Inspection on 15/11/06 for Wychwood

This inspection was carried out on 15th November 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

Wychwood 10/11/08

Wychwood 14/05/08

Wychwood 03/01/08

Wychwood 13/08/07

Wychwood 15/09/05

Wychwood 10/05/05

Wychwood 14/02/05

Wychwood 26/10/04

Wychwood 02/03/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

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

CARE HOMES FOR OLDER PEOPLE Wychwood Wychwood Headley Road Hindhead Surrey GU26 6TN Lead Inspector Graham Cheney Key Unannounced Inspection 15th November 2006 10:00 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 Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wychwood Address Wychwood Headley Road Hindhead Surrey GU26 6TN 01428 607014 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) wychgroup@hotmail.com Mrs Mumtaz Minaz Lalani Mrs Mumtaz Minaz Lalani Care Home 24 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (14), Mental disorder, excluding learning of places disability or dementia (1), Old age, not falling within any other category (6), Physical disability (1), Physical disability over 65 years of age (5) Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The age/age range of the persons to be accommodated will be: 65 years and over. Additionally, three named service users in the category DE (Dementia - under the age of 65 years) may be admitted, as per letter dated 12th February 2004. Additionally, one named service user in the category PD (Physical Disability - under the age of 65 years) may be admitted, as per letter dated 12th February 2004. Additionally, one named service user in the category MD, excluding learning disability or dementia (mental disorder - under the age of 65 years) may Additionally, one named service user in the category MD, excluding learning disability or dementia (mental disorder - under the age of 65 years) may be admitted, as per letter dated 21st March 2005. Additionally one service user may be admitted in the category DE from 45 years of age and above 15th September 2005 5. Date of last inspection Brief Description of the Service: Wychwood comprises of two properties, both the properties are set in the grounds with attractive garden areas. The proprietor is also the Registered Manager, and operates the business with a staff team. The service provides 24hour care for up to 24 adults with a varied range of needs. All of the bedrooms are single with the exception of three, which may be shared by two persons. A number have en-suite facilities that include a toilet and basin, shower or bath. There are communal lounges and a dining room. The home is built on two levels with the upper floor accessed by stairs and a lift. The home’s current fee range is between £370.62 and £866.77 Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the key inspection for the year 2006/2007. This site visit forms part of a key inspection process and was verbally announced which means that the staff and the residents, as they prefer to be known, knew that the inspection visit was going to take place. Mr. Graham Cheney regulation inspector undertook the inspection, and it took four hours to complete commencing at 10.15 and ending at 14.15. The inspector met with nine of the service users during the inspection, reviewed residents’ records, health and safety checks, policies and procedures, and other records held by the home. The inspectors also took a tour of the home. This inspection report also includes the findings of an additional visit undertaken by Mrs. Mavis Clahar regulation inspector on 19th September 2006. During that visit the inspector spoke with several residents and staff. Requirements were made as a result of the visit and it was evidenced during this site visit that action had been taken to comply with these. The reason for reporting on this was to confirm that there has been compliance with these. What the service does well: What has improved since the last inspection? Evidence was presented that confirmed the progress of the planned redevelopment of Wychwood. The proposals included re-siting and improving Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 6 the kitchen and laundry, creating additional communal space, increasing the number of place from 18 to 30 and providing en-suite facilities to most rooms. Planning permission was in place for much of building work, with one further aspect outstanding. Final permission was expected by the New Year, with work expected to commence in the spring. Once completed the redevelopment will provide greatly enhanced facilities for the residents. Evidence was presented to confirm that the requirements made regarding medication arrangements during the recent additional visit and the last inspection (September 2005) had been met. 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. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 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 Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 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. Standard 6 was not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed and identified prior to them moving into the home. EVIDENCE: Evidence gathered from sampling care plans confirmed that sound preadmission assessments were undertaken. Discussions with the registered provider and the assistant manager, confirmed that they visited all prospective residents either in their own home or hospital and that residents and or relatives were encouraged to visit the home prior to admission. Residents in Wychdale (The smaller of the two properties) confirmed that either they or their family had visited the home before they were admitted and that this visit had helped to confirm the home was suitable and could meet their needs. The registered provider stated that the home’s statement of purpose was sent out with the home’s brochure to help prospective residents and their families make an informed choice about the home. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 9 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. The arrangements for care planning were sound thus promoting good standards of health and personal care. The systems for health care are good and promote and maintain the health of service users. Medication management is good with previous requirements having been met. The arrangements for privacy and dignity are good ensuring service users are treated with respect and their right to privacy upheld. EVIDENCE: Care plans were in place for all residents. Sampling showed that these provided a good level of information covering the health, personal and social needs of the individual and how these were to be met. It was also noted that the care plans recognised the individual’s aspirations, e.g. asking the resident if they had a “special place” they liked to go. Wherever possible the registered Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 10 provider stated that they try to facilitate a visit to such places, an example being a visit to Hayling Island. Daily comments were recorded, however the registered provider had recognised that some care staff found written English difficult and was addressing this by providing regular English classes. Whilst the comments recorded provided reasonable evidence that health and care needs were being met, it was recommended that more detail of the interactions between residents and staff be recorded to demonstrate that the holistic outcomes, i.e. the personal and social needs of residents were being met. The registered provider stated that they were looking to introduce a computerised care planning system, which would help in recording evidence that outcomes for residents were being achieved. An additional visit was made to the home on 19th September 2006. During that visit the inspector spoke with a number of residents, all of whom indicated that they were happy with the care and support provided. Some explained how they were encouraged to be as independent as they were able and that this was a positive outcome. The inspector had some reservations about the administration of medication at that time and three requirements were made: During this site visit some actions were required in relation to the medication arrangements. These related to the recording practices; staff signatures and changes to medication as instructed by general practitioners. Entries in the Control Drug register should accurately identify the individual who gave and witness the medication in a form that is not readily copied or forged e.g. a signature. 1. Accurate records must be kept of what medication was given and what was not given with the reasons appropriately documented on the back of the medication administration sheet. 2. Verbal orders from General Practitioners to alter dose or timing of service users medication must be followed up with written confirmation to evidence the GP made the changes to the prescribed medication. Evidence presented by the registered provider, in the form of letters to and from the General Practitioner and pharmacist confirmed that these requirements had been met promptly. Evidence from this inspection, which included observation of storage arrangements, sampling of administration records and discussion with the registered provider and assistant manager, identified that practice had been changed to meet the requirements. On this evidence the overall management of medication in the home was good. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 11 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 adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for social activities are adequate and satisfy the social and recreational interests of service users. Community contact is good ensuring service users maintain contact with family friends and the local community as they wish. The systems for autonomy and choice are good ensuring service users are helped to exercise choice over their lives. Meals at the home are good and offer variety and choice. Kitchen facilities were subject to a requirement to ensure food hygiene is maintained. EVIDENCE: During the visit to the home on 19th September 2006 and as part of this visit, inspectors spoke with several residents who said that they were happy in the home, although some said they would have preferred to be at home, but recognised that they needed the help and support they received at Wychwood. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 12 The home provides a range of activities on a regular basis, for example during this visit several residents were engaged in an exercise class, whilst others were playing a board game with staff. Some of the residents however said that they were bored. When asked if the home could do more for them, they explained that they were bored because they could no longer pursue their hobbies and interests due to physical frailty, e.g. one liked to go shooting, another was an artist. Residents stated that they did not see this as a criticism of the home. The registered provider stated she was confident that the religious needs of the current residents were being met, with regular visits by the local vicar, who offered Bible classes and communion on a monthly basis. Residents stated that they found staff very kind and caring. They felt that they were supported appropriately and their independence was respected. Observations indicated that staff treated residents with dignity and respect. During both recent visits residents told inspectors that they generally enjoyed the food provided by the home and that they were provided with an alternative if they did not like the main meal. Both of the catering staff seemed very positive about their role and demonstrated a good level of insight as to the residents’ individual likes, dislikes and dietary needs. The registered provider had recognised the poor condition and general unsuitability of the kitchen and had prioritised this in the home’s pending redevelopment. The kitchen was to be re-sited and re-equipped to what the catering manager considered a high standard of specification. Whilst this redevelopment was acknowledged, areas of the kitchen the work surfaces were observed to be in a very poor condition raising hygiene concerns. A requirement was made that interim action must be taken to refurbish or replace the damaged work surface to minimise the potential food hygiene risks. The registered provider acknowledged the risks and took prompt action to meet the requirement. At the time of writing this report written evidence had been provided to confirm that the home had replaced the work surface. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. The systems for complaints are good with complaint information available to staff service users and relatives. The arrangements for protection are good safeguarding the welfare of service users. EVIDENCE: Residents who spoke to the inspector said that they felt able to speak to staff if they have a concern or problem and felt that staff would respond appropriately. No concerns were raised by those residents spoken to during this or the visit in September. At the time of the this inspection a letter was received from a member of the public raising concerns about an incident regarding safety and security. This matter was referred to the registered provider, who undertook an investigation, the findings of which were promptly reported to CSCI. The registered person stated that additional staff training on the reporting of incidents had been implemented and staff awareness of the need to supervise residents who were liable to wander heightened. The manager stated that the home makes every effort to maintain resident’s safety and security with security coded locks on the main doors. The provider stated that no further incidents had been reported in relation to this matter. The registered provider stated that staff had received training in the protection of vulnerable adults and that further training was planned for coming months. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 14 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 premises are to a high enough standard to ensure service users live in a comfortable and well-maintained environment. The planned development of the home will provide much improved accommodation and facilities for residents. The arrangements for hygiene are good ensuring the home is clean and hygienic for service users. EVIDENCE: The inspection of the premises was limited to health and safety issues only, as the registered provider presented detailed plans for the re-development of Wychwood. These plans confirm the owner’s commitment to providing a higher standard of facilities for residents. This included the provision of en-suite facilities to most rooms, improvements to the catering arrangements and location of the kitchen, and improvements to the laundry and communal spaces. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 15 The plans also include major changes to the heating and hot water supply with new boilers being installed. During the visit it was observed that a radiator and hot water pipes were uncovered and that a previous requirement had been made in this area following an inspection in May 2005. Given the proposed redevelopment was programmed to be undertaken in the new year, it was a requirement that a risk assessment must be undertaken for all radiators and hot water pipes in areas which were accessed by residents, with action being taken to minimise risk for any presenting a high or immediate risk to residents, i.e. those close to chairs or beds. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 16 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 registered provider and assistant manager stated that they were confident that staffing levels were consistently maintained. This should ensure that residents needs are met. The arrangements for staff development are good ensuring service users are in safe hands at all times. Recruitment and vetting practices are good and safeguard the welfare of service users. Induction and foundation training is good ensuring staff are trained and competent to do their jobs. EVIDENCE: The registered provider demonstrated a high commitment to staff training and development and this had been exemplified by the service achieving Investors in People status. The registered provider stated that over 50 of care staff held a National Vocational Qualification (NVQ) at either level II or III. The assistant manager had undertaken the NVQ level IV and the Registered Manager’s Award. Staff had been provided with a range of training opportunities, which included medication, moving and handling, and fire safety, as was evidenced through the sampling of documentation and discussions with the staff and manager. Further training planned included dementia care and protection from abuse. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 17 The registered provider was confident that the recruitment process was ‘very robust’ with all staff having CRB clearance. Staff from other countries were also required to provide a home country police check. This was evidenced by sampling staff recruitment recrods. The registered provider described the recruitment process, which started with a phone interview. She stated that this could also be made to the individual in their home country and once appointed all staff were went through an induction programme which was in line with recognised standards. From observations during the inspection the level of staff on duty was sufficient to meet the needs of the current residents. Wychwood and Wychdale were being staffing independently meaning that each building had a separate group of staff dedicated to that house. The registered provider and assistant manager stated that they were confident that staffing levels were consistently maintained. Written staffing rotas indicated that shifts allowed for a period of handover time, which was used to clarify roles and share information. Each shift had a senior shift leader. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 18 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 arrangements for the day to day management of the home is good ensuring the home is managed by a person who is fit to be in charge of the home. The systems for quality assurance are good ensuring the home is run in the best interest of service users. The management of service users’ money is good ensuring service users’ financial interests are safeguarded. Health and safety at the home is good and promotes safe working practices. EVIDENCE: Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 19 On the evidence presented the registered persons and assistant manager demonstrated a firm commitment to providing, developing and improving services to meet the residents’ needs. Examples of this included the proposed redevelopment of Wychwood to provide better facilities for residents. The providers also offered accommodation for staff, which helped to ensure that staffing levels were maintained. At the time of the inspection the registered provider was also registered as the manager, maintaining a close contact with the assistant manager who was responsible for the day-to-day operation. The registered provider indicated that at some stage the assistant manager would make application to become registered. Both were experienced and committed to providing good quality services. This gives the home stability and provides leadership and direction to the staff team. The inspector noted the home had a management structure with clear lines of communication and accountability in the home. The home had systems in place for quality assurance, with monitoring undertaken by the registered provider who was also registered as manager. This meant that Regulation 26 (monitoring visits) were not required. The registered provider had regular meetings with relatives and residents to obtain feedback about the home. The home had a policy on service users’ money and provided secure facilities for the safe keeping of money and valuables. Information provided by the registered provider confirmed that the home had a policy on health and safety and that staff have training in food hygiene, first aid, fire safety and other appropriate and relevant training. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 20 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 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 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 Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 21 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 OP19 Regulation 13(4)(a) Requirement A risk assessment must be undertaken for all radiators and hot water pipes in areas which are accessed by residents and appopriate action taken to ensure residents’ welfare and safety pending the refurbishment plan. Timescale for action 15/12/06 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 OP7 Good Practice Recommendations It was recommended that more detail, be included in the care plans, of the interactions between residents and staff be recorded to demonstrate that the holistic, i.e. personal and social, needs of residents were being met. Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Wychwood DS0000013845.V310264.R01.S.doc Version 5.2 Page 23 - 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!