Inspection on 22/05/08 for Woodlands Lodge And Cottage

This inspection was carried out on 22nd May 2008.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodlands Lodge And Cottage 17/09/09

Woodlands Lodge And Cottage 24/05/07

Woodlands Lodge And Cottage 14/12/06

Woodlands Lodge And Cottage 11/07/06

Woodlands Lodge And Cottage 07/12/05

Woodlands Lodge And Cottage 10/06/05

Woodlands Lodge And Cottage 08/03/05

Woodlands Lodge And Cottage 29/09/04

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Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Woodlands Lodge And Cottage 95b Byrons Lane Macclesfield Cheshire SK11 7JS Lead Inspector Ms Julie Porter Key Unannounced Inspection 22 May 2008 10:30 Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 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 Lodge And Cottage DS0000006618.V365375.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 Adults 18-65. 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 Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Lodge And Cottage Address 95b Byrons Lane Macclesfield Cheshire SK11 7JS 01625 610049 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) rw@rossendaletrust.org Rossendale Trust Rachel Windelinckx Care Home 16 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (1), Physical disability (4), of places Physical disability over 65 years of age (4) Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 The home is registered to provide care for up to 16 people including: * Up to 16 people in the category of LD (learning disabilities) * 1 named person in the category of LD(E) (learning disabilities over the age of 65) * Up to 4 people in the category of PD (physical disability) * Up to 4 people in the category of PD(E) (physical disability over the age of 65) 24 May 2007 Date of last inspection Brief Description of the Service: Woodlands Lodge and Cottage is registered to provide care for 16 people with a learning disability. The home is a detached house on the outskirts of Macclesfield town centre. It is in pleasant surroundings in a quiet residential cul-de-sac off the main road. It is run by the Rossendale Trust, a charitable organisation. The Rossendale Trust was established in 1973 and provides both residential and day care for adults with learning disabilities. On the day of this inspection visit there were 15 people living at Woodlands Cottage and Lodge. They have single and shared bedrooms on the ground and first floors. A number of these bedrooms are smaller than the sizes identified in the National Minimum Standards (Standard 25) for Care Homes. However, as the home was registered and in use before 31 March 2002, the home does not have to meet this standard. Local amenities, in the village of Sutton and at other Rossendale Trust services, are a short drive away. Information regarding the fees for living in the home is available from the manager and will depend on the level of support needed. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. This unannounced visit took place on 22 May 2008. The visit lasted five hours in total and was carried out by one inspector. The visit was just one part of the inspection. Before then the manager was asked to complete a questionnaire to provide up to date information about services offered by the home. CSCI questionnaires were made available for people using the service, their relatives and staff to find out their views. Other information received by CSCI since the service was last visited was also reviewed. During the visit various records and the premises were looked at. People in the home on the day of the visit had limited verbal communication and it was difficult to establish their views about the service offered by the home. A short, focussed inspection was carried out at the home on 2 April 2008. This was to check on what action had been taken to meet the requirements made at the last inspection in May 2007. Improvements were found. What the service does well: An assessment document is available (and includes pictures to help people with literacy) so that information regarding people’s needs is gathered before they decide to move there, and supports them in knowing if the home can meet their needs. The home has good links with health professionals to ensure that people’s health is monitored. People who live at the home are supported by staff that know them well so they know how to meet their needs in the way they prefer. Relatives are satisfied that the staff keep them informed so they know about the wellbeing of their relatives. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. People moving to the home have their needs assessed before they are offered a service so that they know their needs can be met at the home. EVIDENCE: Rossendale Trust has an assessment document which would be used to gather information regarding anybody wishing to be considered for a move to the home. The manager confirmed that referrals would be made via the person’s social worker and a full needs assessment would be completed by the local authority. Nobody has moved to the home since the last inspection. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Staff working in the home know the people living there well and information is available so they get the care and support they need. EVIDENCE: The staff team remains constant in the home and the staff know the people living in the home and their families very well so are able to provide continuity of care. One care file was inspected in detail and provided information using the newly developed Rossendale Trust documents. Some aspects of the plan are not fully understood by the staff and as a result the information is incomplete and/or confusing. An example of this is the section which asks for personal safety risks to be identified. This is left blank and the second part of the question asks, “are there any changes which need to be recorded?” - the answer is marked as no. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 10 The new documents cover the person’s needs and abilities in the following areas: medication, mobility, understanding, personal care, weight and social activities. This is set out in tick boxes and would be more useful if there was some written information to provide staff with better quality information about people’s individual needs. Information was also available in respect of other professionals involved with the person’s care such as doctors, epilepsy nurse, speech and language therapists and chiropody. The nurse was in the home during the visit to review a number of the peoples care. Although people who live there were at home during the visit, they did not have the ability to contribute to the meetings. A social worker told us, “The basic care is good. However more person centred strategies could be put in place”. One parent told us that their relative was supported to live the life they chose, within their capacity. Risk assessments still need to be developed further to include people’s individual lifestyles, activities and choices. These need to be used as tools to enable people to achieve goals, learn new skills and further their independence. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 People who use services experience adequate care in this outcome area. We have made this judgement using available evidence, including a visit to the service. People living in the home are given support to make every day decisions but further work needs to done to ensure that they can achieve more independence. EVIDENCE: One care manager told us that the “issue of social isolation and lack of community activity remains a concern”. A parent was of the view that the home could improve if they could have more staff. These issues were discussed with the staff and the manager who reported that there had been some improvement in the range of daily activities now they had access to college courses, but sometimes there are issues with getting out at the weekend due to staffing. The manager was confident that this would Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 12 improve now that they had recruited three new staff. Six staff and the manager were on duty on the early shift on the day of the visit. CSCI questionnaires completed by relatives confirmed that they were satisfied with the level of contact they have from the home and the support given to their relative in maintaining contact with them. We spoke with one person who talked about going on holiday very soon, and was going to go shopping with staff to buy some new clothes and sandals. Holidays have been arranged to give people the opportunity to go away with people with the same or similar interests. Bedroom doors are still not fitted with suitable locks so that their possessions can be kept securely when people are away from the home. Lunch was observed on the day of the visit and people were given choice and alternatives appropriate to their dietary requirements. For example, one person needed a soft diet and one person needed their food chopping into small pieces. Staff were seen busy cleaning during the morning shift and preparing the evening meal during the afternoon shift. People living in the home appear to receive a hotel type service where they get everything done for them. There are lost opportunities for personal development in helping with simple domestic tasks. A care manager has stated that the “service at times appears institutional in context”. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. People are supported by staff and other professionals to maintain good levels of physical and mental fitness, so that they can enjoy a good quality of life. EVIDENCE: People living in the home need various levels of support, from prompting to needing support with every aspect of their life. Equipment is available in the home to meet the individual needs of people as assessed by health professionals involved with their care. On the day of our visit a nurse involved with monitoring people’s health and epilepsy was visiting the home to review the health of a number of people. A nurse is working with staff from the home to look at changes in people’s memory relating to age. All residents of the home are registered with the doctor, dentist and optician. The manager told us at the short inspection on 2 April 2008 that all staff had attended medication training on the 01 April 2008. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Staff receive training and processes are in place to ensure that the people living in the home are safeguarded from harm. EVIDENCE: There is a written complaints policy and procedure for the home. Information provided by the manager indicated that seven complaints had been made since the last inspection and these have been dealt with to the satisfaction of the complainants. All but three staff have attended training on safeguarding adults so they know what to do if they think any of the people living at the home is being abused. One referral has been made to Cheshire County Council under its safeguarding procedures and this matter had been dealt with appropriately. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The premises continue to be well maintained so that people live in safe, clean surroundings. EVIDENCE: A tour of the home was done with the manager. Maintenance problems in both the Lodge and the Cottage have been addressed and the home was fresh and clean throughout. Some window frames still need to be replaced and the exterior is reportedly going to be painted as soon as funds allow. There are three twin rooms in the home; the people living in those rooms have shared them for a number of years. However, this arrangement should be reviewed at the next opportunity to check whether those people continue to be happy to share a room or would prefer to have one of their own. A number of the bedrooms in the home do not meet the space requirements set out in the National Minimum Standards for Care Homes for Younger Adults. However the Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 16 home was registered before these standards came into force and is therefore not required to meet that standard. The rear of the property has been levelled and partly paved, partly laid to gravel. A handrail runs the full length of the property. Entrance and exit doors were discussed with the manager while there is a ramp to provide wheelchair access to the rear, the frame of the doorway prohibits the wheelchair user in accessing the area safely. A portable ramp needs to be provided or access to the rear of the property should be around the building using the ramp by the laundry. The front door of the Cottage has a step and should not be used by wheelchair users with staff lifting the chair over the step the ramp should be used at all times to enter and exit the building. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 People who use services experience adequate care in this outcome area. We have made this judgement using available evidence, including a visit to the service. In the absence of up to date training records and supervision, the manager cannot demonstrate that staff have received training and are working in line with good practice to ensure the welfare of people living in the home. EVIDENCE: Rossendale Trust has developed a training programme for staff which includes National Vocational Qualifications (NVQ) in care and mandatory training. One staff member said that they have found the NVQ “very useful.” Four staff files were inspected, including those of two new members of staff. Two staff had been working at the home for a number of years; their personnel files held copies of their certificates and details regarding Criminal Record Bureau (CRB) checks. The files for the two new staff contained the application forms, interview questions and responses, references and CRB checks. Information on file one stated that a reference had been given verbally but the details of the verbal reference had not been recorded. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 18 There is a continued improvement in the availability of training; notices were seen around the home in respect of the coming training events. Information provided by the training department at the Rossendale Hall identifies that a number of staff have not yet achieved moving and handling training and have not attended fire safety training since May 2007. The manager was more positive regarding the fact staff had received training. She told us that all staff attended health and safety training on 20 May 2008, and that half of the staff team are competent in moving and handling; however, no record was available in the home to confirm this. One member of staff told us, “over the last few years there has been a greater emphasis on relevant training and courses have been made readily available”. Staff said that formal supervision of staff is not taking place but they have had an annual appraisal of their work and training needs. This must be developed further to include formal supervision and the manager must ensure she makes the time for this to happen. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use services experience adequate care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Gaps in training records and lack of evidence that health and safety checks are taking place regularly means that the health and safety of the people who live at the home may not be fully protected. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection and has achieved the National Vocational Qualification Registered Managers Award level 4. She confirmed that visits from a representative of Rossendale Trust to check on the running of the home are taking place each month; however the reports of these visits are kept at the Rossendale Hall site. Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 20 According to the records some staff still have not achieved all the mandatory training in relation to fire safety and moving and handling. Information seen in the fire book demonstrates that the emergency lights are checked monthly and the alarms are checked weekly; the last service of the fire alarm system was 14 March 2008. At the last inspection we were told that service contracts were in place for gas and electricity supply and central heating. Information provided by the manager before this visit only provides limited information in respect of the servicing of appliances and equipment in the home. No information has been provided in respect of the electrical circuits or gas appliances. The heating system was last serviced in September 2006 and electrical appliances in October 2006 . Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 2 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA32 Regulation 17(3)(b) Requirement Records regarding staff training and qualifications must be available for inspection. Previous timescale of 04/05/08 not met. Staff must be appropriately supervised so that they get the support needed to do their work. The electrical equipment, gas appliances, the boiler and the electrical circuits must be serviced/ tested as recommended by the manufacturer or other regulatory body and in line with the service contracts to make sure that the people who live and work at the home are safe. Timescale for action 31/08/08 2 YA36 18(2) 31/08/08 3 YA42 23 31/08/08 Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations Care plans should be produced in a format the residents can understand. (Recommendation made at previous inspection) The location of meetings with health care professionals regarding treatment plans should be considered and when practicable should include the residents. Locks suitable for the residents to use should be fitted to bedrooms, so that their possessions can be kept securely and they can have privacy. The manager should review the arrangements for residents in shared bedrooms at the next opportunity to find out whether they would prefer not to share a room. The manager should maintain the staff training records (or copy) and future training needs at the home. The manager should formally supervise each member of staff at least 6 times per year. The manager should receive copies of the visits made under regulation 26 and maintain them in the home. 2 YA6 3 YA16 4 YA25 5 6 7 YA32 YA36 YA39 Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Region CSCI Preston Unit 1 Tustin Court Port Way Preston PR2 2YQ 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 Woodlands Lodge And Cottage DS0000006618.V365375.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!