found to be satisfactory. It was noted that a simple and concise complaints procedure is clearly displayed for the benefit of residents, their friends, relatives and other visitors to the home. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 16 The home has produced policies and procedures relating to adult protection and abuse, including a whistle blowing policy, in accordance with the recently implemented ‘Safeguarding Adults. The manager confirmed that the majority of staff have received specific adult protection training, however this was not supported through discussions with staff and, due to inadequate recording systems, there was no documentary evidence of relevant staff training since 2005. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a calm and peaceful environment within the home and benefit from accommodation that is safe, comfortable, well maintained and decorated to a satisfactory standard. EVIDENCE: As with many of the environmental standards, the situation at The Grange remains largely unchanged, with its homely and welcoming atmosphere. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 18 During my ‘guided tour’ of the premises, including residents’ accommodation and communal areas, it was evident that the well-maintained décor and adequate furniture and furnishings continue to provide a comfortable, pleasant and homely environment for the residents. Since the previous inspection, as required all exposed heating pipes have been covered. There has also been a recent Occupational Therapy Assessment of the premises carried out. Recommendations made in the subsequent report related to improving access and mobility throughout the home. It concluded that the home: ‘…appears to be friendly professionally run establishment where the needs of the residents are paramount. The home appears to be meeting the needs of the residents’. Following discussion with the manager, it is recommended that consideration be given to converting the currently unused second floor bathroom into a walk in shower room. Residents’ rooms were found to be clean, comfortable and generally well maintained. It was evident that many of the rooms have been personalised, with pictures, family photographs and other small items of furniture and belongings, to reflect individual taste, choice and preference. On the day of the inspection, it was evident that infection control procedures within the home are in place and are closely adhered to. Levels of cleanliness and hygiene remain generally high throughout. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 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. 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. There is sufficient trained and competent staff on duty at all times to meet the assessed needs of the residents. The safety and protection of residents is improved by robust recruitment procedures and appropriate staff training. EVIDENCE: Appropriate staffing levels are evidently in place to meet the current assessed care and support needs of residents. A staff rota has been developed, showing details of which staff are on duty at any time and their designation. There are four care staff employed in the home in the morning, plus a cleaner and a cook. Three staff cover the afternoon and evening shifts and two are on duty during the night - one waking and one sleep in person. It was noted that since the previous inspection, as recommended, staff files have been reviewed and amended to ensure information is more readily accessible. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 20 In addition to the comprehensive induction programme undertaken by all newly appointed staff, the manager confirmed that appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. She added that time for training is paid for. This was confirmed through discussions with staff and supported by training records examined. As previously documented, it is evident, from discussions with members of staff that the manager continues to operate an ‘open door’ policy, with staff feeling confident and able to discuss any issues at anytime. The manager is clearly aware of the need for thorough and robust recruitment procedures, to help ensure the safety and protection of service users. Staff files that were examined were found to be generally well maintained, containing necessary information, including proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. From documentary evidence it was noted that the last formal staff meeting was held over a year ago. Following discussion with the manager and to improve levels of communication within the home, it is recommended that regular, structured and recorded staff meetings be reinstated. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from effective management and thorough quality assurance systems. Satisfactory health and safety policies and procedures, within the home, help to ensure the protection of residents and staff. EVIDENCE: The experienced manager has worked at The Grange for ten years and has been in her current post for the last six years. She is evidently competent to run the home and is in the process of studying for the NVQ level 4 in Management and Care. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 22 She is clearly motivated, positive and approachable and has successfully developed an open and inclusive atmosphere within the home. It is evident that staff feel valued and supported by her: ‘She is very helpful and supportive and always ready to listen.’ Although, through discussion with the manager, it is understood that the Deputy Manager now receives regular formal supervision, in line with other staff supervision there is no adequate recording system in place and consequently no documentary evidence of this being undertaken. Therefore the requirement made following the previous inspection remains outstanding. Effective quality monitoring and consultation with residents is ongoing and includes satisfaction questionnaires for residents, regarding the care they receive. Positive responses to a recent survey indicate a high degree of satisfaction with the home and the services provided: ‘You are all a credit to the high standard set at The Grange. Well done!’ Following discussion with the manager, however, it is recommended that a similar survey be introduced to obtain feedback from residents’ relatives and other visitors to the home. The manager confirmed that the health, safety and welfare of residents and staff remain of paramount importance within the home. As previously documented, staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. Fire safety systems are regularly checked and outcomes recorded. The audible alarms are monitored weekly and quarterly checks of the emergency lighting and smoke alarms are evidently carried out by outside contractors. All accidents are appropriately recorded and reported as required. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 3 X 3 3 3 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 3 3 X 3 2 3 3 The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 (1) (2) (b) & (c) Requirement It is required that a care plan be developed for each resident and be regularly reviewed, with involvement, as appropriate, from the resident or a relative or representative. It is required that the Deputy Manager and all care staff receive regular, formal and recorded supervision, to support their role in the home. (Previous timescale of 30.06.2006 not met.) Timescale for action 30/11/07 2. OP36 18(2) 30/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP21 OP30 Good Practice Recommendations It is recommended that consideration be given to converting the currently unused second floor bathroom into a walk in shower room. It is recommended that all staff training be adequately and appropriately recorded. DS0000014251.V348819.R01.S.doc Version 5.2 Page 25 The Grange Rest Home 3. OP33 It is recommended that the current quality monitoring system be extended to obtain feedback from residents’ relatives and other visitors to the home. The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 The Grange Rest Home DS0000014251.V348819.R01.S.doc Version 5.2 Page 27 - 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!