Inspection on 13/09/05 for Woodlea Residential Care Home

This inspection was carried out on 13th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodlea Residential Care Home 19/07/07

Woodlea Residential Care Home 31/05/06

Woodlea Residential Care Home 16/12/05

Woodlea Residential Care Home 01/02/05

Woodlea Residential Care Home 14/12/04

Woodlea Residential Care Home 29/03/04

Woodlea Residential Care Home 17/09/03

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

CARE HOME ADULTS 18-65 Woodlea Residential Care Home 196 Upper Chorlton Road Manchester Address 3 M16 7SF Lead Inspector Val Bell Unannounced 13 September 2005 at 3pm th 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 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 Stationary 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. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Woodlea Address 196 Upper Chorlton Road Manchester M16 7SF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 862 9521 Mr S Pascau Mrs Dorothy Heaton CRH Care Home 15 14 1 Category(ies) of MD Mental Disorder registration, with number MD(E) Mental Disorder - over 65 of places Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: All the service users will fall within the category of mental disorder and may also have an associated learning disability.(One named service user currently accomodated is agreed 65 years or over) Date of last inspection 01.02.2005 Brief Description of the Service: Woodlea is a private home providing 24-hour care for up to 15 adults with enduring mental ill health. Some of the residents may also have a physical disability. The home is a large converted Edwardian House set in a residential area of Trafford. Shops and a post office are within walking distance from the home. Public transport routes into Manchester city centre and the surrounding area are close by. The philosophy of the home is to maximise the potential of each resident and to develop and maintain independence. Accomodation is provided in 15 single bedrooms, none of which have en-suite facilities. Sufficient toilet and bathroom facilities were provided to meet the needs of the residents. Communal space comprised of a lounge with connecting dining room and a non smoking lounge on the lower ground floor. There is a large private garden to the rear of the property and parking space at the front. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over three days, 13th, 14th and 20th September 2005. The inspection took 9 hours in total. A second inspector accompanied the lead inspector on the 14th and the pharmacist inspector attended the home with the lead inspector on 20th September to assess the medication procedures. During the inspection a tour of the premises was undertaken, various records, including care plans, were examined and the inspectors spoke to residents, staff and management. What the service does well: What has improved since the last inspection? What they could do better: Serious concerns were identified in the administration of medication, hot water temperatures in two residents’ bedrooms and the risk of burning through contact with a hot storage heater. These posed unacceptable risks to the health and safety of residents. The level of structured activities available to residents had deteriorated and residents told the inspector that they would like to do more. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 6 The manager should consider developing carers’ skills to enable them to take responsibility for the care planning process. A number of and several of the homes communal areas had been re-decorated since the last inspection. However, the main lounge showed signs of discolouration due to cigarette smoke and was in need of redecoration. Additionally, cleanliness was an issue in certain parts of the home. The home was also required to review its system of food storage as good practice guidelines were not always being adhered to. 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. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2 Residents admitted to the home could be confident that their needs would be identified. EVIDENCE: The inspector was told that the home had reviewed and updated its’ Statement of Purpose and Service User Guide since the last inspection. However, copies of the updated documents were not made available to the inspector at the time of this inspection. Thorough assessments of need had been undertaken with all residents prior to their admission to the home, including care manager assessments. This ensured that individuals’ needs had been identified and that the home was able to meet those needs. Risk assessments had been regularly monitored and reviewed. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Residents could be confident that their views would be listened to and that any necessary action would be taken to enable them to make choices about their preferred lifestyles. EVIDENCE: Five care plans were assessed during the inspection. Care plans contained comprehensive information and they had been subject to monthly review or more regularly where individual’s needs had changed. There was evidence that residents had agreed the contents of their care plans. Although the inspector was told that the home operated a keyworker system the manager took sole responsibility for the writing of care plans. A recommendation was made to develop the skills of keyworkers so that they can take on more responsibility in the monitoring, review and updating of care planning for residents. This could be achieved by utilising the skills of the two deputy home managers to mentor and guide the keyworkers’ personal development. On the second day of inspection a residents meeting was being held and one of the inspectors was present at the meeting. Staff encouraged residents to air their views and full consultation took place concerning issues that affected their lives. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 10 Action had been taken to minimise identified risks and residents had been given training about their personal safety. Resident’s preferred activities and choices had only been limited where the risk to individual safety could not be minimised. Care plans demonstrated that such decisions had been taken in full consultation with individual residents. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 16 and 17 Absence of structured activity programmes placed residents at risk of not having opportunities to develop self-determination and personal growth. EVIDENCE: During conversations with residents and staff it transpired that the level of activities engaged in by residents had deteriorated since the previous inspection. College placements and supported employment were no longer in evidence. Some staff suggested that this might have happened because of a recent turnover of staff. No evidence was found to demonstrate that a structured activity programme was in place for individual residents. Some residents told the inspector that they would like more activities and these residents made suggestions for improvements during their meeting. The lead inspector was told that part of the problem was that the local drop-in centre had closed for refurbishment and that a new centre in Chorlton would be explored. Most staff commented that they thought the residents would benefit from a structured activity programme. It was detailed in the previous inspection report that resident’s had opted to go on a self-catering holiday this Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 12 year. However, there was no evidence that a holiday or day trips had been arranged for residents. Residents told the inspectors that they each had responsibility for undertaking domestic tasks around the home, such as laundry, setting and clearing tables at mealtimes and keeping their personal space clean and tidy. Residents told the inspector that they enjoyed the meals provided and that they were afforded choice and flexibility at mealtimes. Ample food stocks were held in the homes food stores. Three meals were provided daily and drinks and snacks were always available. Residents had been issued with bus passes and had keys to their bedrooms. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 The absence of a safe system of administration of medication had the potential to place the health and welfare of residents at serious risk. EVIDENCE: Current annual health checks had been undertaken. There was written evidence to demonstrate that the home took prompt action in making the appropriate referrals in relation to residents health concerns. Staff accompanied residents to health appointments and regular health monitoring had been carried out. Staff provided full contact with residents who needed inpatient treatment at hospital. The pharmacist inspector was brought into the home on the third day of inspection due to serious concerns relating to the storage of medication. Staff had been removing medication from the local pharmacy blister packs and putting this into cassette boxes. This practice of secondary dispensing of medication is unsafe and not acceptable. Additionally, a bottle of Oromorph had not been locked in the medicine cupboard. It was pointed out to the inspector that the room in which the Oromorph was stored was always kept locked. However, medication must always be stored securely in line with the pharmaceutical society’s guidelines. The medicine cabinet was inadequate for storing the volume of medication prescribed to residents. Two bottles of medication were being stored in the kitchen fridge, which was not locked. The Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 14 home must either provide a lockable medication fridge or secure medicines in a locked container in the fridge. The following requirement and recommendations were made: • • • The registered person must undertake an urgent review of the medication system with the local pharmacist and a safe system must be in place within one month of this inspection. It was recommended that the registered person obtain a copy of the Royal Pharmaceutical Society Guidelines on the administration of medication in care homes. It was also recommended that a secure cupboard is provided to store the stock of Depo injections prescribed to residents. The lead inspector and pharmacist inspector will return to the home at a later date to reassess the medication system. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Suitable arrangements were in place to ensure that residents were protected from the risk of abuse. EVIDENCE: Two new members of staff were on duty on the second day of inspection. One of the individuals had received training in awareness of abuse at her previous employment, although the second person had not received training. Neither of these members of staff had seen the homes policy on abuse. One of the deputy managers told the inspector that he was exploring suitable training for staff in this area. Residents were clear about whom to inform if they felt they were being bullied or at risk of harm. Although staff were aware that abuse should be reported, one member of staff thought that the manager would be responsible for investigating abuse. The two deputy managers were clear that all allegations of abuse must be reported to Social Services Adult Protection officer. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 High temperatures at two hot water outlets and the surface temperature of a storage heater potentially placed residents at risk of scalds and burns. Certain parts of the home’s décor, fixtures and fittings and general maintenance had deteriorated. This did not provide residents with a comfortable environment in which to live. EVIDENCE: One of the residents assisted the inspector to undertake a tour of the premises. Several bedrooms were inspected. Although eleven bedrooms had recently been re-decorated the standard of décor in some of the other bedrooms and the ground floor lounge was poor. Two bedroom carpets were stained and needed cleaning or replacing. Generally, the bedding provided to residents appeared to be old and in need of replacement. Lockable facilities in bedrooms had been provided according to resident choice. Serious concerns were identified in two bedrooms where the hot water temperature at the hand-wash basins exceeded 43° C. An immediate requirement was made to regulate all hot water outlets to around 43° C. The inspector made a phone call to the home on 27th September, where it was Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 17 confirmed by the manager that all hot water temperatures in the residents’ bedrooms had been regulated to the required temperature. Additionally, a storage heater in one of the lounges was very hot to touch. It was required that a risk assessment is carried out on this equipment. In conversation with residents the inspector was told that the home did not employ domestic staff. A resident also said, “Too many people smoke here”. There was evidence of smoke discolouration in the main lounge, which was designated as the smoking area. This precluded non-smoking residents from being able to socialise with fellow residents in a smoke-free environment. It is recommended that this issue is discussed with residents at their next meeting along with the possibility of installing extractor fans in the homes agreed smoking areas. A further recommendation was made for the registered provider to consider employing a domestic assistant to ensure that essential cleaning of the home is undertaken. The inspector assessed the kitchen and food storage areas. Ample stocks of food were in store and it was encouraging to note that fresh vegetables were provided for residents. Some areas for improvement were identified. All food must be stored above floor level e.g. potatoes. A packet of scones that had been opened was not stored in an airtight container to avoid contamination and puddings in the fridge were not date labelled. The deep fat fryer and cooker were encrusted with grease and in need of deep cleaning. The home had a large private rear garden for residents use. The lawn had been regularly maintained although the area had no character and a suitable seating area had not been provided for residents. A recommendation was made to consult with residents in agreeing a development plan to make the garden area more attractive so that residents can use the area for social and leisure pursuits. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 A skilled and knowledgeable team of carers was in place to meet the needs of residents. EVIDENCE: The home was staffed in excess of the minimum number required on the days of inspection. A new deputy manager had been recruited since the previous inspection. In conversation with the inspector staff confirmed that they had their training needs assessed and had undergone formal supervisions four times per year and performance appraisals on an annual basis. The inspector was told that the provider placed high importance on staff training and a budget had been provided for this purpose. A programme of NVQ training was underway and staff were due to receive training in the protection of vulnerable adults from abuse. This will be fully assessed at the next inspection. Induction training had been carried out with new staff and first aid training had been planned. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 The homes use of a communication book potentially placed residents at risk of not having their personal information stored securely. EVIDENCE: The requirement made at the previous inspection relating to the recording of residents personal information in the communication book remained outstanding. The registered person must devise a system of communication that respects the confidentiality of individual residents and complies with the requirements of the Data Protection Act 1998. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 1 Standard No 11 12 13 14 15 16 17 x 2 2 x x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woodlea Residential Care Home Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score x x x x 2 x x F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? 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 YA12 Regulation 16 (2) n Requirement The registered person must develop a structured activity programme for individual residents that provides opportunities to develop further education and employment skills. The registered person must consult residents about their social interests and make arrangements to enable them to engage in local, social and community activities. The registered person must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person must ensure that risk assessments are undertaken on all hot water outlets in residents bedrooms. Additionally, a risk assessment must be undertaken on the storage heater situated in the lounge. Where the risk of scalding from hot water cannot be effectively managed, thermostats must be set to regulate the hot water Timescale for action 13.10.05 2. YA13 16 (2) m,n 13.10.05 3. YA20 13 (2) 13.10.05 4. YA24 13 (4) 15.09.05 5. YA24 13 (4) 29.09.05 Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 22 6. YA24 13 (4) 7. YA24 23 8. YA24 13 (4) C 9. YA30 23 (2) d 10. YA41 12 (4) a 11. YA1 4 temperature to arounf 43 degrees Celsius. Where the risk of burning due to contact with a hot surface cannot be effectively managed, a suitable cover must be fitted to the storage heater. The registered person must produce a development plan that details the re-decoration, renewals and refurbishment programme for the home. The registered person must ensure that food stocks held by the home are stored appropriately to avoid contamination and risks to the health and safety of residents. The registered person must implement cleaning schedules for all areas of the home and ensure that the cleanliness of the home is monitored on a regular basis. Personal information relating to residents must be held securely and confidentially in line with the requirements of the Data Protection Act 1998. Previous timescale of 01.04.05 not met. The Statement of Purpose must be reviewed and updated to include all the information specified in Regulations 4 and 5 and Schedule 1 of the Care Homes Regulations 2001. The reference to the previous registering authority must be removed. Previous timescale of 01.04.05 not met. 13.10.05 13.10.05 13.10.05 13.10.05 13.10.05 13.10.05 12. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard YA6 YA20 YA20 YA24 YA24 YA30 Good Practice Recommendations The registered person should develop keyworkers skills so that they can take respensibility for care planning. The registered person obtain a copy of the Royal Pharmaceutical Societys guidelines on the administration of medication in care homes. The registered person should provide a separate secure cupboard for the storage of depo injections. The registered person should consult residents on the provision of a non-smoking lounge area in the home. The registered person should consult with the residents on making improvements to the homes garden area. The registered provider should consider employing domestic provision for the home. Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Woodlea Residential Care Home F55F05 S5637Woodlea V241716 300805 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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