Inspection on 07/03/06 for Whitecliffe House

This inspection was carried out on 7th March 2006.

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

Whitecliffe House 29/01/09

Whitecliffe House 01/02/07

Whitecliffe House 30/11/05

Whitecliffe House 02/03/05

Whitecliffe House 02/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Whitecliffe House 30-40 Whitecliffe Mill Street Blandford Dorset DT11 7BQ Lead Inspector Jo Pasker Unannounced Inspection 7th March 2006 12:25p 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 DS0000020446.V283539.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000020446.V283539.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Whitecliffe House Address 30-40 Whitecliffe Mill Street Blandford Dorset DT11 7BQ 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) 01258 450011 01258 488905 whitecliffehouse@coltencare.co.uk www.coltencare.co.uk Colten Care Limited Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places DS0000020446.V283539.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 19 service users who require nursing care. 30th November 2005 Date of last inspection Brief Description of the Service: Whitecliffe House is situated centrally to all major routes into Blandford and is a five-minute walk to the town centre. Adjacent to the home is a Doctor’s surgery. The home is registered to provide both personal and nursing care to older people, nineteen places are available for people requiring nursing care and the remaining twelve for those with personal care needs. Whitecliffe House is an older style building, which has been extended and adapted to provide a full range of accommodation and ample communal space. There is a passenger lift to all three floors making access possible for all service users. All rooms have en suite facilities. There is a communal lounge, dining room and shared garden area with seating. Visitors are always welcome and offered generous hospitality and there is a high standard of “hotel style” catering and domestic services. Limited parking is available at the front of the home or on the street. Colten Care Limited owns the home, a company who have a number of care homes in Dorset and adjoining counties, and is managed on a day to basis by a registered nurse. Colten Care Limited aims to provide residents with a secure, relaxed and homely environment in which their care, well-being and comfort are of prime importance. DS0000020446.V283539.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second of two statutory inspections required in accordance with the Care Standards Act 2000. The lead inspector was Jo Pasker. The inspection took place on 7 March and started at 12.25 hrs and was completed by 16.45 hrs. The total inspection time, including preparation, travelling, inspection and report writing was 10 hours. The inspector spoke to 3 residents, 2 staff members and gathered information from the manager and any documentation available. During the course of the inspection the inspector also observed staff interaction with residents, the carrying out of routine tasks and conducted a tour of the premises. Additional information used to inform the inspection process included comment cards and formal notifications of events regularly provided to the Commission by the registered provider. There have been no complaints made to the Commission since the last inspection. The inspector is grateful for the time and contributions made throughout the day by residents, staff and management. This report should be read in conjunction with the previous report, dated 30 November 2005. What the service does well: Staff were observed to be kind to residents, treating them with respect and appeared well aware of their individual needs and choices. Residents are involved in a variety of activities held within the home and also have regular mini bus trips out to different places. Food served within the home is of a good standard with individuals’ needs and wishes being flexibly met. The home continues to maintain an excellent standard of décor and comfort and offers a friendly, welcoming environment for both residents and visitors. The management style within the home is good, with the manager demonstrating an approachable and professional manner and forging robust multi disciplinary relationships to ensure good quality of care for the residents. DS0000020446.V283539.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: As a result of this inspection a total of 4 requirements and 5 recommendations have been made. Pre admission assessments would benefit from more detailed information regarding when, where and who contributed to compiling them. Although care planning is generally good, more care needs to be taken with details ensuring that all documentation is fully completed, including risk assessments. The allergies of any resident need to be documented on their MAR chart or documented that there are none known, if appropriate. Staff supervision needs to be regularly carried out and well documented. The home should continue to work towards at least 50 of staff achieving a minimum of an NVQ 2 award. All staff records held would benefit from containing contemporary photographs for identification purposes. The home should devise a formal documented means of obtaining stakeholders’ opinions on the running of the home to ensure that the home is run in the best interests of residents. The home should provide a copy of the provider’s annual development plan to improve the home’s quality assurance procedure. All staff must receive a minimum of 6 monthly fire training sessions and this must be recorded and evidenced through staff training documentation. DS0000020446.V283539.R01.S.doc Version 5.1 Page 7 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. DS0000020446.V283539.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000020446.V283539.R01.S.doc Version 5.1 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 the following standard(s): Standard 3 Prior to admission, the needs of each prospective resident are assessed to ensure the home will be properly able to meet them. EVIDENCE: The records of 3 recently admitted residents were examined and found to include details of a pre-admission assessment, although it was unclear where, when and who had carried out the assessment. The home’s assessments were sketchy on details for some areas although all the relevant needs were assessed, including: • • • • • • Personal care and physical well being Diet Continence Mental state and cognition Communication, sight and hearing Mobility and falls DS0000020446.V283539.R01.S.doc Version 5.1 Page 10 • • • • Foot care and oral health Special equipment needed Family/carer involvement Social interests and needs. DS0000020446.V283539.R01.S.doc Version 5.1 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 the following standard(s): Standards 7, 8, 9 & 10 Whitecliffe House has a detailed care planning system in place, which ensures that staff have the information they need to meet the needs of residents, however not all documentation is completed. Good support from community health professionals helps to ensure that the health needs of residents are well met. The home has appropriate policies and procedures in place for the administration and storage of medication, ensuring that residents’ health needs are safely met. Residents are treated with respect and their privacy and dignity is promoted at all times. EVIDENCE: The care records of 3 residents were viewed on the day of inspection. These were found to be comprehensive, up to date and relevant and were based on the findings of robust assessments. They provided suitable information to staff about the needs of each resident and how they are to meet each need. DS0000020446.V283539.R01.S.doc Version 5.1 Page 12 Records demonstrated that care plans are reviewed and updated monthly or more often where necessary, however a few care plans did not have review dates on them. Entries made in residents’ daily records also confirmed that staff followed care plan interventions appropriately. Risk assessments were in place and appropriate steps are taken to minimise any risks identified but some risk assessments viewed were incomplete. This could place the health and welfare of some residents at higher risk. Where care needs have changed, appropriate professionals have been consulted to carry out further assessments etc. Records also demonstrated that residents have access to GPs, district nurses, dentists, opticians, chiropodists, etc and attend for hospital appointments as necessary. Residents and staff spoken to also confirmed this. During the inspection, medicines were properly stored, being locked away and with a refrigerator for cold storage. Staff record fridge temperatures regularly and the records were seen to support this. Records were kept of the receipt, administration and disposal of medication and examination of these showed that all was well recorded. However, medicine administration records did not always state the allergy status (to medicines) of each resident. The home uses a monitored dosage system and residents are assessed for their ability to manage their own medicines; at the time of inspection one resident was selfmedicating. Staff were observed throughout the inspection to treat residents with courtesy, kindness and respect. Residents spoken to confirmed that they receive help when needed and comments made, included: • • “Every member of staff I find very kind and caring” “I’ve really settled into the relaxed, caring environment”. All residents have their own bedrooms, thereby offering an opportunity to be on their own if they wish, or allowing privacy for any visitors or personal care needs. All residents were well presented and wearing jewellery, glasses etc, where appropriate and it was clear from entries made in their care plans that individual needs and likes were respected: • • Resident A “likes to dress smartly; quiet lady enjoys one to one interaction” “encourage Mr X to choose his own clothes”. DS0000020446.V283539.R01.S.doc Version 5.1 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 the following standard(s): Standards 12, 13, 14 & 15 The home provides a wide range of activities and events for residents and satisfies their social, religious and recreational needs. Residents are also encouraged to maintain contact with family and friends and the wider community. Residents are able to exercise choice over their lifestyle, whilst living in the home ensuring that their individual preferences and routines are respected. Whitecliffe House serves a balanced and varied selection of food that meets residents’ tastes, choices and special dietary needs within pleasant surroundings. EVIDENCE: The home employs an activity organiser who spends time with every resident compiling a detailed personal profile of their activity likes and dislikes, which are then reviewed monthly. Entries on these included: • • Resident X “enjoys musical activities” Resident M “likes own company but likes to chat when visited”. DS0000020446.V283539.R01.S.doc Version 5.1 Page 14 A large notice board in the entrance hall details all of the weekly events and activities taking place in the home and these vary from week to week. Residents at Whitecliffe House enjoy quizzes, playing bingo, watching videos, bowls and regular mini bus outings. Residents spoken to on the day confirmed that they were able to choose to follow their own activities and lifestyle on a daily basis. Most were visited and taken out by family and friends whilst some others were able to be more independent. On walking around the home service users rooms were clearly seen to contain their own possessions and personal effects, which was also confirmed from talking to residents. Residents records and the visitors’ book confirm contact with family and friends as well as visits by professionals. Residents select meals in advance from a planned menu, which is based on a 4 weekly rolling menu and reviewed regularly. Residents are offered the choice of a full cooked breakfast in the morning as well a choice of meals for lunch and supper. Sherry and nibbles are available before lunch and tea and biscuits and coffee and cake also available mid morning and mid afternoon respectively. The chef visits residents after admission and records their likes/dislikes and any special dietary needs. These are then reviewed every few months and a copy kept in the resident’s file also. A tour of the kitchen was made with the chef during the course of the inspection and plenty of fresh vegetables and fruit were seen for planned meals. Most residents spoken to said that the food is of a good standard, for quality, choice and quantity although some service user comment cards received, stated that they were unsatisfied with the quality and variety of food offered. On 05 January 2006 the food handling arrangements were assessed and found suitable by an Environmental Health Officer and the inspector saw the relevant report. DS0000020446.V283539.R01.S.doc Version 5.1 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 the following standard(s): Standards 16 and 18 were assessed at the last inspection and met. EVIDENCE: DS0000020446.V283539.R01.S.doc Version 5.1 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 the following standard(s): Standards 19 & 26 Standards 19 and 26 were assessed at the last inspection and met. The home is well maintained providing a safe, comfortable, hygienic environment for residents. EVIDENCE: These standards were assessed and met at the last inspection and a tour of the premises found the home remains clean and in good order. It was noted that the home appeared safe and well maintained during the duration of the inspection. DS0000020446.V283539.R01.S.doc Version 5.1 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): Standards 28, 29 & 30 Standards 27, 28, 29 and 30 were assessed at the last inspection. The home is continuing to work towards staff training for National Vocational Awards, to ensure that residents are safely cared for. Recruitment procedures are in place to ensure that unsuitable staff applicants are not recruited and therefore service users are not put at risk. However some staff records were found to have some recruitment details missing. The home must endeavour to provide more reliable evidence that staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: The home is continuing to work towards 50 of the staff attaining an NVQ level 2 or above, following a previous recommendation. Staff files have still not been updated with photographs and the manager confirmed that new employees’ files also did not contain them. This will therefore remain a recommendation in this report. Following a previous recommendation, training records are now available for all staff and evidenced in a comprehensive spreadsheet (training matrix). However, as discussed in the Management and Administration section of this report, staff fire training is not fully recorded on this record. DS0000020446.V283539.R01.S.doc Version 5.1 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): Standards 31, 33, 35, 36 & 38 Standards 35, 36 and 38 were also assessed at the last inspection. The manager is a qualified nurse and very experienced, although not yet registered. Clear leadership is provided throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The home does have some quality assurance systems in place to ensure that service users’ and their representatives’ views are listened to. However, these could be improved to ensure that the home is run in the best interests of the residents. Residents’ financial affairs are well protected and records show that this is now well managed. An appropriate supervision system is in place but not all staff receive regular sessions. Therefore individual’s training needs and practice may not be thoroughly assessed. DS0000020446.V283539.R01.S.doc Version 5.1 Page 19 The home does not demonstrate that all measures are taken to ensure that the health, safety and welfare of residents and staff are maintained. EVIDENCE: The manager, Mary Minns, is not yet registered but is a qualified nurse and has several years of nursing experience in both hospital and community environments. She has undertaken the in house management programme and is due to commence a diploma in management later in the year. She is well supported by a deputy matron and a team of care staff. A full range of policies and procedures is in place to offer advice and guidance to staff and these are regularly reviewed and updated as necessary. Discussions with staff show that they are clear about roles and responsibilities within the home. Other professionals involved with residents care, also speak positively about the management approach: • “..work in partnership…good communication and standard of care”. Working relationships between the management, staff and residents were directly and indirectly observed throughout the course of the inspection. They were friendly, yet professional, contributing to a welcoming and relaxed atmosphere, which was beneficial to all in the home. Residents and staff spoken to commented that the manager was always available to talk to and was very approachable, caring and professional. Comments included: • • “Matron’s door is always open” “…she works on the floor with us, so knows what’s going on”. The home carries out regular quality assurance audits of different areas, including call bell answering times and care planning. The provider as a whole, Colten Care, commission an independent company to carry out an in depth quality assurance audit of 4 of their homes randomly each year. Residents’ opinions are gathered through meetings held 6-8monthly, although there are no relative meetings offered. The home does write to relatives once a year to ask whether they are happy with the level of contact and information received from the home. Residents who have a short term stay are given an opportunity to comment on the home through a questionnaire. There was no formal evidence seen of how the home gathers other stakeholders’ opinions, such as GP’s and district nurses, although the manager does regularly speak with them and discuss any concerns or issues. There is also no annual development plan available, although it was apparent that plans and work are on-going in maintaining and updating the facilities and equipment available in the home. DS0000020446.V283539.R01.S.doc Version 5.1 Page 20 There are plans for every home to hold a copy of the company’s quality assurance file, which should then contain all the documentation necessary to evidence the monitoring systems and measures in place, to ensure that the home is run in the best interests of the residents. Residents’ finances were checked following a previous requirement made. The financial accounts of 2 residents were sampled and all receipts, transaction records and the monies held were found to tally. Following a previous requirement made, staff supervision records were checked. Supervision records were evident in staff files although sessions held with some staff appeared irregular and there had been no further entries made since the last inspection. Matron confirmed that management and clinical supervision takes place but could not evidence this with any documentation. Group supervision does take place during staff meetings, which occur 3-4 times a year, but these are also not documented on individual staff member’s files. All aspects of health and safety were evidenced through discussion with the registered manager and in the tour of the premises. The fire log was viewed and showed that the fire doors and emergency lighting were tested regularly as required, but staff fire training was not up to date and training records seen confirmed this. This therefore places residents, staff and visitors at risk. Any in house fire training must be accurately documented on the training matrix and all staff must receive 6 monthly fire training. All of the home’s service certificates seen were in date and included fire alarm testing, gas boilers and electrical testing. DS0000020446.V283539.R01.S.doc Version 5.1 Page 21 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 1 DS0000020446.V283539.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 17 Requirement Timescale for action 30/06/06 2. OP9 13 3. OP36 18(2) 4. OP38 23(4d) All residents’ care plans and risk assessments must be fully completed, to minimise any potential risks to their health and safety. The medicine administration 30/06/06 records for each resident should clearly state any allergy to medicines, or none known. The home must ensure that all 30/06/06 staff receive regular formal supervision at least 6 times a year and keep a record of this. All staff must receive a minimum 30/06/06 of 6 monthly fire training sessions and this must be recorded and evidenced through staff training documentation. DS0000020446.V283539.R01.S.doc Version 5.1 Page 23 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. 3. 4. Refer to Standard OP3 OP28 OP29 OP33 Good Practice Recommendations Pre admission assessments would benefit from more detailed information regarding when, where and who contributed to compiling them. The home should continue to work towards at least 50 of staff achieving a minimum of an NVQ 2 award. All staff records held would benefit from containing contemporary photographs for identification purposes. The home should devise a formal documented means of obtaining stakeholders’ opinions on the running of the home to ensure that the home is run in the best interests of residents. The home should provide a copy of the provider’s annual development plan to improve the home’s quality assurance procedure. 5. OP33 DS0000020446.V283539.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000020446.V283539.R01.S.doc Version 5.1 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. 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