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Inspection on 15/08/05 for White Lodge Residential Home

Also see our care home review for White Lodge Residential Home for more information

This inspection was carried out on 15th August 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a commitment to providing good care in the home. Residents spoken to commented on the helpfulness of the staff team. One resident said, "the girls are amazing". There is a good choice of meals, which are varied, plentiful and well managed to meet residents` individual taste and preferences. The home provides a safe environment to live in. The home has good systems in place and a good staff team.

What has improved since the last inspection?

The home has implemented the two requirements and five recommendations. Two new bedrooms have been registered and the home provides all single bedroom accommodation. White Lodge is situated at the end of a drive and was not easy to spot, driving along Havant Road. Since the last inspection a new signpost has been erected at the end of the drive, making the home clearer to passing traffic. The home has sent an application for approval of a new registered manager.

What the care home could do better:

Service users would benefit from more organised activities. The inspector discussed the use of questionnaires as one way of obtaining feedback from service users about the service the home provides and suggestions for improvement. It was agreed that this would be implemented.

CARE HOMES FOR OLDER PEOPLE White Lodge 67 Havant Road Emsworth Hampshire PO17 7LD Lead Inspector Rodney Martin Unannounced 15 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service White Lodge Address 67 Havant Road Emsworth Hampshire PO17 7LD 01243 521812 01243 370958 WLCareLtd@AOL.com Mrs Jill Kathryn Dowsett Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) CRH 25 Category(ies) of OP Old age - 25 registration, with number PD Physical disability - 1 of places White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: To accommodate one named service user D.O.B -7/10/1945 in the category P.D (Physical Disability) Date of last inspection 13th December 2004 Brief Description of the Service: White Lodge is a residential care home providing care and accommodation for up to twenty-five service users aged 65 years and over; situated on the Havant Road, in Emsworth. The home is privately owned. White Lodge is a detached building set back from the main road. There are parking facilities and gardens to the front and rear of the home. The home has twenty-five single bedrooms, with sixteen provided with en suite toilet facilities. The home has added two new bedrooms, with en suite toilet facilities. However, the registered person decided to use the home’s two double bedrooms as single bedrooms and as such did not want to vary the conditions of registration to increase from twenty-five to twenty-seven service users. Approval was given on 13 April 2005 for the two extra bedrooms. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place between 9.15am and 1.45pm. The proposed registered manager was available to assist the inspector. The inspector met briefly with Jill Dowsett, responsible individual. There were two requirements in the previous inspection report, dated 13 December 2004, about staff receiving formal supervision and having training in basic core subjects. These have been implemented. The home had also agreed to put in place five recommendations and these are referred to throughout this report. The inspector was able to tour the building as well as speak to the staff members on duty. The inspector had a meal with residents at lunchtime. Residents were appreciative of the care they received, had no complaints and stated that the food served was very good. The inspector received eleven comment cards from service users, prior to the inspection, at the beginning of July 2005, and two comment cards from relatives/visitors. The only negative comments were regarding the perceived absence of the owner and management. One relative wrote, “during holiday periods, additional staff do not appear to be employed, so remaining staff do appear to be very stretched at times. Otherwise it is a clean, welcoming and well run home”. There has been an absence of a registered manager in White Lodge since December 2004. In the interim Jill Dowsett, registered person fulfilled the role of manager until her proposed manager returned from maternity leave. The commission received an application on 31 May 2005 for the registration process. The inspector was able to confirm that the home has been providing sufficient staff, although one resident currently has a higher dependency level, which at times requires two carers. On the day of the visit the home was accommodating twenty-three residents, which included one resident in hospital. Since the last inspection, on 13 December 2004, there has been five permanent admissions and seven clients came for a respite short stay. Care, medication, fire and staffing records were inspected. These were relevant and up to date. All standards, bar three [17, 34 and 35] were inspected on this occasion. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 6 What the service does well: 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 White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 7 contacting your local CSCI office. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5, and 6 Residents assessed needs and aspirations are being met within White Lodge. Prospective residents are able to make an informed choice about whether or not the home is able to meet their particular needs. EVIDENCE: The home has an appropriate statement of purpose and service users guide, which is available for service users. Since the last inspection, the home had seven clients come for a short stay. The inspector discussed the use of a file for short stay clients, to be kept in their bedroom, to include the statement of purpose, service users guide, a copy of the home’s brochure, a copy of the terms and conditions of residency, useful information about meal times, fire procedures, activities et cetera, and an exit questionnaire. A separate file is kept for each service user for financial details, confidential matters and a copy of the terms and conditions of residency. The home has a terms and conditions of residency was found to be satisfactory, which includes White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 10 the right of service users to self medicate and also includes that there is insurance of up to a £1000 for any claim. Following a referral to the home the relative normally visits first and then the prospective service user is invited to view White Lodge. The prospective service user can also be visited in hospital or in their own home. Since the last inspection, the home has introduced the use of a pre-admission assessment form as a quick tool for recording details, following a visit to the prospective service user. There was evidence that service users were appropriately placed within White Lodge and that the home was meeting their assessed needs. Since the last inspection the home had purchased a book for recording admissions and discharges book. White Lodge does not provide intermediate care, although prospective service users can come for a short respite stay, if there is a vacancy. As noted above, seven clients came for a short stay in the home, since the last inspection in December 2004. Short stay service users are assessed in the same way as permanent service users. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11 The arrangements for planning care are good, ensuring residents’ physical and emotional health needs are met with evidence of good multidisciplinary working. Working practices in the home ensure the promotion of privacy and independence for service users. The home has clear arrangements in place for supporting terminally residents in the way they prefer. EVIDENCE: Care plans are kept in one folder. The care plan covers activities of daily living, mental and emotional health, social interests, hobbies, religious and cultural needs and any carer/family involvement. Each care plan has a photograph of the resident, for identification. Since the last inspection residents have signed their care plan. The home has a separate care plan update file. All care plans had been updated monthly and were last reviewed in July 2005. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 12 The personal and oral hygiene of each service user is maintained and this is recorded in their individual file. An individual record is kept of all health professional visits. The majority of service users are registered with the Emsworth surgery. One service user is registered with Southbourne surgery and two service users are registered at Havant health centre. Service users have a choice of attending surgery or other medical services but the majority, because of frailty and through convenience, have domiciliary visits by the optician, dentist and dental repair technician and chiropodist. Service users have access to all other health professionals on an as needs basis. It was reported that there is very good support from the district nurses and GPs from the Emsworth surgery. Since the last inspection the home has produced digital photographs of the residents to aid in the administration of medication. White Lodge operates a Nomad dosage system. Currently none of the service users are on a controlled drug, apart from one service user who has been prescribed Temazepam. This is kept locked, with in a locked cabinet. The inspector observed staff giving medication at lunchtime. This was done sensitively. Some of the staff have attended a safe handling of medicines course from Chichester College, ensuring that staff have a basic knowledge of medication and the home’s policy and procedures for medication practices. Each bedroom has an extension telephone. External calls can be put through to the individual service user. Service users can have their own private line if they wish. Service users are not charged for telephone calls. The inspector observed one resident making a call on their mobile ‘phone. Service users can see their GP in the privacy of their own room. The name a service user prefers to be called is recorded on their care plan. Staff were observed to treat service users with respect. The home has sent a letter out to every family about the service user’s wishes concerning terminal care and arrangements after death. It was reported that some relatives had replied. The proposed manager has made a list of those outstanding and told the inspector that this would be followed up. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The quality and quantity of food provided is sufficient to meet the needs of the residents. There are currently limited activities and residents would benefit from a fuller programme during the week. EVIDENCE: Service users were participating in music and movement and various quizzes, on the day of the inspection. The inspector discussed, with the manager, the benefits of staff attending an activities course to further the opportunities for service users to fulfil their personal aspirations and support them in the promotion of the core values of independence and fulfilment. Although the home had a timetable of activities for the month, displayed, there was not much planned. The proposed manager told the inspector that they were looking to develop activities within the home. Service users are able to receive their visitors in private. The home has a ‘quiet’ lounge that can also be used for service users to entertain their visitor(s). Details of the visiting arrangements are contained in the statement of purpose and service users guide. Service users have friends/family visiting them. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 14 Since the last inspection the cook has produced four-weekly menus, instead of operating with a weekly menu. Service users are mainly traditional in their preferences. However, they have a choice each day of main course. On the day of the inspection service users could choose from homemade mince beef and onion pie, vegetarian quiche or cheese salad, although bar one opted for the pie. There was banana and toffee crumble, fresh fruit or yoghurt for dessert. The inspector was able to have lunch with the residents. Residents, spoken to, said that the meals were good and there was always plenty to eat. Since the last inspection the menu is displayed. Residents, spoken to, were aware of were to look and found it useful. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a satisfactory complaints procedure, which residents feel able to use and an adult protection procedure, to safeguard residents from abuse. EVIDENCE: Since the last inspection the home has kept a complaints log. The home’s complaints procedure is contained in the statement of purpose and service users guide and contains details of the steps for making a complaint and how someone can contact the Commission. Although the Commission has not received an official complaint, four complaints were recorded in the complaints log. These had been dealt with within the timescale and satisfactorily resolved. The home has the updated adult protection policy and procedure from Hampshire County Council, dated July 2003, as well as a policy and procedure on “whistle blowing. Staff, spoken to, were aware of what constitutes abusive practices. Staff have received adult protection training. There have been no incidents of abuse recorded in the home. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 16 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 Residents live in a clean, safe and pleasant environment, where they have individualised their bedrooms, to meet their needs. EVIDENCE: The inspector was able to tour the building. Since the last inspection two new bedrooms [room 4 upstairs and the room immediately below it] have been registered and are now occupied. The home did not increase their registration for the two extra beds but instead the two double bedrooms in White Lodge are only each accommodating one service user. The home has a garden with an arbour in the back garden and a summerhouse, which is enjoyed by service users in the summer months. The appearance and signposting of the building avoids stigmatising the service users, as the home is set back from the roadside. However, since the last inspection a new signpost has been erected at the end of the drive, making the home clearer to passing traffic. White Lodge has two lounges, one specifically for television and the other as a quiet lounge, although this also has a television. Both lounges have French White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 17 doors leading into the garden. The home has an ‘L’ shaped dining room. The home has a toilet and walk-in shower on the ground floor, as well as a separate bathroom. There is a bathroom on the first floor. Hoists are provided in both bathrooms. Currently none of the service users are permanently in a wheelchair, although some require one for transferring. En suite toilets are provided in sixteen of the twenty-five bedrooms. Bedrooms are decorated as they become vacant and the carpet renewed, if appropriate. There is a passenger lift to the first floor. Grab rails are provided in the communal areas, including bathrooms and toilets. Hoists are provided in both bathrooms. Risk assessments are in place. A radio transmitter alarm call system is available in each room. The home has a separate laundry room, which is situated away from the kitchen and food preparation. The home does not specifically employ a laundry assistant, as care staff are responsible for service users’ laundry. The home was found to be clean and free from offensive smells. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Residents are supported by sufficient staff to ensure their needs are met. The home’s recruitment procedure and staff development plan ensures residents are protected. EVIDENCE: White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 19 On the day of the inspection there were three carers on duty, the proposed manager, a cook and a domestic. White Lodge employs eighteen staff members. Since the last inspection three carers and one night care assistant left but the home has recruited six carers. Three of the new staff live on the premises, in accommodation on the top floor. It was reported that the home now has a full compliment of staff. White Lodge currently has two temporary staff members, one helping in the kitchen from 4-6pm and the other working a night shift at the weekend. The inspector was able to view staff files. These contained the application form, which included a signed declaration under the Rehabilitation of Offenders Act and proof of identity. The inspector discussed the current policy for Criminal Records Bureau checks [CRB] and Protection of Vulnerable Adults [PoVA] checks. Since the last inspection the home has negotiated with a firm to provide basic core training; this includes basic first aid, coping with aggression, dementia training, diet and nutrition, fire safety awareness, food hygiene, health and safety, infection control, manual handling and risk assessment. Staff start with an induction and a foundation paper. All staff members have commenced the basic training. Several staff members, spoken to, said that they appreciated the training and saw it as a platform to build on their knowledge and skills in the caring profession. Currently none of the staff are involved in NVQ training although the deputy manager is start NVQ level 4 in management and care, in September 2005. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 and 38 The proposed manager provides good leadership, which ensures staff are supported, and residents health, safety and welfare are promoted and protected through the home’s practices. EVIDENCE: White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 21 Since the last inspection, following the resignation of the registered manager, the deputy manager has returned from her maternity leave and has been promoted to manager. The commission has received an application for approval as registered manager, which is being processed. She is shortly due to finish NVQ level 4 in management and care and then will go on to complete the extra units for the registered managers award for NVQ level 4 in both management and care. The proposed manager communicates a clear sense of direction and leadership within White Lodge. Staff, spoken to, said that they felt supported by management and there was evidence of a good team spirit, encouraged by the proposed manager. Residents, spoken to, were appreciative of her style of management. The home has the necessary policies and procedures to ensure the health, safety and welfare of residents and staff. The home’s records are kept on the computer. White Lodge is registered under the Data Protection Act 1998 and has a current certificate. The inspector discussed with the proposed manager the use of questionnaires and producing a newsletter as well as more potential involvement by relatives/friends and volunteers. A system of supervision is now in place and the proposed manager has implemented the action required in the last report. The majority of staff have had an annual appraisal and a supervision session. Six staff have had two, one to one sessions. It was reported that the deputy manager has started having supervision with some of the staff. The inspector discussed with the proposed manager various forms of supervision to include one-to-one, work practice issues dealt with in group supervision or supervision covering all aspects of the staff member’s practice. Samples of records seen on the day of the visit were found to be satisfactorily maintained, including medication records, staff records, fire records and service users’ case notes. Records are kept in accordance with the Data Protection Act 1998. Since the last inspection all service users have signed their care plan, indicating ownership of the care the home is proposing to deliver for them. The fire logbook was inspected and fire safety equipment had been tested and serviced regularly. All staff have receive fire instruction and there was evidence of this in the fire logbook. The home has a current fire risk assessment. The health, safety and welfare of residents is promoted and protected by the manager ensuring that White Lodge is a safe environment to work in, by staff having received current training in first aid, manual handling, infection control, fire safety et cetera. Relevant assessments have been carried out. White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 3 3 White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 24 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 White Lodge H54 S43778 White Lodge V244313 150805.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!