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Inspection on 16/10/08 for Whitemoss Resource Centre

Also see our care home review for Whitemoss Resource Centre for more information

This inspection was carried out on 16th October 2008.

CSCI found this care home to be providing an Good service.

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

Staff gather as much information about a person as possible before they go to stay at Whitemoss. People told us that their health care needs are met by the service. Activities are available for people to participate in. Staff treat the people who use the service in a respectful manner. Policies and procedures were in place to protect the health, safety and wellbeing of all. People knew who to speak to if the were not happy or if they wanted to make a complaint about the service. People who use the service liked the food that was served at mealtimes.

What has improved since the last inspection?

Several areas of the home had been refurbished with new carpets, furniture and decorated improving the environment for people to live. Several staff had attended safeguarding awareness training.

What the care home could do better:

Care plans should contain more detailed information about people`s specific care needs and how these needs are to be met.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Whitemoss Resource Centre Benmore Road Blackley Manchester M9 6LD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Adele Berriman     Date: 1 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Whitemoss Resource Centre Benmore Road Blackley Manchester M9 6LD 01617407704 01617206733 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Harold James Connor Type of registration: Number of places registered: Manchester Children, Families and Social Care care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Statement of Purpose must be maintained in line with the requirements of Schedule 1, of Regulation 4 (1) of the Care Homes Regulations. The Statement must be kept under review and updated. Any changes to the home`s purpose must be agreed with the National Care Standards Commission prior to implementation. The authority must at all employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. The home must be managed at all times in accordance with the guidance and regulations issued in respect of older people`s homes by the Secretary of State for Health under Sections 22 and 23 (1) of the Care Standards Act 2000. The home provides accommodation for a maximum of 27 service users, 6 of whom are in receipt of long term care all of whom require care by reason of old age (OP). The matters detailed in the attached schedule of requirements must be completed within the stated timescales. The staffing arrangements at the home must be maintained in line with the minimum Care Homes for Older People Page 4 of 28 Over 65 27 0 levels set out in the guidance published by the Residential Forum, ` Care Staffing in Care Homes for Older People `. This must be reflected in the Statement of Purpose. Date of last inspection Brief description of the care home Whitemoss is a purpose built Local Authority provision located in the North of the City, which provides a range of services within the immediate area and from referrals City wide. The home provides accommodation and personal care for twenty residents within the category of old age (OP). Five of these places are long stay placements and the remaining twenty two are used for short term and respite care. The home is located within a residential area of Blackley and it is within easy reach of local shops, public transport and the local motorway network. Large gardens surround the property and there is car parking space for visitors. Accommodation is provided on two floors with access via a lift or stairway. All accommodation is offered in single rooms; none of the rooms offer en-suite facilities. There are a number of lounge areas, which offer larger group living arrangements or small quiet lounge areas. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited Whitemoss on the 16th October 2008. We arrived at 11.30am and left at 7.30pm. During our visit we talked to people who were staying at the home and to some staff on duty. We also looked at a selection of records, policies and procedures and toured of some areas of the building. Before our visit the registered manager of Whitemoss completed an Annual Quality Assurance Assessment (AQAA). This document gave the service an opportunity for them to tell us what they do well, how they feel they have improved in the last twelve months, what they felt they could do better and what their plans for improvement were in the next twelve months. Care Homes for Older People Page 6 of 28 Five people who use the service and six staff completed survey forms to tell us what they thought about the service. The cost of the service is between 102.00 and 379.00 pounds a week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Where possible, peoples needs are fully assessed before they are admitted to the home. Evidence: When we visited, four people were in permanent residence. A further twelve people were residing at the home for a period of respite. The home provides a respite service for both planned and emergency admissions. They told us that when an admittance to the home is planned the individual is invited to spend time at the home to make themselves familiar with the service. Information relating to trial visits to the service was detailed in the Service User Guide. They told us that where possible peoples needs and wishes were assessed before they moved into the home. Pre admission assessments were carried out by a senior Care Homes for Older People Page 10 of 28 Evidence: member of staff who visited the person in their home or in hospital. In addition, information from social and health care professionals was sought to ensure that the service was able to support the needs and wishes of the individual. We saw evidence of this information during our visit. Whitemoss does not provide intermediate care facilities. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by the service. Evidence: We saw that the people resident at Whitemoss had a care plan on their own personal file. The format of the care plan gave the opportunity to record peoples needs and wishes in most aspects of their lives. Peoples capacity to make decisions was not considered in their care plans. This information should be included to ensure that people receive the care and support they require. We examined four care plans during the visit and the detail of the information in the documents varied. For example, one care plan contained clear information about how a person mobilised. The care plan stated is able to mobilise slowly but confidently. She is at risk from falls but does not currently use a walking aid, uses a wheelchair for long distances, has a profiling rise and fall bed to help her from lying to sitting Care Homes for Older People Page 12 of 28 Evidence: position. We saw other information that was not clear. For example, the section of a persons care plan titled, mental health and cognition, stated that the resident had a form of dementia and that they had a lack of insight into their condition. The care plan stated that the person needs encouragement to support and fulfill their potential. We saw no information as to what encouragement was needed and how it needed to be delivered. Staff spoken to showed a good knowledge of how people needed to be supported, however, information on individuals care plans should fully demonstrate how peoples needs are to be met to ensure they receive the care and support they require at all times. We saw a lot of assessments, care planning documents and records on peoples individual files that had not been dated or signed. All documents should be signed and dated to ensure that people are aware of the validity and age of the records. They told us that people living at White Moss on a permanent basis are registered with a local GP. People receiving respite care at the home are registered with a local GP on a temporary basis for the period of their stay. There was information on peoples files that told us that they had received visits from local health care professionals. People living at the home told us that they always receive the medical support they need. One person told us when I ask for the GP, when not well, he is always sent for. During our visit we saw staff interacting with people in a positive and respectful manner. Five people living at Whitemoss completed a survey form. They told us that they always receive the care and support they need and that staff listen and act on what they say. The service had a policy available relating to medication. They told us that this policy was currently under review and would be updated in the near future. Information was available to staff responsible for administering medication on what to do if a person refused their medication. We saw that medication was stored appropriately. We randomly selected some Medication Administration Records (MAR) and found that they were completed appropriately. They demonstrated that they had a procedure for recording the medication that people brought with them to Whitemoss when they were visiting for a short period of respite. One person using the service had diabetes. They told us that their medication was administered by the district nursing service who would inform them if the person needed to increase their food intake. There was no information recorded about what actions the staff team would need to take if the persons condition changed. Care Homes for Older People Page 13 of 28 Evidence: Information and guidance should be available to the staff team about peoples specific health conditions to ensure that appropriate action is taken if a persons health situation changes. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with opportunities to make choices about how they want to spend their time and what food they want to eat. Evidence: We saw a programme of activities available within the service. The programme scheduled activities over a seven day period and included general knowledge quiz, bingo, armchair exercises, arts and crafts, reminiscence, cards and dominoes, skittles and carpet bowls. On the day that we visited several residents went out to participate in the Lord Mayors Games, a competition between several services within the Manchester area. One resident who had returned from the games told us that shed had a wonderful time. She told us that she had not competed in the games but had gone along as support for other people. During the visit we saw that people were able to choose how they spent their day. People staying at Whitemoss for a period of respite told us that they could take part in the activities of they chose to. Two people told us that they preferred to sit in a quiet Care Homes for Older People Page 15 of 28 Evidence: lounge and watch TV. People told us in their survey forms that there were always activities arranged that they can take part in. They told us that visitors were welcome at any time. Several relatives of people using the service were seen visiting during our visit. We spoke to senior staff who demonstrated that peoples choices were respected. They told us about a new call system that had recently been installed. The system consisted of a call bell for people to alert the staff team via a pager. The system also included sensors on peoples beds to detect if a person has been incontinent or if they have got out of bed. They told us that some people had chosen to have the urine sensors on their beds turned off. This demonstrated that people who use the service had been given a choice. However, there was no information contained in peoples care plans to demonstrate that these choices had been made. All information relating to peoples choices should be recorded to ensure that the staff supporting them are aware of what care and support they need. Meals were served in a large pleasantly decorated dining room with the tables decorated with condiments, cutlery and flowers. We saw a sample of the menu. It gave people a choice of foods at lunch and teatime. They told us in their AQAA that they had changed the menu after consultation with the people who use the service. One person wrote about the food, no complaints. Very welcoming tables. Another person told us that they have a variety and always hot. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were aware of how to make a complaint. Evidence: They had a complaints procedure and a summary of the procedure was avialable in the foyer of the home in a leaflet titled tell us what you think. The leaflet gives information about how a person can raise a complaint, compliment or comment with Manchester City Council. The leaflet tells people about the Councils three stages of their complaints procedure. People who use the service told us in their survey forms that they knew who to speak to if they were not happy about the service and all stated that they knew how to make a complaint about the service. We saw a complaints log when we visited. The purpose of the log was to record all complaints received by the service. The log did not give the oppertunity to record the outcomes of investigations into complaints. This information should be recorded so that a clear record of complaints is maintained at all times. They told us that they had not received any complaints about the service since our last key inspection. Care Homes for Older People Page 17 of 28 Evidence: The manager told us that following a requirement from our previous inspection report all staff were in the process of receiving awareness training of Manchester City Councils safeguarding procedures. They told us that no allegations of abuse had been made or referred since our last key inspection. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have access to pleasantly decorated and comfortable communal areas around the building. Evidence: Since we last inspected the service they had carried out several improvements to the homes environment. These improvements included, new carpeting and floor covering in many areas of the service and new furnishing and bed linen for the majority of the bedrooms. We saw that some communal areas around the building had been redecorated which provided people who use the service with a pleasant environment. We looked around several other areas of the building including the bedrooms of two of the people who live at White Moss on a permanent basis. These bedrooms were individualised with the peoples personal effects. Several bedrooms and toilet facilities throughout the building did not have any hot water available. They told us that there had been a recent problem with the hot water supply and action was being taken to address the situation. A new patio door had been fitted from the lounge into the garden area, the lock to this door was a yale type lock and a key was required to open the door in the event of an Care Homes for Older People Page 19 of 28 Evidence: emergency. They told us that the door was not a designated escape. We recommended that they seek the advice of Greater Manchester Fire and Rescue service about the appropriateness of the lock in place. People who completed a survey form told us that the home was always fresh and clean. A laundry room was available that contained appropriate facilities. We found that the sluice facility in the laundry was damaged and some areas of the flooring needed attention. There was no ventilation in the laundry. We saw two small windows but they could not be reached as they were blocked by equipment that was no longer in use. The service should seek advice from the Environmental Health Department on appropriate infection control procedures for the laundry. Also, advice should be sought about appropriate ventilation of the room and all equipment no longer in use disposed of. We saw that several windows around the building were dirty. The service should make appropriate arrangements to ensure that the windows in peoples bedrooms and in communal areas are cleaned when needed so people can easily see through them. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a team of staff who have a good awareness of their needs. Evidence: We looked at the recruitment records of three members of staff. They told us that once a persons recruitment has been completed, their application form, references and Criminal Records Bureau (CRB) check are stored at Manchester City Councils central human resources department. We saw that people were supported by staff in a positive manner and that staff demonstrated a good awareness of individuals needs. The majority of staff said that they usually have the right support, experience and knowledge to meet the needs of the people they support. People told us that staff listen to them and act on what they say. One person told us that staff are very good and always on hand to support and listen. Another person told us very good staff. Staff told us that they are being given training that is relevent to their role, that helps them understand and meet the individual needs of people and that keeps them up to date with new ways of workling. Care Homes for Older People Page 21 of 28 Evidence: We saw staff training records which told us that several staff had recieved training in moving and handling, cultural and religious awareness, IT training, risk assessment training and adult safeguarding. The records that we saw contained little information about the content of the training and it is recommended that fuller details are recorded as an audit of what further training may be needed. They told us that the majority of staff had achieved their National Vocational Award (NVQ) level 2 or above. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures were in place to protect the health, safety and welfare of people. Evidence: We saw that there were clear lines of accountability within the service. We spoke to two shift managers and they both demonstrated a good awareness of the needs of the people they support and their role. Before our visit, the manager of the service completed an Annual Quality Assurance Assessment (AQAA). The document gave them the opportunity to tell us information about the service including what they did well, what they could do better and their plans for improvements in the next twelve months. It also told us what policies and procedures they had in place and information relating to the needs of the people who use the service and the staff team. The completed AQAA contained some of the information we required. Care Homes for Older People Page 23 of 28 Evidence: Procedures were in place for the safekeeping of peoples finances. All transactions were recorded and these records were checked on a monthly basis. They told us that they were in the process of implementing new quality assurance paperwork to monitor the service that is provided. They said that the new documentation also gave them the opportunity to monitor the management and administration of the service. The majority of staff told is in their survey forms that their manager meets with them regularly to give support and discuss how they are working. We saw on some staff files evidence of staff supervisions taking place. They told us that they were trying to improve time management within the service to ensure that all staff receive regular supervision for their role. We saw that policies and procedures were in place to protect the health, safety and wellbeing of all. Copies of these procedures were readily available at the home. They told us that Manchester City Council had recently changed its procedure for reporting accidents within the home. The new procedure did not give the opportunity for accidents to be monitored as the procedure stated that the information was sent to the councils Health and Safety department. A record of accidents should be maintained to ensure that the cause of accidents can be monitored. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Detailed guidance and information about peoples needs, healthcare needs,wishes and risks to their welfare should be recorded to ensure people receive the care and support they require at all times Peoples needs relating to their decision making and capacity to make decisions should be documented in their care plan. Individual risk assessments should be developed so that they consider all known risks and the documents reviewed on a regular basis to ensure that they contain up to date information. All risk assessments should be dated and signed by the assessor. Peoples choices of environment and equipment should be recorded to ensure they receive the care and support they require. The services complaints log should include the outcomes of any investigations and their outcomes into complaints. Advice should be sought from the Environmental Health department about appropriate infection control procedures for the laundry. All equipment no longer in use should be removed from the laundry. Advice should be sought from Greater Manchester Fire and Page 26 of 28 2 7 3 7 4 14 5 6 16 21 7 21 Care Homes for Older People Rescue service about the appropriateness of the patio door lock leading to the garden area. 8 9 10 26 29 38 The service should develop a system in which windows are cleaned on a regular basis. Fuller details of traning received by staff should be kept as an audit of future training required A record of all accidents that occur within the service should be available for monitoring purposes. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!