Inspection on 10/07/06 for The Hollies

This inspection was carried out on 10th July 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Hollies 09/11/05

The Hollies 24/05/05

The Hollies 05/01/05

The Hollies 20/10/04

The Hollies 20/01/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 The Hollies Church Road Shustoke Coleshill Birmingham B46 2JX Lead Inspector Sheila Briddick Key Unannounced Inspection 10th July 2006 13:30 The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 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 Hollies DS0000004357.V301397.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 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. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hollies Address Church Road Shustoke Coleshill Birmingham B46 2JX 01675 481139 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) Mrs Alison Thorneywork Mr Anthony P Shepherd Mrs Alison Thorneywork Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2005 Brief Description of the Service: The Hollies is a detached house located in the small village of Shustoke, which is an about 1 ½ miles out of Coleshill. The home is currently registered for 3 people with Learning disability, men or women. However the Commission for Social Care Inspection has imposed a Condition on the registration of the home that no new admissions are made until the registered person has successfully completed an agreed programme of professional training. The property is set in about 3 acres of land and is also home to a number of animals and house pets. The ground floor consists of two lounges, a toilet, kitchen/dining area and a utility room. Upstairs are five bedrooms, two bathrooms and a toilet. The registered provider manages the home and also lives there. The home has limited off the road parking in front of the main gate. A large amount of parking space is available if needed beyond the gate. A bus service goes through the village hourly. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for service users and their views of the service provided. This process considers the care home’s capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. This unannounced inspection took place over two separate visits, the first taking place at 1.30pm on Monday July 10, 2006 and finishing at 4.30pm. A second visit was made at 10.30am on 21st July, 2006 and finishing at 11.45am. The inspection involved: • • • Discussions with the Registered Provider and Main Carer. Discussion with the people living at the home. Two service users were identified for close examination by reading their, care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for residents. A tour of the environment was undertaken, and records were sampled, including health and safety, and fire records. Interactions between service users and Carers were observed. The views of a professional involved with the service provision were sought and verbal feedback was given. • • • Finally, feedback took place with the Carers about the inspection findings. What the service does well: The people living in this home continue to be supported to live ordinary and meaningful lives in an environment that is warm, comfortable and welcoming. People are actively involved in daily living activities as part of the lifestyle of living on a smallholding however, the carers are supporting service users to continue their own interests, which includes music and singing and maintaining relationships with family and friends. Service users gave positive comments about the home and talked about the lifestyle they were enjoying and plans they had for holidays and short breaks. One service user is going to Blackpool for a weekend break with the Carer, another service user said they were “still deciding what to do. A new service user said that since coming to live at the home they felt their health and well being had improved. A service directly involved with the service provision were complimentary about the support given to the people living in the home. It was felt that the The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 6 carers encourage communication and independence and that the service users are more relaxed and very happy”. This observation is made from feedback received from service users and also by observation when the service is visiting the home. This is a very relaxed home and it was pleasing to see service users coming home from their day service talking excitedly about the days activities whilst at the same time being very comfortable to make themselves a cup of coffee. This activity was done very naturally further demonstrating how safe and confident people feel living there. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in this home can be sure that their needs are fully understood by the people caring for them and that they will be involved in any decision-making regarding their needs and choices. EVIDENCE: A new service user had come to live in the home since the last inspection visit, this had been an emergency admission. A copy of the care management assessment had been obtained and all other information relating to the needs of the service user had also been forwarded to the service and in place on the service user’s file. The service user had been involved in developing the care plan from information gathered and any possible risk had been discussed with them. The service user was met with and they said they liked the home and felt relaxed living there. They appeared happy and comfortable with the other people in the home but had already known them prior to coming to live in the home through attendance at the same day service. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 9 There was evidence on the care plan file of ongoing review of the longer term needs of the service user and the provider indicated through discussion an understanding of the service user’s wish to live a more independent lifestyle and was supporting this at review meetings. There has been a recent increase in fees for the service and this has been documented on each a service user’s Contract The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home can be sure that their assessed and changing needs, and personal goals are reflected in their care plan through a review system that involves themselves, family members or friend and other care professionals. Risk management is ensuring that service user’s health and well-being is reviewed regularly with them. EVIDENCE: Two care plans were examined as part of the case tracking process for this visit. These were found to be up-to-date and in good order. Care plans drawn up were in plain English and easy to understand. Care plans are being reviewed with the service user on a regular basis and involve significant professionals, family and in one instance an Advocate. Any changed need is amended on the care plan. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 11 The service is working closely with key workers at the day service in implementing person centered planning. Feedback received from the day service was complimentary about the role of the carers in supporting any person centered planning work, for example, a service user expressed an interest in developing their woodwork skills and is now able to learn new skills at the day service and has support to practise them when at home. During the visit the service user was planning to help make a wooden gate that evening with the Carer. Advocacy support has been accessed for one service user as part of making decisions about their day service provision and through discussion the carers demonstrated the value and positive impact this had for the service user in enabling them to make their views known. Discussion with people living in the home and observation of care practice demonstrated that independent lifestyles are promoted and supported as part of the family style living environment. Service users are supported to manage their finances by either having responsibility for daily monies to be spent at the day service or full responsibility for managing their own finances, which included personal banking. Known risks have been identified and recorded on care plans as part of the risk management strategy and these had been reviewed in January 2006, including mobility around the home and any risks with eating and drinking. Risk strategies promote independence and service users are involved in risk strategies agreed, this includes self administration of medicine. A good practice recommendation was made for encouraging service users to sign care plan and risk assessment agreements. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home have opportunity to live ordinary and meaningful lives appropriate to their needs. Lifestyle in the home promotes and respects service user rights and responsibilities. Service users are supported to maintain family links and friendships. Food provision is good and ensures a healthy and well balanced diet for the people living in the home. EVIDENCE: The home situation in a small village presents some limitation to local activities however service users enjoy pub lunches in the village, going to the local car boot and village activities for example Art and Craft shows and Agricultural Shows. Each service user attends the same day service and this also includes accessing local colleges. The preferred choices of service users daily routines during the week and at weekends is clearly identified on their care plan. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 13 Daily routines in the home are very relaxed and informal, based on a family style living environment. Service users appeared relaxed, happy and comfortable, being able to freely access and use the facilities available. Service users coming home from their day service were very comfortable with making himself a drink whilst talking about their day with the carers and planning the evenings activities. Service users talked about enjoying helping with the animals and other activities involved in running a small holding however it was also evident that service users are encouraged and supported to continue with their individual hobbies and interests which includes listening to music, woodwork, jewellery making and knitting. A record of meals taken is kept and shows that this is varied and wellbalanced. Food stocks in the home were in ample supply and reflected against the meal records. Service users said that they liked the meals and during the visit were being actively involved in discussion about the meal for the evening, which was agreed to be, faggots, chips and peas with ice cream for pudding. Service users said we all eat together and once a week we have a take-away Care plan records show that advice and guidance is sought from dietician services when necessary and any individual risks involved when eating have been assessed and specific guidance recorded on the care plan. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health-care needs of the people living in this home are assessed and met with evidence of local and specialist health-care services being readily available to them EVIDENCE: Records continue to be maintained of individual health-care needs and visits made to health-care specialists. This includes the GP, psychology services, dentists and opticians and records show that service users continue to be in good health. Associated risks from livestock, including poultry and gardening activities have been discussed with the home’s GP and protection given through immunisation, i.e. Tetanus immunisation. There is significant evidence on care plans that service users continue to keep routine appointments to dentists and opticians and a chiropodist visits every two months to attend to foot care. Carers are supporting a referral made through day services to speech and language therapy services for one service user. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 15 Medicine management is good with records being well maintained and medicine is stored securely and appropriately. One service user is managing their own medication, which is Paracetamol they take as required and the home has agreed a risk management strategy with the service user, based on promoting and respecting their independence. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place for listening to service user’s concerns by Carers who have a good understanding of the importance of protecting service users from harm. EVIDENCE: The have been no complaints made about the service in the last 12 months. Through discussion with service users and their carers and observation of care practice it was demonstrated that service users views are listened to and acted upon. Service users were seen to be comfortable and relaxed with the carers and contributed to discussions freely and openly. The carers have a good understanding and knowledge of how advocacy services can support service users in decision-making and through the complaints process. The carers spoke of relationships that have been developed with family members of service users and stated that they receive many compliments regarding the care being provided to their relatives. A good practice recommendation was discussed about recording compliments made to the home. Professionals spoken with had a high regard of the care provision and comments included; The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 17 - it is quite rare to have a service promote such good communication between us and offer feedback about successes in the home environment achieved by service users. Service users living in the home said that hey felt safe and were happy living there. One service user commented, the lifestyle here has helped my health, and I feel more relaxed. The service provision is from the providers own home and no other staff are supporting the care however, there is a written plan of emergency care provision that could be implemented in the event of the provider not being available which ensures that service users would be protected from harm by the nominated relief staff cover. This includes ensuring emergency carers have had Criminal Records Bureau, (CRB) checks. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is warm, welcoming and homely and providing service users with a comfortable place in which to live. EVIDENCE: A tour of the environment took place and was found to be homely, safe and comfortable. Service users bedrooms were in good order and reflected their personal interests and lifestyles. Bathrooms and toilets were clean with fresh towels in place, each service user has their own towel rail and a shelf for keeping toiletries. The kitchen is the hub of the home environment and is of a farmhouse style. The fridges were clean with food covered and thermometers in place to monitor temperatures. There is a utility room off the kitchen area where washing machines, fridges and freezers of a domestic kind are situated. The laundry area was clean and in good order. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 19 Furniture and fittings are of good quality throughout the home and service users bedroom décor is bright and cheery. The family have their own garden area, which is used for leisure and eating outside during the summer months. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Carers have a very good understanding of service user’s individual needs, this is evident from the positive relationships, which have been formed between the carers and service users. EVIDENCE: The provider and her partner are the sole providers of care with no other staff being employed. Both carers have recently achieved an NVQ Level 2 in Care and enrolled on an NVQ Level 3 course to begin in September 2006. The carers are working closely with other professionals in the service provision including psychologists, nurses, social workers, learning disability nurses and day-care staff, as a result of this involvement they are able to develop further their knowledge and skill in the provision of care for people with learning disabilities. The carers are also members of the Small Homes Care Services Trust and access the service for advice and training when necessary. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 21 Comments received from professionals regarding the care provision included; The carers really work well in promoting communication and independence for service users. Service users are much more relaxed and they are always supported to access activities in the day centre The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The ethos of this home is to provide a living environment in an atmosphere of openness and respect in which service users feel involved. Service users can be sure that the Carers are competent and have sufficient knowledge to promote and maintain their safety. EVIDENCE: Observation of care practice and discussion with both carers demonstrated that they are competent to run the home and keen to develop their skills in the provision of care and for this reason they have committed themselves to achieving an NVQ at Level 3 in Care. This service is an individual care service and not belonging to an umbrella organisation and as such have found some difficulty in the development of a good quality assurance system. Records being kept in the home demonstrate that systems are in place regarding health and safety and care management. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 23 Seeking the views of others has not taken place and good practice recommendations were discussed of how the views of the people living in the home could be sought. Health and safety management in the home is adequate and records show that risks are reviewed annually or as needs change. Records relating to fire safety are in good order fire drills are practised and service users are reminded about fire safety. A safe environment is ensured by maintaining regular checks on central heating systems, water heating, electrical items and ensuring that hazardous substances are safely stored. An environmental health visit was made to the home on the 19th of May 2006 and recommendations made were implemented. The outside environment, which is also a smallholding, is accessed by service users who assist in caring for animals and poultry kept by the carers if they wish. This is in good order and access is good. Carers are aware of the possible risks to humans from disease from animals and poultry and seek veterinary advice as necessary. This has included seeking precautionary management of poultry that would be necessary in the event of an outbreak of ‘bird flu’ epidemic in Great Britain. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 N/A 35 N/A 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 25 Yes 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. Standard Regulation Requirement Timescale for action The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 26 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 YA6 YA39 Good Practice Recommendations It is recommended that service users sign, where possible, any agreements made with them and this is documented on their care plan. It is recommended that the views of the people living in the home be sought, with advocacy support, and documented on an annual basis. Advocacy support offered to service users could be day service key workers. The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 The Hollies DS0000004357.V301397.R01.S.doc Version 5.2 Page 28 - 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!