Care Home: Montfort Fields 12

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What the care home does well The staff try to find out what people like to do.They try to find out what they like to eat and try to make sure that is what they get for their meals.They have written down what help you need to check that they are helping you properly.If someone needs medicines or creams they will make sure they get them.If someone is ill they make sure that they get the right treatment.If someone is upset and unhappy the managers and the staff will try to find out why. The staff watch to make sure people are happy.The home is clean and well decorated.Each person can keep their own things in their room and those rooms can be decorated how they would like them to be.The home has a pleasant garden for people to sit and walk in.The staff are cheerful friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The managers are also cheerful friendly and helpful and do most of the things that help the staff to do their job. What has improved since the last inspection? This home was `excellent` last time we inspected it. What the care home could do better: We made no requirements or recommendations at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Montfort Fields 12 Montfort Fields 12 Kington Herefordshire HR5 3AT 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: Michael Moloney Date: 0 9 0 3 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 31 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 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Montfort Fields 12 Montfort Fields 12 Kington Herefordshire HR5 3AT 01544231030 01544231030 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) : www.macintyrecharity.org MacIntyre Care care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 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: Learning Disability (LD) 5 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home This home is run by McIntyre Care. The manager is called Lindsay Ross. The home is a detached house Kington, Herefordshire. Montfort Fields is home to five people. You can walk into the town from it. Care Homes for Adults (18-65 years) Page 5 of 31 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 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 31 How we did our inspection: This is what the inspector did when they were at the care home Before we went to the home we looked at the information that the manager had sent us. We often ask for this before an inspection and always ask the same questions. This tells us how the home thinks that they are doing. We also look at the information that the home has sent us about accidents that have happened to people who live and work in the home. We did not tell them that we were coming. One inspector visited the home. His name was Mike Moloney. He was there for four hours. Care Homes for Adults (18-65 years) Page 7 of 31 We looked at how two of the people who live in the home are looked after and what had been written down about this. Because the people who live in this home could not talk to us we watched how the staff looked after them and talked to them about what they did. What the care home does well The staff try to find out what people like to do. They try to find out what they like to eat and try to make sure that is what they get for their meals. Care Homes for Adults (18-65 years) Page 8 of 31 They have written down what help you need to check that they are helping you properly. If someone needs medicines or creams they will make sure they get them. If someone is ill they make sure that they get the right treatment. If someone is upset and unhappy the managers and the staff will try to find out why. The staff watch to make sure people are happy. Care Homes for Adults (18-65 years) Page 9 of 31 The home is clean and well decorated. Each person can keep their own things in their room and those rooms can be decorated how they would like them to be. The home has a pleasant garden for people to sit and walk in. The staff are cheerful friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The managers are also cheerful friendly and helpful and do most of the things that help the staff to do their job. Care Homes for Adults (18-65 years) Page 10 of 31 What has got better from the last inspection What the care home could do better 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 Michael Moloney 77 Paradise Circus Queensway Birmingham Care Homes for Adults (18-65 years) Page 11 of 31 W Midlands B1 2DT 01216005300 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 12 of 31 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 13 of 31 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. People who may want to live in this home and their representatives have the information needed to choose a home, which will meet their needs. They would have their needs assessed and a contract which clearly tells them about the service the will receive. Evidence: We saw that the home has a Service User Guide that contained the information that people may want if they are thinking about arranging for someone to live there. This is information that must be available by law. We talked to the manager and she confirmed that nobody new has come to live at the home since the last inspection. She told us about the process that the company insists that she follows as and when new people are admitted and from the way she talked she was aware of what this would be. Care Homes for Adults (18-65 years) Page 14 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: We looked at how people who live in this home are involved in decisions about their care and the activities that they are involved in. We saw that Care Plans had been drawn up in a person centred way. These are plans that are developed up by the home that identify what each person needs to be healthy, what they enjoy doing and what they dont like to happen to them. These are all written down and guidance is drawn up for the staff to follow and takes into account all of these things. We saw that these records had been reviewed regularly to make sure that they were still meeting the individuals needs. We saw that decisions about important issues that had to be made in peoples best interest had been recorded in a way that explained why and how the choices had been arrived at. We saw written descriptions of how those plans could be put into effect safely. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: We talked the staff who explained peoples plans had been drawn up by talking with them and their relatives. As people have difficulty expressing themselves the staff told us that they had also developed the plans from their experience of what they had seen each person enjoying over time. Care Homes for Adults (18-65 years) Page 16 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, cultural and recreational activities are to their liking. Evidence: We looked at how the home meets the social needs of the people living there. We looked at peoples care plans, which had been developed in a person centred way, and saw that these showed what people liked to do and what they did not like to do. We saw records that said that they went to such things as swimming, did jigsaws, went shopping, went to drumming sessions and horse riding. We saw that each person had a clearly identified weekly timetable and that staff carefully planned each week to make sure that everyone got to their planned activities and appointments. We saw that the home had two vehicles that can be used to transport people to and from their planned activities. Staff told us that they use these vehicles regularly. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: One of the people who live in the home was eager to show us photographs of the two holidays that they had been on in the last year. Staff told us that all of the people who live in the home have a holiday each year but in this persons case they were known to enjoy their holidays so much that a case was made for them to have a second one. We looked at the meals that were served in the home. We saw records that showed that the diet is varied and nutritious. We saw that the meal that was served on the day of the inspection was well presented. The staff who prepared the meals told us that they had current food hygiene certificates and we saw that the training records maintained by the home confirmed this. They also told us that the menus had been developed by observing what individuals liked and disliked and by offering choices whilst out food shopping. Throughout the inspection we saw that the staff talked with the people who live in the home in a friendly, clear and professional manner. When they called someone by their name it was the name that had been agreed and entered in their records and the people being addressed were seen to be comfortable with this. We saw that when a member of staff entered bedrooms or bathrooms they always knocked and called before entering the room. Although there were suitable locks on all of the doors the nature of the disabilities of the people living in this home made the issuing of keys to them inappropriate. Care Homes for Adults (18-65 years) Page 18 of 31 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: We looked at the records of two of the people who live in this home to see if their health needs are being met. We looked at peoples assessments and they contained information about any medical conditions that affected each person and the records also said how each condition should be managed. Within the records we saw entries that showed when and why people saw healthcare professionals such as consultants, general practitioners, physiotherapists, dentists and chiropodists. We talked to the staff and they showed that they were aware of what individuals wishes were in relation to their personal care. Throughout the inspection we saw the people who live in the home reacting to the staff in a way that showed that they trust them and are used to being treated with respect. The records that we saw also contained information about peoples weight as part of the system for monitoring their general health. We talked to the staff and they showed that they were aware of the general mood of each person and would try to pick up if someone was out of sorts and work out if they needed to contact their G.P., dentist, chiropodist or some other healthcare professional. We saw that peoples medications are reviewed on a regular basis by their doctor. We Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: saw that there are accurate records of when the medication is administered and we saw that the medication is stored safely. We talked to the staff who said that they had all received training in the safe handling of administration of medication and we confirmed this by looking at the training records that are kept by the home We discussed the deprivation of peoples liberties and the manager told us that there were no issues in the home that needed to be referred to the local authority. Care Homes for Adults (18-65 years) Page 20 of 31 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 who live in this home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: We talked to the manager who confirmed that the home has received no complaints. We saw a copy of the homes complaints procedure was seen and this contained the information someone would need if they wished to raise a problem with the home or its owners. The manager told us that no issues had been referred into the local procedures that are designed to protect vulnerable adults. We watched the staff talking with the people that they support and although the level of the disabilities of the people who live in the home means that they are unlikely to be able to access formal policies we saw that they, the staff, would be aware of any dissatisfaction expressed and it was seen that a whistle blowing policy is available to be used. The manager also explained that some of the service users monies are managed by the home. Full records were seen to be kept outlining any transactions and those records are Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: monitored by the homes manager and are also subject to checks her line manager. Care Homes for Adults (18-65 years) Page 22 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation meets service users needs and provides a safe, clean, very homely and comfortable home. The accommodation is decorated, furnished, equipped and kept to a high standard. Evidence: We visited 12 Montfort Fields which is a home situated at the end of a close on a modern housing estate in the north Herefordshire town of Kington and is within easy walking distance of the towns amenities. It is a residential house that has been adapted to its current use in a sensitive manner. There is limited off street parking available. We saw that there are three areas where the people who live in the home can gather these being the lounge, the dining area and the conservatory. The conservatory looks out onto the well maintained garden that contains a summer house as well as other garden furniture and equipment. We saw that each of the five people who live in the home have their own bedroom with three of these being upstairs and two down. Each bedroom had been personalised with help form the staff and although he could not express himself verbally one of the people who showed us his room made it clear that he liked how his room had been decorated. Each floor had its own bathroom for the people who live there to use. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: On the ground floor we also saw a well equipped laundry area that could be used to keep peoples clothes, towels and bed linen in clean and hygienic condition. Care Homes for Adults (18-65 years) Page 24 of 31 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 excellent 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 the people who use the service and are sensitive to their needs. Evidence: We looked at the staffing rotas and talked with the manager and her staff and found that there were enough staff on duty to meet the needs of the people who now live in the home. We were told by the staff and saw from the staffing rota that an extra member of staff is often available to take people out, particularly in the evenings and week ends. We looked at the training that the staff had received. We saw training records that showed that the home has an ongoing programme of training in such things as manual handling, food hygiene and infection control all of which means that they are more aware of ways of meeting the safety and hygiene needs of the people who live in the home. We spoke to the staff on duty at the time of the inspection and they confirmed that they had undertaken this training. The document that the manager had returned to the Care Quality Commission before the inspection showed that a high proportion of the staff were qualified to at least National Vocational Qualification level 2 in care. This is a qualification that is considered appropriate for someone working in a service such as this. The manager also said that any new staff who had not worked with people with the kinds of needs that the people who live in this house have are expected to undertake foundation training in how to meet their needs within the first few months of working Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: there. We saw that notes were kept of whether or not background checks had been completed to ensure that people who are wishing to work with vulnerable people who are fit to do so. The manager told us that the main files for each of the staff were kept in the area office in Shrewsbury. We did not visit that office and inspect the files on this occasion as our experience is that when we visited after inspecting other homes within this group we have found the necessary records to be well ordered and in place showing that the company has a robust recruitment procedure. We watched the staff working with the people who live in the home. We saw that they were polite, friendly, professional and attentive. We saw that the people who lived in the home approached the staff easily and when they did the staff appeared to understand what was being asked of them even though little speech was involved. The staff also told us how they organised their working days around the known wants of the people that they care for and an example of this was when one of the people that they were working with made it obvious that they should be out walking with them and not talking with an inspector. The members of staff involved immediately went with the person who wanted to go for a walk. Care Homes for Adults (18-65 years) Page 26 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: We talked to the manager and she told us that has the Registered Managers Award which is an appropriate qualification for someone running a facility such as this. We saw that the home is well run and that there is an open and positive management approach. The manager and the staff also told us that the provider organisation is very supportive to the home and its staff. We talked about the new rules that must be followed if the home needs to deprive someone of part of their liberty in their own interests. The manager explained the process that she had followed to check whether or not the way they prevent someone who lives in the home from falling down the stairs was appropriate. We also saw that the written process adopted by the proprietor for evaluating whether or not a decision was in the Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: best interest of an individual had been used to show that one of the people who live in the home would want an extra holiday and would want the money it cost to be spent in such a way. We looked at how the provider monitors how effectively the home meets the need of the people who live there. We looked at records that showed that a senior manager had regularly visited the home to carry out formal and recorded checks each month that focuses on the safe delivery of care. We asked staff and they confirmed that those visits do take place. The manager also talked about the monthly reports that she has to complete. These contained information about staffing levels and any reasons for variations within them, what staff training had taken place, what monthly meetings with individual members of staff have taken place and a range of health and safety matters. We saw that equality and diversity for the people who live in the home are promoted within the assessments, care plans and activities. A variety of records were seen that showed that safety issues are constantly monitored. Records of such things as fridge freezer temperatures, fire equipment tests, gas safety tests, hot water temperatures and portable appliance testing were seen to have been maintained. Accident records were looked at and these showed that such incidents were monitored by the senior management. Hazardous materials were seen to have been stored in a locked cupboard. Staff records also showed that the mandatory training that is necessary to keep the service users safe has been taking place. This includes training in such things as food hygiene, fire prevention and infection control. Staff spoken to confirmed that these records were accurate. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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