Care Home: Elmhurst

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What the care home does well People living in the home told us it was homely, they were happy, and they liked living there. And staff very supportive all the time. The manager was described as approachable and prepared to listen, this allows any concerns to be dealt with before they become complaints. A good choice of food and drinks are available. This ensures that people receive a varied and nutritious diet. Two people told us `the food is very good`. The staff at Elmhurst promote peoples health care, a District Nurse told us the manager and staff were quick to contact them to seek support and advice if they thought anyone was in need of nursing care. More staff have completed National Vocational Qualification in training, this means staff have better knowledge and understanding to support people. What has improved since the last inspection? The environment has been improved to prevent the spread of infections. Accidents are recorded and we are told of these, this helps us and the home to identify any risks to people. What the care home could do better: The way the registered manager makes sure the staff have the right qualities to work with people living in the home must be improved. Care plans and risk assessments need to be reviewed more regularly and when peoples needs change, this is to make sure peoples needs are always and consistently met by staff. We also asked the home to review the way it keeps information and to make sure it follows Data Protection Guidelines. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elmhurst 69 Pollard Lane Bradford West Yorkhsire BD2 4RW     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: Caroline Long     Date: 0 6 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 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 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 Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Elmhurst 69 Pollard Lane Bradford West Yorkhsire BD2 4RW 01274638151 01274634890 elmhurstcare@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Deborah Fitzmaurice Type of registration: Number of places registered: R & N Partners care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Elmhurst is a pair of stone built semi detached Victorian style family houses converted to provide residential accommodation for 22 older people. The home currently has 10 single and 5 double rooms. Only one room, a single, has en suite facilities. Accommodation is on three floors with access to the first floor by stair lift. The laundry and office are situated in the basement. A small neatly kept garden to the front of the house overlooks the road and offers a sitting area for clients. A conservatory to the rear of the building is used as the designated smoking area. There is no ramped access to the house and parking is on the road. The home is situated in the Bowling area of Bradford within walking distance of local shops, a park and a golf course. The home is Care Homes for Older People Page 4 of 27 1 0 0 2 Over 65 0 7 15 7 Brief description of the care home one of two in the Bradford area owned by the same proprietors and employing family members. The two homes work closely together and the proprietors take an active interest in the day to day activities of the homes. Care Homes for Older People Page 5 of 27 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 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This is what we used to write this report. We looked at information we have received about the home since the last key inspection. Care Homes for Older People Page 6 of 27 Due to our error we information before the inspection, called an annual quality assessment questionnaire. However we were able to use one which we had received for previous service review. We sent surveys to people living in the home. One inspector visited the home unannounced. This visit lasted over six hours and included talking to the staff and the registered manager about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We spent time talking with people who live in the home and one relatives and a health professional who was visiting. We looked at three peoples care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. We found Elmhurst has a well established staff team who are aware of peoples needs and personal preference, and where there are any improvement which need to be made the manager is aware of them. Also people told us they like living at Elmhurst. Information provided by the manager on 10th October 2008 indicated that the current weekly fee for the home is from 341 to 377 pounds per week. Additional costs include the provision of extra support by staff, toiletries, hairdressing, holidays, leisure activities and clothes. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 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 27 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. People will be assessed before admission to the home to make sure Elmhurst is the right place for them to live. Evidence: The registered manager told us information is made available to anyone interested in moving into the home. Usually the registered manager will visit them at their home and complete an assessment to make sure Elmhurst will be able to provide a service that will meet the persons needs. As part of this process they will also gather information form any other agencies involved. Where possible the person is then encouraged to visit the home for a day or overnight providing them with the opportunity to meet everyone and to get a feel for the home. Three peoples files who had recently moved into the home were looked at in detail. Two were found to have moved in due to an emergency however they did have a Care Homes for Older People Page 10 of 27 Evidence: assessment carried out on the day they moved in. The third did have an assessment carried out before the person moved into the home and this did contain details of most aspects of persons daily life and health needs. We did not see any information from other health professionals which had been obtained before the person moved into the home but the registered manager told us this is obtained but is usually archived shortly after they move into the home. This information with the pre assessment would have enable the registered manager to make a informed decision about whether the home has the staff skills and equipment necessary to look after the person properly. The registered manager explained following the assessment the home provides people with a letter confirming they can meet the persons needs. One person described how they had chosen it because a relative had stayed there. Four people in their surveys told us were given enough information about the home before they moved in. The staff records showed and staff confirmed they had the necessary training to enable them to look after people properly. Staff also told us they had received specialist training when needed for instance palliative care. The home does not provide intermediate care. Care Homes for Older People Page 11 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the health and personal care they receive is based on their individual needs. The principles of respect dignity and privacy are followed. Evidence: Four people told us they received the care and support they need and were satisfied with the care they received at Elmhurst. Examples of comments made were:It is a good home they look after us ok. When I am ill the Dr is always called or the nurse. Staff very supportive all the time. One health care professional told us I would be happy to have any of my relatives stay at Elmhurst without a doubt. People living in the home told us staff respected their privacy and dignity. They were able to give examples as to how staff did this. Staff were observed providing support in a kind and helpful manner and people were clean and dressed in co-ordinating Care Homes for Older People Page 12 of 27 Evidence: clothes. A health professional confirmed this was always the case when they visited. At the previous inspection we asked for peoples care records to be dated and the full range of care needs laid out in a plan of care which provides staff with guidance on how to be consistent in meeting peoples needs. Four peoples case records were looked at in order to check this had been carried out and plans had been formulated, which helped staff provide support to people according to their needs and wishes. The care plans consist of assessments of peoples personal and health care which is carried out following moving into the home this provides the information on which the care plan is first based. The plans identified most of the individuals personal needs and covered aspects such as daily living, catering and medication. These were supported by risk assessments which described the possible risks to people and the actions the staff needed to take to minimise these risks. Talking with the registered manager, a supervisor and the staff showed us they are fully aware of peoples care needs and personal preferences and are proactive about identifying any changes and consulting with health professionals. Also when questioned staff were able to confirm they were assessing any risks to people and regularly making sure that the person was safe. However we were able to identify two areas where the care plans and risk assessments had not been updated. The home therefore needs to continue to improve upon its record keeping and review its care records more frequently, as this will help to make sure all staff are fully informed about peoples needs. Peoples health care needs are promoted and maintained. The records showed people were accessing health care professionals such as General Practitioners Chiropodists and District Nurses. A health professional was visiting the home when we visited and confirmed that the manager will always contact them and seek their advice. A sample of medication was checked and was correct. The registered manager explained they have recently started using a new local pharmacist who reviews people medication regularly and supplies the medication in a container that helps to make sure people always get the correct doses. Care Homes for Older People Page 13 of 27 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. People are supported in exercising choice and control over their daily and social activities. People are given a choice of nutritious drinks and meals when they request them. Evidence: The registered manager and staff promote Elmhurst as peoples own home this enables them to follow a daily routine of their choice which resembles the one they would have had previously in their own homes. Friendships had developed between people living in the home and people who were able were helping each other. This focus encourages people to remain independent and have as much control over their lives as is possible. The atmosphere at the home was very calm and relaxed. People can sit in communal lounges or spend time in their rooms and can rise and retire as they wish. Staff were seen taking time to talk to people who needed comforting. The home does not employ an activities co.ordinator; the staff alongside their other duties carries out activities. People told us there are a range of activities happening, Care Homes for Older People Page 14 of 27 Evidence: such as foot spa pampering hair and nails bingo skittles and trips to the Blackpool. Four surveys were returned where one stated there are always activities two stated usually and one sometimes. Comments made were:- I take part if I feel I want to. I take part in the ones I want to do. One person told us how much they had enjoyed accompanying the maintenance man to the shops. We did not see any relatives when we visited but the service user guide tell us visitors are welcome any time at peoples discretion. There is no restriction on where they are entertained and refreshments will be made available on request. The home has a dog and birds one person was seen walking around with the dog and cuddling it the staff explained this person believed it was their dog and found comfort in it. There were books and magazines around the home for people to read. However on the day we visited we did not see anyone taking part in any activities in the lounge areas and many people remained in the lounge area either watching TV or sleeping. Tables are set with tablecloths and matching crockery and cutlery. People can choose whether they sit in the dining area or their rooms to eat. On the day we visited people lunch was meat pie or sausage followed by cake and custard everyone said it was very good. The staff told us there was alway a choice of meals available. The kitchen was last awarded 5 stars in 2007. Comments made by people were:I have put on weight always plenty to eat. Meals are very nice and they always welcome my husband. Care Homes for Older People Page 15 of 27 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. People are able to express their concerns and are safeguarded from harm. Evidence: Four people told us they feel able to make their views known if they have any concerns or complaints. Also four surveys returned all said they knew who to speak to if they were unhappy and all knew how to make a complaint. The home has a complaints procedure in the reception area. There has been one complaint since the last inspection which was investigated and resolved. The complaints policy was reviewed in 2007 and includes how long a response will take and it asks for people to make a complaint to the head of care first and then the registered manager and registered provider. As this is a small home where the registered manager is readily available it maybe more user friendly for all complaints to be dealt with in the first instance by the registered manager. All the complaints are kept together we explained this would not meet with the data protection act guidelines. The registered manager agreed to review this. There are regular meetings in the home where people can make their views known. Care Homes for Older People Page 16 of 27 Evidence: The manager told us a copy of the local policy and procedure No Secrets is available for reference. Some staff had received training in adult protection and safeguarding from Age Concern and two staff are aware of whom to alert if an incident occurred. However discussion with the registered manager and staff showed although they were aware of some of the actions to take to safeguard adults and what constitutes abuse, they would benefit from further training about local procedures. Care Homes for Older People Page 17 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and clean home. Evidence: The home is very homely, comfortable and clean. Three people told us this was normally the case and four people who returned their surveys also told us the home is always fresh and clean and has no smells. People said their rooms were clean and comfortable, they liked them and they have been decorated and furnished to their personal interests and tastes. There are two lounges and two dining areas downstairs one of the lounges has a television. One of the dining rooms has a small kitchenette with a vending machine where people can buy drinks and crisps etc. There are double and single rooms with communal bathrooms, the bedrooms are on the first and second floor and there is a chair lift to each floor. The registered manager explained when they assess whether the home is suitable for anyone they always assess their ability and safety on the stairs. The registered manager told us that various refurbishments have taken place over the last year, both the lounges have been refurbished; and some of the windows have Care Homes for Older People Page 18 of 27 Evidence: been replaced with double-glazing. At present they are building a new conservatory. However there were still areas that would have benefited from further improvements and we saw one of the beds was in need of replacing. We were also concerned about the safety of the glass in the bathroom and bedroom doors, the provider has now looked at the glass and tells us it is safe in the bedrooms and meets the required standards, and as a prevention he intends to change the glass in bathroom doors. At our last inspection we asked for the home to make improvements to the bathroom and to the laundry, we found these had been carried out. To help prevent the spread of infections and to make the home a clean and comfortable place to live the a cleaner is employed for five days a per week. Also five of the staff have had infection control training. Care Homes for Older People Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service. However to make sure only suitable people are employed they need to improve their recruitment procedures. Evidence: People living in the home said there were generally enough staff available to meet their needs. They made positive comments about the staff such as:- Staff are always helpful when I am not well. They are kind and caring. Nothing is too much trouble for any one they are happy to help. We saw they had enough time to sit and talk with people and when talking to people they listened and displayed both warmth and humour, which people appeared to like. Staff also told us there was enough staff available for them to have the time to sit and talk to people. The staff rotas show that there is normally four in a morning and three on an evening for twenty one people. We looked at three staff records all to make sure the home was employing suitable people for the job. We found one person had started work in the home before the full police checks had been carried out. Care Homes for Older People Page 20 of 27 Evidence: There is an induction programme in place that ensures new staff members are given the right information to be able to do their jobs well. Two staff told us about the training they had received such as moving and handling, palliative care and infection control. The registered manager explained training is updated regularly and staff have carried out dementia, and protection of vulnerable adults training. She also explained over half of the staff have carried out their national vocational qualification in care at level two or above. This qualification gives people the necessary basic skills to care for people properly. Staff told us they felt very supported by people in the home and regular staff meetings were held. Care Homes for Older People Page 21 of 27 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 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 run in peoples best interests. Evidence: The registered manager has worked for the home for over twelve years she has her National Vocational Qualification level two and three in care and has told us she is about to commence further training to update her skills. She runs the home to meet the needs of the people who live there. There have been positive comments about the registered manager by the people who live in the home and the staff who all felt she was approachable, supportive and responsive to peoples needs. The registered manager is supported by a senior carer who takes responsibility for the smooth and safe running of the shift. People are asked their views of the home annually, and regular audits are carried out Care Homes for Older People Page 22 of 27 Evidence: monthly. We saw some of the questionnaires which were returned in 2007 and they were very positive. Comments made were:- It is a good home. People are helpful with me and my family. Also Residents meeting are held regularly, so the home can be run the way people living in it want it. However the home does not seek the views of relatives or health professionals, it should therefore consider seeking their views as a further improvement of their quality assurance. The registered manager explained the home does not hold money on peoples behalf. Three staff files were examined, the surveys and staff spoken to confirm the staff receive regular supervision and feel fully supported by the management. At our last inspection we asked the home to keep a record of all accidents or incidents. And we must be notified of any events, which affect peoples well being. We looked at the accident file and found there were only a few recorded. The registered manager explained this was because many people were independent and to prevent people from falling in the lounge area there was always a member of staff. We looked at a recent accident and this had been reported to the Commission. The registered manager told us the annual checks for health and safety are in place. The maintenance man is responsible for the checking of all health and safety documents. Care Homes for Older People Page 23 of 27 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 27 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 1 29 18 You must ensure that all staff have completed a full application form and given details of previous employment. Any gaps in employment must be explored and details recorded. Two satisfactory written references must be held on their personnel file. A satisfactory CRB check must be in place. Where a POVA first check has been obtained prior to a CRB in exceptional circumstances, there must be evidence that the staff member worked under supervision pending the receipt of the full CRB check. 03/11/2008 To protect people using the service and to ensure only suitable staff are employed at the home. Care Homes for Older People Page 25 of 27 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 7 Care plans and risk assessments need to be reviewed more regularly and when peoples needs change, this is to make sure peoples needs are always and consistently met by staff. To protect peoples, records of complaints should be kept in lines with data protection. To keep staff updated they should attend further local training about the procedures for reporting abuse. The bed identified during our inspection should be renewed and a review of all the other beds should take place to be sure they are not of a satisfactory standard. 2 3 4 16 18 19 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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 © (2008) 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 Older People Page 27 of 27 - 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!