Inspection on 12/12/05 for Wellington Park Nursing Home

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Wellington Park Nursing Home 10/10/07

Wellington Park Nursing Home 12/06/06

Wellington Park Nursing Home 19/05/05

Wellington Park Nursing Home 10/01/05

Wellington Park Nursing Home 19/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Wellington Park Nursing Home 76 Wellington Road Bush Hill Park Enfield Middlesex EN1 2PL Lead Inspector Peter Illes Unannounced Inspection 12th December 2005 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 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. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wellington Park Nursing Home Address 76 Wellington Road Bush Hill Park Enfield Middlesex EN1 2PL 020 8360 5977 020 8364 0696 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) Goldsborough Healthcare Limited Jane Ann Hepton Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 30 service users may receive nursing care. Date of last inspection 19th May 2005 Brief Description of the Service: Wellington Park Nursing Home is owned by BUPA Care Services providing both nursing care and personal care. The home is registered for thirty-three older people of which thirty places are for service users who require nursing care. The home is purpose built and is situated in a residential area, approximately one mile from Enfield Town. All bedrooms have en-suite facilities, telephone point and a remote controlled television. Two rooms are currently shared by two service users with the rest of the rooms being single occupancy, the inspector was informed that the use of double rooms was gradually being reduced. Respite care is provided for people who normally live at home. The home’s stated aim is to provide high quality nursing care for the older people who live there using the company’s health and care knowledge, specialist skills and values to deliver as individual a service as possible to residents. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took approximately seven hours. The registered manager was not on duty and the head of care was present or available throughout. There were twenty three service users accommodated at the time of the inspection and a number of vacancies. The inspector was informed that the home was in the process of reviewing the use of its double bedrooms that might have implications for the number of people that the home may accommodate in the future. The inspection consisted of: meeting and speaking to the majority of service users, four of them independently; discussion with five relatives that visited, three of them independently; a brief discussion with a visiting Sister from the Catholic church; independent discussion with the head of care; independent discussion with another nursing member of staff; discussion with four care staff and discussion with the administrator and handyperson. Further information was gained from a tour of the home and a range of documentation kept at the home. What the service does well: The home provides nursing and personal care to service users with a range of complex needs. A stable staff group supports service users and are knowledgeable about their needs. Relatives and other visitors are made welcome at the home. A range of stakeholders including service users and relatives are consulted on a regular basis regarding the care and overall service offered at the home. This information is used to plan further improvements to the service offered. The home is well decorated and maintained and provides a pleasant environment to live and work in. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective service users can be confident that their needs will be assessed when they enter the home and reviewed once admitted so that both their needs and changing needs can be addressed. EVIDENCE: At the last inspection a requirement was made that the home’s initial assessment form included information relating to service user’s social needs. The inspector was informed that this had been included in a new assessment tool introduced since the last inspection. The inspector was informed that all service users had been re-assessed using the new format. Three service user files were inspected at random. These were all seen to contain a satisfactory assessment of the individual service users needs using the new assessment tool and these were seen to include their social needs. Other areas covered in the assessment included service users needs in the following areas: nursing needs; skin vulnerability; moving and handling; vital signs, temperature, pulse and blood pressure and nutritional needs. The assessments seen had been signed and dated by the assessor. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 9 The home does not provide intermediate care. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 11 Service users needs are included in their care plans to assist staff support service users in meeting these. Service users health needs are met including through accessing a range of relevant healthcare professionals. Service users wishes in the event of their death are sought to assist staff to sensitively deal with these should it be necessary. EVIDENCE: A random sample of three service user care plans was inspected. Each of the plans were seen to be based on needs identified in their assessments and included a separate night care plan. Individual plans included sections on promoting a safe environment, personal hygiene, skin integrity, physical mobility, continence and a nursing care plan. These were all being reviewed on a monthly basis. Care plans were also informed by a general risk assessment and a moving and handling risk assessment. All files had been reviewed monthly and contained a photograph of the service user. There was evidence that the majority of service users are registered with one of two GP practices. The inspector was informed that one of the GP’s visited the home on a weekly basis with the other GP seeing the other service users Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 11 as required. One service user had a small pressure ulcer that records indicated was being satisfactorily treated. The inspector was informed that the home used specialist external health professionals when required. Evidence was seen of input from a tissue viability nurse since the last inspection. The inspector was also shown referral forms for other specialist health professionals such as occupational therapy, physiotherapy and speech and language therapy and informed that referrals are made to these services when required. Evidence was also seen that service users have access to a chiropodist, dentist and optician on a regular basis. A requirement was made at the last inspection that the frequency of how often service users that spend significant amounts of time being nursed in bed are turned was clearly documented. Turning charts were sampled and the requirement seen to have been complied with. A CSCI pharmacist had inspected the home’s medication policy and procedure since the last inspection and the findings sent to the provider organisation separately. The findings were generally satisfactory although requirements were made regarding a clear audit trail for medication entering and leaving the home, the temperature of the room the medication is stored in and also the temperature of the dedicated fridge used to store medication. These still needed to be fully complied with and are restated although the required date for these were a few days beyond the date of this inspection. The fridge user to store identified medication was seen to be very full and an additional recommendation is made that the home considers purchasing a larger fridge for this purpose. A requirement was made at the last inspection that service users wishes in the event of their death are recorded. There is a section for this information now included in the new assessment format that had been appropriatley completed on the files inspected including where service users or their relatives had declined to discuss the issue. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14 & 15 Service users are actively encouraged to maintain contact with relatives, friends and others in the community who are made welcome when they visit the home. Service users are also encouraged to maintain as much as control and choice over their daily lives as they wish and are able to. They also enjoy a choice of varied and healthy meals. EVIDENCE: Evidence was obtained from discussion with service users, relatives and from documentation in the home that visitors are made welcome at the home. One service user stated that when their relative visited, which was most days, the relative and service user were offered a cup of tea. The inspector spoke to three relatives independently and all confirmed that they were made to feel welcome by staff when they visited. Minutes of quarterly relatives meetings were seen and the home’s administrator told the inspector about arrangements that were currently in hand to prepare for a Christmas function to which relatives and others were invited. The inspector also spoke briefly to a sister from the Roman Catholic Church who visited the home regularly to give communion to service users who requested this. She confirmed that she was always made welcome at the home and stated that “people are happy here, it’s a good place”. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 13 Service users spoken to confirmed that they were able to bring their own possessions into the home and service users bedrooms seen were suitably personalised with photographs and other personal possessions on display. The inspector was also informed that service users, their relatives or other representatives dealt with all the service users finances and that the home did not keep money or deal with finances for any of them. A satisfactory menu was seen that gave alternatives for all main meals. The inspector was invited to join service users for lunch on the day of the inspection that was delicious. Service users on the table that the inspector joined told him that the food was always that good and that staff asked them individually before each meal which alternative they would like. Some service users were observed being assisted with their meal and this was done in a friendly, efficient and unhurried way that those service users clearly appreciated. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home’s adult protection procedure and guidance to staff need to be reviewed to ensure that service users are protected as much as possible. EVIDENCE: The home had an adequate adult protection policy and guidance for staff that was seen. This appeared to be a generic provider organisation policy however and did not refer specifically to the local authority policy for the area the home is situated in. A copy of that local authority policy and procedure was not available at the time of this inspection and staff spoken to were not aware of any specific requirements of this procedure. A requirement is made that the home acquires a copy of this policy, reviews the guidance to staff in the light of this and ensures that the home’s policy reflects and is consistent with the local authority’s procedure. The inspector was informed that staff do undertake protection of vulnerable adult training. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 15 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 & 24 The home is well decorated and maintained to provide a pleasant environment for service users and staff to respectively live and work in. Further work is still needed however to ensure that all service users are able to keep their personal possessions secure in their bedrooms. EVIDENCE: The inspector undertook a tour of the premises. The home was generally well maintained, decorated and provides a pleasant environment for service users to live in. The home had recently appointed a new handyperson who was spoken to independently. He was enthusiastic about his duties and had prioritised maintenance work that was needed throughout the home. This included decorating vacant rooms and routine maintenance to bath/ shower rooms. A requirement was made at the last inspection that all service users had a lockable space in their room for the safekeeping of personal possessions. The Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 16 inspector was informed that this had been complied with and was shown drawers in service user’s rooms at random that had been fitted with locks. One service user however showed the inspector a lock on a drawer in their room that they stated had been there for some while but indicated that this was of little use as he had never been given a key for it. The requirement is restated. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 17 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 & 30 A staff team in appropriate numbers assists meet service users needs and those staff have access to a range of training opportunities to help them do this. EVIDENCE: The staff rota for the home was inspected and was satisfactory with staff on duty during the inspection matching those recorded on the rota. Staffing levels in the home are as follows: two qualified nurses and six care staff on duty on the early shift; two qualified nurses and four care staff on duty on the late shift and one qualified nurse and three care staff on duty at night. In addition the home employs a satisfactory range of kitchen, laundry and domestic staff. Requirements were made at the last inspection regarding staff training in care planning, record keeping, management of pain, moving and handling and infection control. One of the nursing staff has been appointed to coordinate training for all staff and has developed individual employee’s training records, these were sampled and found to be satisfactory. Evidence of training that had recently been undertaken by staff included adjustment of air mattresses, care of people with Parkinson’s disease and basic foot care. Evidence was also seen of other training planned for early 2006 including palliative care and care of people with diabetes. The head of care also stated that it was primarily individual nurses responsibility to ensure their clinical practice skills were up to date although the home did access specialist training for nurses including from St Joseph’s Hospice. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 18 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, 36 & 38 The home has effective consultation systems to contribute to the home being run in the best interests of service users including safeguarding their financial interests. Service users are supported by a staff team that themselves receive a range of management support and supervision although this needs further attention in an identified area. EVIDENCE: The home has a range of ways of monitoring the quality of care in the home with a view to ongoing development of the service provided. Evidence was seen of regular satisfaction surveys for service users and relatives. These were seen to be themed with areas including care, maintenance and laundry services being consulted on since the last inspection. Evidence was seen of three monthly relative meetings. An external manager visits the home from the provider organisation on a regular basis to monitor the service provided at the home and reports of these visits are sent to CSCI. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 19 The inspector was informed that the home does not take responsibility for service user finances and that these are dealt with by service users themselves, their relatives or other representatives. This includes service users personal allowances with the home paying for additional items such as hairdressing and newspapers and then sending out monthly invoices regarding these. A requirement was made at the last inspection that staff must receive regular documented supervision at least six times a year. Evidence was seen to indicate that this requirement was being complied with and staff spoken to also confirmed this. During the inspection a number of staff from black and ethnic minority communities were spoken to and a number of service users and relatives. The inspector formed the impression that although relationships between staff and relatives were generally positive some staff from black and minority communities felt they received more negative feedback from relatives than other staff. During discussions with a small number of relatives a few remarks were made inferring that some staff from black and minority communities had difficulty expressing themselves clearly enough to service users. The clear inference was that this was because English was not their first language. The inspector’s own experience was that all staff spoken to and observed during the inspection were able to express themselves clearly, including to service users. A requirement is made that the home reviews its equality policy with staff, service users and relatives and ensures that there are sufficient support mechanisms in place for staff from black and ethnic minorities and that any potential barriers to communication between staff and relatives are sensitively addressed. Requirements were made at the last inspection regarding annual safety checks being carried on fire fighting equipment and electrical portable appliances; these were seen to have been complied with. During a tour of the building it was noted that the door closure on one service user’s bedroom door did not work properly and that another bedroom door was propped open with a waste paper bin. The inspector was informed that some service users and their relatives wanted the identified service user’s bedroom doors kept open. The inspector saw a business continuity plan that gave guidance to staff on action to take in the event of a major emergency but this was not a specific fire risk assessment for the building. A requirement is made that a full and current fire risk assessment and fire plan is available for the home and that the fire officer is formally consulted on and approves these. A requirement is also made that all fire doors are kept closed unless held open by an approved electro-magnetic device or unless a specific agreement is reached with the fire officer following a specific risk assessment, to meet assessed needs for identified service users. Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X 2 X X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 2 X 2 Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 21 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 OP9 Regulation 13 Requirement The registered persons must ensure that all medication received for service users is signed for on the medicine administration record and any medication carried forward is also documented to ensure no mishandling (previous timescale of 17/12/05 had not been reached). The registered manager must ensure that the temperature of the area where medication is stored is maintained at 25oC or below and the medication refrigerator is maintained between 2-8oC (previous timescale of 17/12/05 had not been reached). The registered persons must ensure that the home obtains a copy of the adult protection policy for the local authority in which the home is situated in, ensures that the home’s own policy reflects and is consistent with the local authority’s procedure and that staff are made aware of this. DS0000027825.V265076.R01.S.doc Timescale for action 17/12/05 2 OP9 13 17/12/05 3 OP18 13(6) 31/01/06 Wellington Park Nursing Home Version 5.0 Page 22 4 OP24 16(2) 5 OP36 12(5) The registered person must ensure that all the bedrooms have a lockable space provided. (previous timescale of 30/7/05 not met). The registered persons must ensure that the home reviews its equality policy with staff, service users and relatives and ensures that there are sufficient support mechanisms in place for staff from black and ethnic minorities and that any potential barriers to communication between staff and relatives are sensitively addressed. 31/01/06 28/02/06 6 OP38 23(4) 7 OP38 23(4) The registered persons must 31/01/06 ensure that a full and current fire risk assessment and fire plan is available for the home and that the fire officer is formally consulted and approves these. The registered persons must 31/01/06 ensure that all fire doors are kept closed unless held open by an approved electro-magnetic device or unless specific agreement is reached with the fire officer following a specific risk assessment, to meet assessed needs for identified service users. 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 Refer to Standard OP9 Good Practice Recommendations The home should consider purchasing a larger dedicated refrigerator for storing medication. DS0000027825.V265076.R01.S.doc Version 5.0 Page 23 Wellington Park Nursing Home Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Wellington Park Nursing Home DS0000027825.V265076.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!