Care Home: Broadway Residential Home

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well The home provides care from a well trained staff team in a bright and pleasant environment. Records relating to the care required by service users is detailed to provide staff with full information regarding the individual needs of the service users. Records relating to the care given are also detailed. Activities are appropriate to the service users and one to one time is spent with service users who are unable, or do not wish, to participate in group activities. Staff numbers are good and all staff were polite and professional in their interaction with service users. What has improved since the last inspection? The decor within the home continues to be at a high standard through continued redecoration. Signs to indicate bathrooms and toilets have been fitted to provide greater orientation within the home. Two bedrooms have now been provided with ensuite facilities and some new furniture has been purchased. What the care home could do better: The home should continue to review the service provision, particularly as the registration is changing to enable care for people who have dementia to be accommodated. Key inspection report Care homes for older people Name: Address: Broadway Residential Home 22-32 Flemington Avenue Liverpool Merseyside L4 8UD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jeanette Fielding     Date: 1 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Broadway Residential Home 22-32 Flemington Avenue Liverpool Merseyside L4 8UD 01512876500 01512262212 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.flightcare.co.uk Flightcare Limited care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE. Old age, not falling within any other category. The maximum number of service users who can be accommodated is: 17. Date of last inspection Brief description of the care home Broadway Residential Home is a care home that provides personal care and accommodation for up to 17 older people. Broadway Residential Home is located on the same site as Broadway Nursing Home and is one of six care homes owned by Flightcare Limited. The home is located in the Norris Green area of Liverpool and is close to local amenities and within easy access to bus routes. The home is a single storey building, which has been converted from an old school into its present day function as a residential care home. There are 17 single bedrooms, two of which have en-suite facilities. All the bedrooms are particularly spacious and the majority contain Care Homes for Older People Page 4 of 26 Over 65 0 17 17 0 Brief description of the care home additional items of personal furniture. Communal space within the home consists of two lounges, a small lounge and a larger lounge with a dining area. The home also benefits from a well-maintained garden that residents can easily access. The fees for the home are 330 pounds per week. Care Homes for Older People Page 5 of 26 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was undertaken in one day over a period of seven and a half hours. As part of the inspection process, all areas of the home were viewed including some of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Observation of the interaction between staff and people who live at the home provided further evidence of the actual care given. the care files of five service users were case tracked to evaluate their care. Discussions took place with the Responsible Individual, Registered Manager, care staff and service users. The Manager completed an annual Quality Assurance Assessment form to give additional information regarding the home. The Care Quality Commission is currently processing an application from the owner to change the registration to enable service users who require personal care due to their dementia to also be accommodated. Discussions also took place with the Responsible Care Homes for Older People Page 6 of 26 Individual and Registered Manager regarding this. Evaluation of the homes abilities to meet the needs of people who have dementia were also evaluated during this visit in view of the change in registration to enable people who have demential to be accommodated. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: 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 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 Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. A detailed assessment is undertaken on all prospective service users to provide staff with information regarding the care needs of each new service user to ensure that those needs can be met and thereby provide a good quality of life. Evidence: The home has produced a detailed statement of purpose to provide full information about the home. A service user guide has also been produced and together, these documents provide current and prospective service users with full details of the services and facilities provided. A copy of the service user guide has been placed in each of the bedrooms to give full access to service users and visitors. Prospective service users and their relatives a re invited to visit the home and to view vacant bedrooms prior to admission. This visit also provides the opportunity to meet with other service users and staff. Social workers undertaken an assessment of the service users where possible and provide the home with a report, identifying the care Care Homes for Older People Page 10 of 26 Evidence: needs that are needed. Each prospective service user is also assessed by the manager, or one of the senior staff, to identify the service users needs and to ensure that those needs can be met. A dedicated preadmission assessment form is completed which identifies care and social needs, equipment necessary to meet those needs and any preferences that the service user has. The preadmission assessments for two recently admitted service users were seen and both were found to contain sufficient information to enable the initial plan of care to be prepared. Details are recorded regarding special diets, mobility and individual abilities. Discussion took place with the manager regarding the preadmission information that requires to be obtained for service users who have dementia. She is currently preparing a new assessment format and will implement this when a service user who has a diagnosis of dementia is to be admitted. At the time of the visit, there were no vacancies at the home. The manager was able to demonstrate a good knowledge and understanding of the care required by people who have dementia and of the information that she will need to obtain prior to their admission. Care Homes for Older People Page 11 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide staff with full information regarding service users needs to ensure that each is provided with the appropriate level of care and support. Evidence: Individual care plans are prepared for each service user. These are prepared, initially based on the information gathered at the preadmission assessment, and then built on and updated as more information is gathered about the service user or as their care needs change. Information is recorded following visits to or by GPs or other healthcare professionals and care plans are updated with information or advice given by these persons. Care plans are prepared in an easy to read format and comprehensive details regarding the activities of daily living are prepared. Short term care plans are prepared for some issues i.e. orientation following admission and urinary or chest infections. Long term plans include personal care, weight, nutrition, moving and handling and health and safety. Individual files also give details about personal preferences such as preferred time of going to bed and rising, diet and activities. The care files identify any cultural and spiritual needs of the service users and the manager was able to demonstrate her knowledge and understanding of these. Care Homes for Older People Page 12 of 26 Evidence: Risk assessments are undertaken and risk management plans are put in place to reduce or remove any potential risks and to ensure that the service user is protected. Regular reviews of care plans and risk assessments are undertaken with the service users and/or their relatives where appropriate, and the care plans are signed by the service user to confirm their agreement with it. Daily records are completed by the staff and provide evidence of the actual care given. Discussion took place with the manager regarding the different types of care plans that can be used for people who have dementia, as she is currently preparing new care plans in view of the change of category for new admissions. It was evident that she has sought advice regarding these and was knowledgeable about the information that needed to be gathered and recorded to inform the staff. Medications are administered to service users by appropriately trained members of staff. Some service users administer their own medications and risk assessments are undertaken to ensure that the service users have the ability to do so safely. Appropriate storage facilities are provided in bedrooms for those service users who choose to hold and administer their medications. For service users whose medications are administered by the staff, a detailed policy and procedure has been produced and is followed by all staff. Medications are securely held and a detailed record of medications entering or leaving the home is made. Medication administration record sheets were found to be well maintained and up to date. Handwritten entries were clear and were signed by two people to confirm the accuracy of the entry. The manager undertakes regular audits of the medications to ensure that standards and accuracy are maintained to protect the service users. Observation of staff and service users at the time of the visit showed that staff spoke discreetly with service users when referring to personal care. Service users interacted with the staff and the staff were polite and professional at all times. All service users are provided with single bedrooms to provide privacy and dignity. Staff were observed to respect these values in their interactions with service users. Care Homes for Older People Page 13 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. A good variety and number of activities are offered to provide service user with stimulation and entertainment. Evidence: The home employs an activities co-ordinator to provide actives and stimulation for the service users. A weekly programme of activities is prepared and is displayed. At the time of the visit, service users were choosing the trips that they would like to go on. A range of various activities are offered and a record is maintained of all service users who participate and of those who choose not to. Service users who choose not to join in with group activities are provided with one to one time with the co-ordinator. Service users spoken to were of mixed feelings about the activities. Some said that the choices were good and some said that they did not enjoy what was offered. Those who said that they did not enjoy the activities were unable to suggest any other activities and said that they would prefer to spend time alone in their room watching television. Staff confirmed that all service users were encouraged to participate but a few chose not to. Regular service user meetings are held and provide the opportunity for new ideas for activities to be suggested and also provides a forum for open discussion. The manager confirmed that she, and the staff, were always looking for new ideas. One service user said that they would like to use the internet, but had no Care Homes for Older People Page 14 of 26 Evidence: wish to use a computer and had no idea what the internet really was. Service users are taken out by staff to the local library, shops and pub as they wished. Meals are served in the dining room, lounge or in the service users own bedroom as they wish. The menu provided evidence that a choice of meal is offered and that a varied and balanced diet is provided. Dining tables are attractively laid and the dining room provides a pleasant environment in which to take meals. Meals were observed to be well presented and smelled appetising. A full cooked breakfast is available and snacks are provided between meals. Special diets or meal preferences can be provided and these can be discussed with the chef. Relatives and friends are are free to visit service users at the home at any time. Service users can meet with their visitors in one of the communal areas or in their own bedroom as they wish. Two relatives said that the staff always made them very welcome and were very happy with the care given to their relatives. Care Homes for Older People Page 15 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 complaints procedure is good so people who live in the home are able to express their concerns and be listened to, their rights are protected and they are safeguarded from abuse. Evidence: The home has a robust complaints procedure and details on how to make a complaint are displayed in the foyer and detailed in the service user guide. No complaints have been received by the home in the last twelve months although one relative commented about the time it took staff to answer the door as they got wet when it was raining. This was due to the staff being busy attending to service users. This was discussed with the owner who stated that he will look at ways of improving the access area. Service users spoken to said that they would feel comfortable in speaking with the manager on any issue which caused them concern and were confident that any matters raised would be dealt with. All staff are given training on the protection of vulnerable adults during their induction training and are given subsequent updates on this on a regular basis. Evidence of training is documented in the staff training files. Staff spoken to were able to demonstrate that they were aware of the different types of abuse and of the action they would take in the event of abuse being suspected. The home has a Care Homes for Older People Page 16 of 26 Evidence: whistleblowing policy to enable staff to report any issues to the acting manager. All staff are fully vetted prior to commencing work at the home to ensure the protection of service users. Care Homes for Older People Page 17 of 26 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All areas of the home are decorated and furnished to a high standard to provide service users with a pleasant place in which to live. Evidence: All service users are provided with single bedrooms, two having en-suite facilities. The bedrooms are extremely large and many of the service users have provided their own furniture to provide seating areas. Seating and other furniture is provided by the home where the service user does not wish to provide their own. Service uses are encouraged to personalise their rooms with pictures, ornaments and items of memorabilia. All bedrooms are decorated and furnished to a high standard and a programme of redecoration and refurbishment is on-going. The home provides two lounges, a small lounge and a large lounge/dining room. All communal areas are decorated and furnished in a homely way and provide a pleasant environment for the service users. Since the last inspection, two walk-in showers have been provided to provide additional facilities for all service users, particularly those who have mobility difficulties. Service users spoken to said that they liked the showers as it made bathing much easier. Baths are available for those who prefer these. Corridors have been redecorated and recarpeted. All bedrooms and communal areas are located on the ground floor and so full access is Care Homes for Older People Page 18 of 26 Evidence: provided for people who have mobility difficulties or require to use a wheelchair. Corridors are wide and spacious. The home is situated in the same grounds as a nursing home which is operated by the same owners. Between the two homes is a garden area which is provided with seating and walkways. Access to the garden is across a driveway and so staff escort service users to the garden to ensure their safety. Service users are free to use the garden as they wish. Service users personal laundry, and the homes linens, are laundered on site. Clothing is carefully laundered and ironed and returned to the service users promptly. Personal clothing is labeled to ensure that it is returned to the correct service user. The home is maintained to a high standard with all repairs being addressed as soon as they are identified. Staff spoken to confirmed that they were all responsible for ensuring that health and safety issues are identified and addressed and for the reporting of repairs. All areas of the home were observed to be clean and fresh and there were no unpleasant odours. Infection control policies are in place and it is evident that staff follow procedures at all times. Care Homes for Older People Page 19 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements, recruitment and training ensure that service users are cared for and supported safely. Evidence: The home employs a manager, senior care assistants and care assistants to provide care and support for the service users. The staff rota showed that sufficient staff were employed and deployed to care for the service users. The home also provides staff to attend to catering, laundry, housekeeping and maintenance. Administration staff are employed on the same site as the home. The home has a robust recruitment procedure. All prospective staff are required to complete an application form prior to being called for interview. Two references and taken and checks are made through the criminal records and protection of vulnerable adults bureaux. Qualifications are verified and certificates are required to be provided. There have been no changes to the staff team in the last twelve months and many of the staff have worked at the home for a number of years. No agency staff are used by the home and current staff cover each other for annual leave and sickness. The records for four staff were inspected and all were found to be well maintained and up to date. All care staff hold NVQ at level two or above and the files provided evidence of on-going training. Domestic staff have also achieved NVQ qualifications. Care Homes for Older People Page 20 of 26 Evidence: The company employs a training officer who provides and co-ordinates training for staff in all six homes owned by the company. Staff are given supervision every two months and six monthly appraisals. Staff have recently been given training in the care of older people who have dementia in preparation for the change in registration to enable staff to provide the appropriate level of care. Staff were spoken to during the visit to the home and all were able to demonstrate that they were knowledgeable about the care needs of each service user and of the level of care and support that each was to be given. All staff were aware of the different types of abuse and of the action they should take in the event of it being suspected. Staff were knowledgeable about their role and responsibilities and each said that they enjoyed their work. One member of staff said that she had worked in other homes but enjoyed this home more than any of the others. She explained that she had been given full induction and that training was given on a regular basis. Regular staff meetings are held for open discussion and the dissemination of information. Care Homes for Older People Page 21 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and has comprehensive systems, policies and procedures in place to ensure that the health and safety of service users and staff are promoted. Evidence: The registered manager holds NVQ at level 4 and experienced in managing care services for older people. She was able to provide evidence that she has continued to develop her knowledge and understanding through continued training. The manager has an open door policy to ensure that she is readily available for service users, staff and visitors to the home. The home holds small amounts of money for service users at their request and detailed records are held of these. The money and records are regularly audited and are available to the service user and/or their relatives on request. Regular service user and relatives meetings are held and these are usually well attended. Care Homes for Older People Page 22 of 26 Evidence: Managers meetings are held for the manager to meet with the managers of other homes owned by the company. Questionnaires are sent to service users, relatives and other stakeholders on a regular basis and the findings are displayed in the home together with the statement of purpose, service user guide and inspection reports. All equipment used in the home, and the premises are checked on a regular basis by appropriate companies or authorities. Certificates of safety and compliance are held in the home. All records were found to be well maintained and up to date. Health and safely issues are addressed as soon as they are identified to ensure that service users, staff and visitors are protected. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Older People Page 24 of 26 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 Requirement 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 Requirement 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!