Care Home: Braemar House

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What the care home does well Braemar House is family run and people have lived there a long time so they know each other well. The home is close to shops, the sea front, churches, and local services so people can walk to where they need to go or get buses or trains. People have their own rooms, most of which have their own toilets or bathrooms. People can do things they enjoy. They can go on holidays, and help around the house.The home look after people who are ill well. They make sure they have the support they need. What has improved since the last inspection? Since the last inspection the lounge has been redecorated and the manager has made sure staff are safe while they are at work. What the care home could do better: The manager needs to make sure that everybody at the home has a person centered care plan. The manager needs to make sure that all the staff have the training and support they need to do their job. Some of the files have too much information in them which makes it hard to find information which is up to date. The manager should keep some of this separately, so that it is easy to find the information people need. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Braemar House 38 Seaway Road Preston Paignton Devon TQ3 2NZ The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Finniear Date: 0 1 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Braemar House 38 Seaway Road Preston Paignton Devon TQ3 2NZ 01803666011 01803666011 braemarhouse@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Anna Teresa Hill,Miss Cara Marie Hill,Miss Rian Marie Hill care home 12 Number of places (if applicable): Under 65 Over 65 0 12 2 12 dementia learning disability Additional conditions: That the home be allowed to accommodate up to two service users named elsewhere with DE(E) Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 28 A bit about the care home Braemar House is a large semi-detached property situated on the level, near the beach and all local facilities, whilst being within easy walking distance of the local Community Resource Centre. The home provides accommodation for up to 12 adults with learning difficulties two of who may have a Dementia associated with their learning disability. The home is situated in a residential area of Preston and service users are encouraged and supported to be an integral part of the local community. Fees range from #306.58 to #639.94 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 28 How we did our inspection: This is what the inspector did when they were at the care home To complete this inspection we visited Braemar House twice, without letting them know when we were coming for the first visit; we spoke to people who live at the home and staff on duty; we talked to the manager about how the home is run; we looked at the records the home keeps and we asked the home to complete an Annual Quality Assurance Assessment telling us about how the home is run. We We also asked people who live at the home to fill out questionnaires about what it is like to live there. What the care home does well Braemar House is family run and people have lived there a long time so they know each other well. The home is close to shops, the sea front, churches, and local services so people can walk to where they need to go or get buses or trains. People have their own rooms, most of which have their own toilets or bathrooms. People can do things they enjoy. They can go on holidays, and help around the house. Care Homes for Adults (18-65 years) Page 7 of 28 The home look after people who are ill well. They make sure they have the support they need. What has got better from the last inspection What the care home could do better The manager needs to make sure that everybody at the home has a person centered care plan. The manager needs to make sure that all the staff have the training and support they need to do their job. Some of the files have too much information in them which makes it hard to find information which is up to date. The manager should keep some of this separately, so that it is easy to find the information people need. Care Homes for Adults (18-65 years) Page 8 of 28 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Michelle Finniear 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information that is clear and easy to understand is available about the home to help people decide if it is the right place for them. Evidence: Braemar House has a statement of purpose and service user guide, which gives people who might be thinking about moving into the home information about what it is like to live there. The guide is written in plain language and the statement of purpose has been personalised with photographs and symbols. This helps people understand the text better, and to make a decision about whether Braemar House is the right place for them. No new people have been admitted to the home since the last inspection. At that time discussion was held with the owners on the admission process they would follow. This included full pre-admission assessments, overnight stays and consultation with people already living at the home to make sure they were happy with the new placement. Discussion was also held on a recent situation where a person had to leave the home following a change in their needs. Some people regularly visit Braemar House for respite care. These people are wellknown to the people who live at Braemar House, who enjoy their visit. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: People who completed questionnaires for this inspection said that they were asked if they wanted to move into a home, and that they received enough information before they moved in so that they could make a decision if it was the right place for them. One person felt they had not received sufficient information, however this may have been many years ago. People spoken to on the visit said they had lived at the home for a long time and were happy there. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Braemar are supported to make choices in their lives and have full plans to show the support they need. Person centred plans should be completed for all people at the home. Some files may benefit from older records being archived. Evidence: Each person living at Braemar House has a plan of care based on an assessment of their needs for support. Three plans were seen on the first visit, and these included both a text version of the plan, and a more person centred plan. The person had been involved in designing this themselves in a format that was significant to them. The plans seen were being reviewed every six months with the person concerned, and they signed the plan to confirm their agreement or indicate why they wished to make changes to the support and services they received. One persons plan seen centred around a sweet theme, and included photographs and information about the people of significance to them and events throughout their life which they had enjoyed or found significant. This approach helps people understand the plan better, and where there are particular communication difficulties helps them make staff understand what they want. It also helps staff understand peoples life experiences and the challenges that they face. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: The plans seen also contained specific information about risk taking and management, and safety information regarding issues such as moving and handling and management of health conditions. Work is still being undertaken on some plans, and it is important that these are completed with people living at home to make sure each person has an opportunity to make their views heard and experiences acknowledged. The care being delivered to one person with high needs was discussed, and this was then related to their care plan. This was found to be an accurate reflection of the care being delivered, however files may benefit from non-current information being removed to make it easier to be clear about current needs. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Braemar house have opportunities to follow their hobbies and interests and develop new skills. Evidence: People who live at Braemar have opportunities to pursue hobbies and interests, develop new skills and take part in the life of the local community. On the second visit time was spent talking to people who lived at the home about how they spend their time and activities they enjoy. People spoken to were excited about their forthcoming holidays and were happy to talk about how they spend their week. People at the home have opportunities to take part in workplace activities and day centres, for example the Dawlish Gardens project or the local resource centre at Hollicombe, which is within walking distance. The day before the second visit people had requested an evening barbecue which had been provided, and the home is situated very close to the seafront and promenade, as well as local shops and services. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: People living at the home were also keen to show us evidence of hobbies and interests they follow, and this could be seen in their bedrooms. People also have opportunities to attend local specialist clubs, restaurants, take aways, and church if wished. Contact with family and friends was encouraged. People living at the home eat a balanced diet as far as possible. Several people take out packed lunches during the day, and the main meal is taken in the evening. On the second site visit to the meal was fish and tomato sauce with fresh vegetables. Summer menus are now in use and people have a choice in the food served. The home has the capacity to cater for special diets, including medical diets such as diabetic if required. People living at home are encouraged to take part in the running of the home, for example laying the tables helping with washing-up and keeping their rooms clean and tidy. People also have opportunities to undertake laundry and some shopping/cooking for the home. One person who completed a questionnaire wrote I like helping staff and another wrote Healthy food - good for my weight. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are being met. Evidence: On the first site visit time was spent looking at peoples care plans and files and discussing the care they needed. On the second visit we spent time speaking to people who live at the home, observing and discussing how their needs were being met. People living at Braemar house have been together as a group for a considerable time, but as they are getting older differences in their abilities and health care needs are becoming more apparent. The home are having to adapt the way they run to meet these different needs - for example organising smaller holidays to meet differing needs. One person at the home has been very frail for several years and the home has a high level of support and input from specialist nursing and palliative care teams to maintain their placement, along with a high level of care being delivered by the home. The homes staff have had specialist training and been involved in local paliative care groups to ensure they are able to deliver this high quality care and receive the support they need. For other people the home is ensuring people receive preventative health care screening such as mammography and all the people at the home have received a health action plan assessment undertaken by the local general practitioner. Input is Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: received from specialist medical services such as dietitians, speech and language therapists and podiatrists as needed. Assessments have been undertaken by district nurses of pressure area care and pressure relieving equipment has been obtained where needed. People spoken to said they were seen by the opticians and dentists regularly. They also have access to hospital clinics such as for hearing loss. We looked at the homes medication systems. The home uses a monitored dosage system which means medication is supplied to the home in a series of blister packs by the pharmacist. These make it easier to check that medication has been given out and helps ensure the risk of errors is reduced. Medication is being stored securely at the home in a locked cupboard and there is a lockable refrigerator for medication needing to be kept cold. All medication given to people is signed for by the staff member who gave it to the person, and the records seen were all completed. All staff have received training in medication administration to ensure this can be done safely. The supplying pharmacist inspects the system in use regularly. People are supported to manage their own health care wherever they can or wish to do so. As an example one person with diabetes keeps their own medication with them and the homes staff support them with testing their blood levels as needed. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes policies and procedures on complaints management and safeguarding. Evidence: Braemar House has a complaints procedure available and people spoken to on the second visit or who completed questionnaires understood what to do if they were unhappy about something at the home. The home have not received any formal complaints since the last Inspection but acknowledged that some people living at the home had been upset and disturbed by the distress of another person no longer at the home. Staff have all received training or information on recent changes to legislation in relation to capacity and decision making. Information is available on safeguarding and adult protection which should help protect people living at the home from abuse or abusive practice. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Braemar House provides a comfortable environment to live and work in. Evidence: On the two visits time was spent looking at the accommodation the home provides for people who live and work there. The property is a large house, converted to a care home but has limited outdoor space. There is parking at the home, and on street parking nearby. Braemar house is situated close and level to the sea front and local shops and services in Preston, Paignton. The building is well maintained and comfortable. Currently all rooms are for single occupancy, however two would be suitable for shared accommodation if the need ever arose. Many rooms have en suite facilities and there are bath or shower rooms on each floor. Communal areas include a large lounge/diner on the ground floor and a smaller craft or activities/computer room for general use. Peoples bedrooms were personalised and individual with evidence of links to family and friends, activities and holidays undertaken and interests. People are encouraged to keep their own personal space clean and tidy and make decisions over decoration and furnishings. During the evening of the second visit people chose to spend time in their rooms or in the lounge area carrying out craft activities of their own choosing and watching television. People also helped in the kitchen, clearing tables and washing up. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Laundry facilities are capable of achieving a sluicing cycle which helps to ensure that laundry can be disinfected appropriately if needed. Discussion was held on infection control measures and plans for managing infection risks particularly with concerns over the more frail people in mind. Since the last inspection the home have told us they have redecorated the lounge and communal area and some bedrooms. All areas seen were clean and well maintained. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is family run and informal. Some staffing systems require attention to make sure they are kept up to date and ensure people are being well supported. Evidence: On the first site visit we sampled some staff records to see how the home recruits and trains staff members and the support they receive to do their job. We looked at the recruitment files for two members of staff, other records such as training and development plans and discussed the staffing arrangements at the home. The manager and owners provide much of the staffing at the home, and did so on both visits carried out. The files seen showed that the home carries out a full recruitment process, including taking up references and criminal records bureau checks. These help to make sure that people are card for by staff who are suitable to be working with potentially vulnerable people. However the staff files seen also showed they had not completed their induction programme, even though they had been at the home for several months. The owners felt that as they worked closely with staff in such a small group all areas of the working practice had been covered but just not recorded in the file. The home have interview formats to ensure they operate equality and diversity procedures and intend to develop these further. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Supervision systems have fallen behind schedule. Supervision is a system that combines professional development and work place management issues to ensure that staff are working consistently and to their full potential to support people. Staff training and development profiles have been provided since the last inspection, but these show some areas of core staff training have not yet been completed. The manager confirmed there have been difficulties booking people onto courses locally but that they are persevering. People who work at the home who completed questionnaires said they enjoyed working at the home. One wrote Braemar is very welcoming care home, family run, which gives the place a great feel and another said I have been impressed in the way Braemar House cares for its residents. Their care is tailored to each individual. They have respect and confidentiality at all times. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being well managed. Evidence: Braemar House is a family run home with the owners and manager comprising much of the staffing group. Rian Hill, the manager has worked at the home for 14 years and has extensive experience of working with the people who live there. Rian shares some of the management responsibilities with her sister and mother who also work in and own the home. Braemar house has a system for assuring the quality of the service provided and experienced by people living at the home. This includes a series of internal and external audits which are undertaken some monthly, looking at records, cleanliness and managing of care plans. The audits help to ensure that the home keeps up to date with systems. There is also a series of questionnaires sent to people to comment on the service and this includes the people who live at the home. This helps to ensure that as well as day to day input people have a more formal route to influence the way the home is run. People spoken to on the visit confirmed they were happy to talk to the owners about the home and the way it was run at any time. Questionnaires are also completed by Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: stakeholders such as family members, visiting professionals and district nurses. On the first site visit we looked at a number of records for the home, including testing of appliances, safety certificates, risk assessments and the management of money held in trust. All of these sampled were satisfactorily maintained. The home has clear systems for the management of health and safety at the home, some of which were sampled on this visit. Water temperatures are regulated and electrical systems tested regularly for safety. The home has regular fire tests and people spoken to who live at the home were able to confirm that drills are held regularly and they knew what to do and where to assemble in the event of a fire. Since the last inspection the home has provided a series of risk assessments for safe working practices for staff. They also have employed a health and safety consultancy to support them with the required assessments. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 The format being developed for Person centred planning should be continued for all people living at home. This helps to ensure that peoples life experiences are acknowledged and wishes regarding support are made available in a format they can understand and use as a tool for communication. Care plan files would benefit from ensuring only current and recent information is kept together. Training needs identified should be met. People who work at the home should receive regular supervision and appraisal to ensure they are working consistently. 2 3 6 35 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!