Inspection on 21/04/06 for Woodlands House

This inspection was carried out on 21st April 2006.

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

Woodlands House 24/10/05

Woodlands House 10/05/05

Woodlands House 07/02/05

Woodlands House 03/11/04

Woodlands House 04/03/04

Woodlands House 29/09/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Woodlands House 205 Woodlands Road Woodlands Southampton Hampshire SO40 7GL Lead Inspector Mrs Michelle Presdee Unannounced Inspection 21st April 2006 09:00 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 Woodlands House DS0000012161.V287513.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. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Woodlands House Address 205 Woodlands Road Woodlands Southampton Hampshire SO40 7GL 023 8029 2213 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) woodlands@compuserve.co.uk H W Group Ltd Caroline Cooper Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Woodlands House is a detached property set in extensive grounds in Woodlands on the edge of the New Forest. There is a bus stop outside the service, with links to Southampton, Totton and Lyndhurst, and a railway station is nearby at Ashurst. The home is owned by H W Group Ltd, who also own two other residential homes in Winchester and Bristol. Accommodation is arranged on two levels in the main house, with a single story extension called the cottage, attached by a covered walkway. Building work has recently been completed to provide a further four single rooms with en-suite facilities, and a passenger lift between floors. There are nine single rooms in the cottage and a further twenty-five rooms in the main house, two of which can be used for shared occupancy. All rooms benefit from en suite facilities, aside from one room, which has a private bathroom close by. The fees for the home range from £432-£600. The home benefits from spacious communal areas. There is a lounge, library and garden room in the main house with additional seating outside the dining room, and a lounge in the cottage. Both living areas have a dining room and kitchen. There is also a small garden room off the main lounge with delightful views across the homes gardens. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6.5 hours. During this time all key standards were inspected. The manager of the home assisted through out the inspection. During the inspection, a tour of the premises was undertaken, with four service users rooms randomly chosen to view. The majority of service users were spoken to in the lounge and dining room. Discussions were held with five members of staff and one visitor to the home. Assessments, care plans and other records were viewed. Written information received from the home and previous reports have also been used to make judgements on the home. Five service user comment cards were received. The eight issues, which, were raised at the last two inspections, were addressed and it was found these had been satisfactorily actioned. What the service does well: What has improved since the last inspection? A new manager has started work in the home since the last inspection; both service users and staff expressed their satisfaction with the manager. A lot of work has been put into the home, addressing the previous identified shortfalls. Assessments and care plans have been improved, providing staff with more information. Records held on staff and staff training has all been improved, ensuring the safety and protection of service users. Appropriate risk assessments on service users and the building have been undertaken. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 6 Supervision of all staff has been started and the manager is also hoping to undertake staff appraisals. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment process provides sufficient information for care staff to meet service users needs, although additional information would be of benefit. The home does not provide intermediate care. EVIDENCE: The files of the last three service users to enter the home were sampled. It was found all had undergone the same admission procedure. An initial inquiry form had been completed. The manager or one of the seniors then visits the service user, either in hospital or in their present accommodation. A preadmission assessment is formed using any other information available at that time. Once the service user has been in the home for a little while an assessment is completed. The assessment looks at mobility, communication, hygiene, eating and drinking, psychological aspects, culture and leisure. Discussions with two of these service users confirmed the assessment process Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 9 works. They felt they were being well cared for with all their needs being met. Both felt the home had matched and bettered their expectations. Discussions were held with the manager on both improving the assessment and including and recording the involvement of the service user. It was clear care staff and the manager knew more information than was recorded on the assessment. In one situation the service user became distressed when speaking with the inspector as to how she had come to be at this home. On discussion with the manager, it was clear this was an on-going concern of the service user and the manager was aware how this should be managed. However there was no information on the assessment and care plan. Service users are not currently formally involved in the assessment process. Discussions were held on including service users, recording their views on the assessment and getting them to sign the assessment. The home does not provide intermediate care. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans give sufficient information to identify service users needs and show how the needs are to be met by care staff. The medication procedure is followed, ensuring service users safety. The core values are promoted in the home ensuring service users are treated with respect and their right to privacy is respected. EVIDENCE: All three-service users had individual plans of their care. These provided adequate information for carers to know a service users needs and how to meet them. Care plans were reviewed on a monthly basis, which involved looking at each are and ticking if there had been no change. The inspector was advised if there is a change this is recorded on the care plan. For the three service users plans viewed, there had been no change to their care plans. Daily and night notes are maintained for each service user. Discussions were held on Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 11 including the service user in this process and recording their views and obtaining their signature. Discussions were also held on ensuring all information is recorded on the care plan. In discussion with one service user, she expressed feelings of isolation and wanted regular outings. On discussion with staff members the inspector was advised the service user had been offered many outings, but had always refused at the last minute. It was agreed this should be recorded on the care plan. Other service users spoken to praised the home and the staff. Comments such as “staff are always available”, “the girls are great” were received. Service users felt the home offered a wide range of services and their needs were met. Service users felt their privacy and independence was respected, but help was always available if needed. Care plans also include details of service users health needs. All visits by health professionals are recorded on the service users plans. These include details of any recommendations or planned treatment. The home has a comprehensive medication procedure. Only the senior members of staff who are currently completing a long distance course on medication are responsible for the administration of medicine. The home uses blister packs, which are delivered into the home on a monthly basis. The inspector was advised all medication is checked when it enters the home and then stored in the two medication trolleys which are attached to the wall. At the times of administration, the appropriate trolley is taken around the home. Medication is given to the service user and records are maintained. At lunchtime it is not possible to take the trolley into the dining room, so carers take the medication to each service user, signing the medical record after each individual has taken their medication. The inspector checked the medical administration records in both parts of the home and found all records to be accurate. The records of controlled medication were checked and it was found these were all correct and wee signed and stored appropriately. The inspector was advised two service users currently self medicate. Assessments have been completed and the service users signatures have been obtained. Records are maintained of all medication returned to the pharmacist and the pharmacist signs the record. It was clear from observing staff interacting with service users they are aware of the core skills and work with service users in a way, which promotes their dignity and independence. Service users spoken praised the staff and felt they worked very hard. Comment cards received had agreed their privacy was respected and they felt they were treated with respect. Service users were pleased staff spent time on an individual basis talking to them. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The home provides a variety of social activities, giving service users the choice to join in when they wish. Visitors are made welcome to the home. A varied menu with a choice and good quality food is served to service users in a pleasant environment. EVIDENCE: Service users spoken to on the day certainly felt the home had matched their expectations. Service users enjoyed the space of the home having several communal areas to choose from and use of the library. Service users enjoyed the grounds of the home and most talked about going for a walk on a regular basis. The home employs some one to arrange all social activities in the home. On discussion with this member of staff it was clear her role is important to her and a lot of effort is put into meeting service users needs. The social activities coordinator explained she asks service users on an individual basis and group basis what their preferences are for activities in the home. Social events in April included a sweepstake on the Grand National, an Easter bonnet parade, the derby races, a concert in the home and a footwear sale. The home is Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 13 planning a theatre trip, attending a local tea dance, attending a local bowls club and arranging a summer barbecue. Visitors are always made welcome at the home and are asked to sign in and out of the home. Service users spoken to stated their visitors are always made welcome and offered a cup of tea or coffee. A lot of service users spoken to spoke of their enjoyment of going out with their family. The home can facilitate private family get-togethers and meals in the library for special events. One service user did express that they felt a little isolated in the home and would like more outings. However on discussion it transpired outings had been offered both to social events and to local shops but these had been declined. The majority of service uses in the home are able and independent. It was clear they are offered choices in their daily living activities. Service users stated help was always available if they needed but some were happy to be left to manage their own personal care. Service uses have a choice at mealtimes and service users stated if they did not like either of the choices an alternative was always found. At lunch time service users spoke of their involvement of the menu confirming if there were special dishes they wanted on the menu the chef would try and put this on the menu. Service users were very pleased with the new chef and the interaction they had with them. The menu is displayed on the notice board in the home. Only one special diet was catered for, which the chef had an awareness of and this was recorded in the service users care plan. Meals are served in both the main dining room and the dining room in the cottage. The inspector had lunch with the service users in the dining room in the main building. The mealtime was pleasant and relaxing. Service users who expressed their satisfaction with the meals in general required no assistance. One comment was made which other service users agreed on was the need for their plate to be warm as the food goes cold quicker without this; the manager was aware of this request. Service users had enjoyed sherry in the lounge prior to lunch. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users felt confident their complaints would be listened to and acted upon. Service users are protected from abuse although staff would benefit from guidance on dealing with suspected abuse. EVIDENCE: The home has a complaints procedure, which details all the relevant information, including phone numbers, address and timescales. The commission has received no complaints since the last inspection. Service users on the day clearly felt their complaints would be listened to and acted on. Service users stated they would speak to the manager if they had a complaint. Most stated they would involve their family members if the complaint was not dealt with, but felt this was unlikely to happen. Details of the complaint procedure are included in the contract and the service user guide. It was agreed the majority of service users do not have a copy of these and it was agreed all service users would be given a copy of the service user guide. Policies and procedures relating to the protection of older people and information on abuse are available in the home. Training on the adult protection was provided in November 2005 and has been arranged for September this year. On discussion with staff members it was clear they had an awareness of the types of abuse. Some staff members were more uncertain of the procedures to put in place if abuse was suspected. This was discussed at the time and the manager stated it could be discussed at a staff meeting. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean, safe, pleasant and well-maintained environment for the enjoyment of service users. EVIDENCE: The home provides a clean, well presented, safe and homely environment for all service users. The home is decorated to a good standard; one bedroom has recently had a new carpet and another has been re-decorated. The bedrooms seen were clean and had been personalised by the service users, who appeared proud of their bedrooms. Service users clearly enjoyed the environment of the home and made very strong comments; “this could not be bettered” “the grounds and wildlife are beautiful”. The member of staff responsible for keeping the home clean felt it was a rewarding and responsible job, and would welcome some help. The home is trying to recruit another domestic. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 16 All areas of the home seen were safe. All cleaning and laundry products are now kept together in a locked cupboard. All communal toilets have liquid soap dispensers and paper towels minimising the risk of spreading infection around the home. Risk assessments have been completed on the building. Woodlands House DS0000012161.V287513.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): 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. The home has good recruitment and training procedures, which ensures that service users needs are met by sufficient numbers of competent staff. EVIDENCE: From records seen and from discussion with service users and staff members, the home has adequate staff on duty. Service user felt the staff worked very hard and were very good at their jobs. One service user stated, “nothing is too much trouble, they encourage us to ring our bells”. Staff members spoken to felt there were adequate staff on duty at all times to meet the needs of service users. They felt service users were well cared for and had their needs met. The staffing records of the latest two care staff to join the home were checked. It was found all had completed all necessary paperwork, appropriate checks had been undertaken and references obtained. All paperwork is collated at head office and when all has been completed and finished the home is informed they can then start that person working in the home. Records are then maintained at the home and are available. All new staff will undertake the new induction process. As staff go through each section, they discuss with either the manager or one of the care supervisors and both sign to say they are now competent in that area. Training is an area, which has improved. The manager has created a training record for each member of staff stating when they have completed training and when they are due to take the next training. Certificates of courses Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 18 undertaken are kept on the staff members file. Recent training in the home has included Control of substances Hazardous to Health (COSHH), basic food hygiene, first aid, manual handling, fire training and dementia. Further fire training has been booked for July, adult protection training in September and health and safety training is being looked into. The manager advised the Commission over 50 of staff have satisfactorily completed a National Vocational Qualification (NVQ) Level 2. The staff spoken to on the day of the visit felt training in the home had improved and for them had covered all the areas they felt they had needed training. Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 19 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): 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. The home is well managed and the manager has a clear direction for the future. Service users views contribute in the development of the home. Service users finances are protected and the health and safety procedures in the home ensure service users are protected. EVIDENCE: The manager has been in post four months and already made good progress in the home. Records and training are areas where there have been improvements. From discussions with staff members and service users it was clear they were already pleased with the new manager, both groups feeling they could approach her if there was a problem Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 20 It was clear from discussions with service users, staff members and one visitor the home is run in the best interests of the service users. The service users in the home are independent and well able to express their views, which is respected by the staff in the home. Service users have regular meetings and are also given questionnaires to fill out on the home. These were viewed and it was clear they feel the home is well run with very little negative comments. One service user had commented her room was cold, this had been looked into and a small thermostatic heater had been purchased. The kitchen was well organised and clean. All food in the main fridge was covered and dated. It was noted the fridge in the small kitchen in the bungalow did have some items, which were not covered and dated, which it was agreed would be addressed. Menus are organised on a weekly basis and the food ordered as required, the butcher could deliver daily. The chef felt with the budget he was able to buy good quality food with no restrictions. The chef did comment he would like a hot plate but thought this was being looked into. The temperature of the fridge and freezers were being recorded daily. The accident book was seen, which had been appropriately completed and the information had been stored in a relevant place. The home does not manage the finances for any of the service users. One service user who had recently been admitted to the home had no money and the family were abroad. The home had ensured the service user had all they needed and had kept a receipt for each item bought. The family agreed and brought the necessary funds in. From records sent to the Commission and from the fire log book it was possible to establish all members of staff have received one session on fire training, with night staff receiving training every four months. The necessary tests were being carried out in the agreed timescales and being recorded in the fire logbook. The home had held a full evacuation and the fire brigade had been called. The manager felt this had worked well and a good record was maintained. The fire alarm had been serviced on 7/7/05 and the emergency lighting on 5/4/06. Woodlands House DS0000012161.V287513.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woodlands House DS0000012161.V287513.R01.S.doc Version 5.1 Page 24 - 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!