Inspection on 03/04/07 for Willow Lodge

This inspection was carried out on 3rd April 2007.

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.

Other inspections for this house

Willow Lodge 02/02/06

Willow Lodge 11/10/05

Willow Lodge 04/02/05

Willow Lodge 11/10/04

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

CARE HOMES FOR OLDER PEOPLE Willow Lodge 59 Burdon Lane Cheam Surrey SM2 7BY Lead Inspector Alison Ford Key Unannounced Inspection 3rd April 2007 10:30 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 Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willow Lodge Address 59 Burdon Lane Cheam Surrey SM2 7BY 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) 020 8642 4117 020 8642 7729 trilodge@hotmail.com Trilodge Limited Mrs J E Grant Asha Paroomatee Gobin Care Home 27 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (0) of places Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two (2) places for service users under the age of 65, with dementia, can be accommodated. 2nd February 2006 Date of last inspection Brief Description of the Service: Willow Lodge is a large detached residence in Cheam that is registered, with the Commission for Social Care Inspection, to provide nursing care for up to twenty-seven people with dementia. A variation is in place to allow two younger residents to live in the home, others are over the age of sixty-five. The home is owned by Trilodge Ltd and run as a family business with two of the directors, both nurses, frequently working in the home alongside the registered manager. The home prides itself on offering a high standard of care in comfortable, safe and homely surroundings in which the wellbeing of the residents is of prime importance. It is well served by public transport links, near to the station and local shops. Accommodation is provided in a mixture of single and double rooms arranged over two floors and there is both a passenger and stair lift. There are two spacious lounges, a conservatory and an attractive well-maintained rear garden. Various adaptations throughout ensure that all areas of the home are accessible to residents. At the time of this inspection fees range from £580 - £670 a week. Some extra charges may be payable for services such as hairdressing and these would be discussed prior to admission. The homes Statement of Purpose, the Service User Guide and a copy of the latest inspection report can be obtained from the home. Inspection reports can also be obtained from the Commission for Social Care Inspection or downloaded from the internet. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2006/2007. In writing the report consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. A partial tour of the premises was undertaken; many of the twenty-six residents currently living in the home were spoken to, also four relatives that were visiting and several members of staff. Various records that the home is required to keep, as evidence of its commitment to the protection and health and safety of its residents, were seen and also a sample of care plans which identify the help and support that residents need and show how their assessed health care needs are met. Since the last inspection there has been one complaint, which was dealt with according to the local authority safeguarding of adults procedures. This was found to be unsubstantiated. At the time of this visit a further issue was being investigated under the same procedures. What the service does well: This home offers well-maintained and homely environment for up to twentyseven people with dementia. It is clean and warm and specialist adaptations ensure that all areas are accessible. Assisted baths and toilets suitable for wheelchair users are throughout the home and there is a pleasant garden where residents can sit in the summer month. The home has a Statement of Purpose and a Service User Guide, which are given to residents or their representatives at the time of admission and explain the range of services that the home can offer. This helps them to have the information that they need to decide whether the home will be suitable for them. Questionnaires are sent out annually to measure how well the home meets its stated aims and objectives. Prior to their admission, all new residents would be visited by a senior member of the nursing team and an assessment of their physical needs undertaken to make sure that they can be met. Care plans are then compiled to identify the support that will be needed. These plans are reviewed regularly to ensure that changes are identified and that all of the staff are helping the resident in the way that they prefer. The Registered Manager of the home ensures that the provision of staff training is given a high priority and it is planned to make sure that all staff have the skills that are needed to deliver this care. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 6 All of the residents agreed that they are treated kindly and relatives that were visiting were very complimentary about the attitudes of staff members describing them as” very pleasant and caring” Many staff members have worked in the home for several years and residents appreciate the continuity of care and seeing the same people all the time. Organised activities are held daily in the home, for those who wish to join in, and various pieces of craftwork that residents have done are displayed on the walls. Birthdays and other occasions are celebrated and relatives and friends are encouraged to visit as much as they would like to. Residents were complimentary about the meals served in the home and the cook has worked there for many years. Choices are always available and special diets can be catered for. Complaints about the home are few and all staff have received training in issues around the recognition of adult abuse. Health and safety practices with in the home are good, comply with current legislation and provide evidence of the homes commitment to the protection and wellbeing of residents and staff. What has improved since the last inspection? What they could do better: Although a Service User Guide is given to residents at the time of their admission, so that they have all of the information that they need, this must be amended to reflect the fees that are charged by the home. It must also contain information about when these might be increased. It is recommended that copies of this document should be left in resident’s rooms for reference. The home cares for people with dementia and many residents have difficulty communicating. So that staff can understand more about them and their past lives and achievements more work must be done with regard to their “life histories” and social interests. This will also allow staff to provide activities, which will interest residents and stimulate their remaining abilities. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 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 Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,3,6 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents and their families are able to access most of the information that they need to decide whether the home will suit their needs and a comprehensive pre-admission assessment generally ensures that their healthcare needs can be met however, more work is needed to ensure that it will suit their social preferences. This home does not offer intermediate care. EVIDENCE: The home has a Statement of Purpose and a Service User Guide, which is revised annually. In order to ensure that prospective residents and their families have all of the information that they need when they are choosing a home, amendments must now be made in line with the regulations in respect of the fees to be charged. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 10 Copies of the Service User Guide are given to residents during the admission process however, this should provide a guide to way the home runs and the services that are provided and therefore it is recommended that a copy should be put into each residents room. It must also be expanded to include a copy of the latest inspection report. The care plans of four residents, who had moved into the home since the last inspection, were assessed. They all contained evidence that a full and comprehensive pre-admission nursing assessment had been undertaken which then formed the basis of subsequent care planning. There was limited information available to illustrate whether potential residents social needs and interests had been taken in to account during the admission process so that they could choose if life in the home would suit them. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9, 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. An individual care plan, reviewed regularly, reflects the care being given, the support that is required and ensures that residents changing needs will be identified. Residents can be confident that they will always be treated in a manner, which ensures that their dignity and privacy are respected and that medication procedures within the home will protect them. EVIDENCE: The four care plans, that were assessed, reflected the care and support that is currently being provided. Both actual and potential problems are identified and although standardised plans are used, they have been selected carefully to ensure that they are appropriate for the identified problems and compiled according to best practice guidelines. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 12 Although medical and nursing needs are well documented there is limited information about residents past lives and achievements. In order that staff can develop an understanding of resident’s present behaviour and identify activities and pastimes, which would stimulate their remaining abilities, work must be undertaken to try and produce residents “life histories”. Risk assessments, nutritional screening and moving and handling assessments are all in place and also regular review of factors, which may predispose to pressure sore formation. Several examples of pressure relieving equipment were in use in the home. The majority of residents are registered with one doctor and other healthcare professionals visit the home as required. The medication system has recently been changed to a monitored dosage system. Storage, administration and records were all in order at this visit and the supplying pharmacist will be undertaking regular audits and training sessions in the home. Residents and their relatives confirmed that staff are always very kind and caring towards them. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are activities within the home, which are suited to the resident’s capabilities and provide daily interest for them and visitors are always welcome, so that links with friends and families can be maintained and encouraged. A nutritious appealing diet helps to add variety to resident’s days and, they are supported to exercise as much choice over their lives as they can. EVIDENCE: An activities organiser ensures that a varied programme of activities takes place in the home and examples of resident’s artwork are displayed throughout the home along with photographs of events that have occurred. Relatives are always made welcome and they are encouraged to join in the Christmas and summer parties that are held in the home. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 14 The advanced stages of dementia, of many of the residents, limits the amount of choices that they can make however, they are encouraged to select their clothes and what they would like to eat. The lunchtime meal was served during the visit. All the residents confirmed how much they had enjoyed it; menus were seen and were varied and nutritious. One resident has a vegetarian menu, and the cook is aware of any particular dislikes and would offer a choice. Residents are weighed monthly and any fluctuations would monitored however there must be a record kept in the home of the food that they have actually eaten and this was discussed during the inspection. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16,18 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There is a complaints policy designed to ensure that any concerns would be dealt with promptly and effectively and residents and their relatives generally feel confident that procedures are in place to safeguard them from abuse. EVIDENCE: There is a clear complaints procedure in place in the home and relatives that were spoken with during the inspection visit were confident that any cause for concern would be addressed appropriately and dealt with sensitively. Since the visit an issue has been raised that has suggested that this has not been the experience of one complainant however this is still under investigation. The management team within the home must ensure that residents and their relatives feel confident enough to raise concerns without worrying about the possibility of any reprisal. All staff have received training in adult abuse awareness and the protection of vulnerable adults and those spoken with were able to demonstrate an understanding of the procedures to be followed. It was noted that new staff members begin work prior to the receipt of Criminal Records Bureau clearance. An assurance was given that checks are made against the Protection Of Vulnerable Adults register however a copy of the confirmation of this must be available in the home for inspection. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 16 The Registered Manager was reminded of her responsibilities with regard to the supervision of any staff member who is employed prior to the completion of all of the necessary checks. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. This home offers a well-presented, well-maintained and clean environment, which meets the needs of its residents and allows them to live in a comfortable homely atmosphere. EVIDENCE: The home is situated in a pleasant residential road close to local amenities. It is well maintained, complies with fire safety regulations and is presented in good decorative order. Furniture and furnishings are homely and adaptations have been made throughout the home to ensure that it meets the needs of the residents. The range of communal space means that there can be different activities happening throughout the home at the same time. There is a large rear garden which is well used during the summer months and parking facilities to the front. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 18 Resident’s bedrooms are light and airy, all of them have washbasins and shared rooms have privacy screens available. Residents have been encouraged to personalise their rooms with items from home to make their surroundings more familiar and to retain their individuality. The home was, as usual, very clean and free from malodour. It was noted that there is a sluicing disinfector in a cupboard upstairs, which is not locked. It is not considered, by the home, that this poses a risk to any of the residents on that floor however it is recommended that a lock should be put on the door to prevent any untoward incidents occurring. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents can be confident that there will always be enough staff in the home to meet their needs and that they have all undergone training which will help them understand how to support and care for them. Recruitment policies are in place to help to protect residents and maintain their safety. EVIDENCE: Staff turnover is very low in this home, giving residents continuity of care and a feeling of safety and familiarity. Two new members of staff had been employed since the last inspection and their files were seen. One was complete however the other was awaiting clearance from The Criminal Records Bureau. An assurance was given that checks are made against the Protection Of Vulnerable Adults register however a copy of the confirmation of this must be available in the home for inspection. The Registered Manager was reminded of her responsibilities with regard to the supervision of any staff member who is employed prior to the completion of all of the necessary checks. Staff training continues to be given high priority in the home and exceed the minimum standard with all members of the staffing team being encouraged to Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 20 attend training courses, relevant to the work that they perform. Many of them have undertaken several courses at NVQ level 2. As well as increasing the knowledge of staff the process of them all undertaking the training together promotes a team feeling with them all helping each other and being able to contribute a different perspective. At the time of this inspection there were sufficient staff, both trained nurses and carers, to have time to support residents and off duty rotas showed that this was always so. Additional domestic, laundry and catering staff are employed. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents and their relatives are confident that an experienced, competent and well-qualified person manages the home so that their best interests will be protected, and policies and procedures are in place to maintain their safety, however they are often not able to express their opinions about the service that they receive in any formal way. EVIDENCE: The Registered Manager of the home, a registered nurse, has many years experience in working with this client group and a background in nurse education. The two directors, both trained nurses, are also often in the home. This strong management team are able to lead by example and support the staff. There is a welcoming relaxed atmosphere in the home and the low staff Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 22 turnover supports staff comments on their satisfaction with their working conditions. There are regular staff meetings and the minutes of these were seen. Relatives confirmed that they are always able to approach the management team in the home and an annual quality assurance questionnaire is sent out to try and gain the views of residents and their relatives. The home does not take responsibility for the finances of any of the residents they all have relatives or representatives to do this for them. Certificates of worthiness and maintenance for the equipment in use in the home and to protect the safety of residents were seen and were generally in order. The certificate providing evidence of electrical safety in the home was missing and The Registered Manager will arrange for a duplicate. Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 23 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X X Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 OP1 Regulation 5(a) Requirement The responsible person must ensure that the Statement Of Purpose is amended in line with the regulations to include information relating to the fees that are payable. The responsible person must ensure that the Service User Guide includes a copy of the latest inspection report for the home. The responsible person must ensure that the pre-admission assessment includes information relating to residents social care needs and preferences. The responsible person must ensure that residents care plans contain information relating to their past lives and achievements in order to understand their present behaviour and plan activities that will interest and stimulate them. The responsible person must ensure that there is a record of food that is consumed by residents in enough detail to provide evidence of a nutritious DS0000019131.V335270.R01.S.doc Timescale for action 03/07/07 2 OP3 5 03/07/07 3 OP3 14 03/07/07 4 OP7 15 03/07/07 5 OP15 Schedule 4 (13) 03/07/07 Willow Lodge Version 5.2 Page 25 6 OP29 19(11) 7 OP16 22 and balanced diet. The responsible person must 03/04/07 ensure that there is evidence that clearance has been obtained from the POVA register prior to new members of staff beginning work. The responsible person must 03/04/07 ensure that residents and their relatives feel confident enough to raise concerns without worrying about the possibility of any reprisal. 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 OP1 Good Practice Recommendations It is recommended that a copy of the Service User Guide should be put into resident’s bedrooms so that they and their families can be sure of the services that are provided by the home. It is recommended that a lock should be put on the door to the sluice upstairs to prevent any untoward incidents. 2 OP19 Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 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 © 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 Willow Lodge DS0000019131.V335270.R01.S.doc Version 5.2 Page 27 - 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!