Care Home: Rosevale

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What the care home does well Assessments of peoples needs are undertaken and include details of potential risks this ensures that staff know peoples needs and they can be met. Activities being provided are meeting the preferred needs of people living at the home. People stated they receive care in a way that respects their privacy and dignity. Comments received included " we are kept informed about any changes" and "The care my mum receives at the care home makes it possible for her to live this part of her life in the best way she feels comfortable and secure". A complaint`s procedure is in place to ensure that any concerns raised are investigated and dealt with thoroughly.Staff receive training, which helps them to look after people safely. Audits on how the home runs are carried out by the management team to ensure the quality of the service is monitored and any shortfalls identified are dealt with thoroughly. What has improved since the last inspection? Wellburn Care Homes Limited are providing help and support to people living in the home, staff and relatives, to ensure that they are happy with how the home is operating since the takeover. What the care home could do better: Advice should be sought from the North Yorkshire Fire and Rescue Service, in relation to safer methods of holding open two doors and fire alarm testing being undertaken to ensure that people`s health and safety is protected. Review the number of beds registered with the Commission for Social Care Inspection, and ensure that it reflects the homes current needs. CARE HOMES FOR OLDER PEOPLE Rosevale 33 The Village Wigginton York YO32 2PR Lead Inspector Denise Rouse Key Unannounced Inspection 21st January 2008 09:50 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosevale Address 33 The Village Wigginton York YO32 2PR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01434 633055 Wellburn Care Homes Limited Vacant post Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies 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: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 42 09/03/06 2. Date of last inspection Brief Description of the Service: Rosevale is a Care Home offering personal care for up to 42 people. The home is located in the village of Wigginton close to local amenities. The home operates on two floors and stair lifts allow people who live there access to both floors. The home has its own grounds, and plenty of parking spaces to the front of the building. The home is owned by Wellburn Care Homes Limited who acquired it in October 2007. Fees charged on the day of the site visit ranged from £365.00 to £520.00. A copy of the last inspection report is available to people. The service user guide is being updated, the draft is available to people which contains a summery of the services available within the home. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good, quality outcomes. The accumulated evidence used in this report has included: • A review of the information held on the home’s file since its last key inspection. • Information submitted by the registered provider in the Annual Quality Assurance Assessment. • Surveys received from six people living at the home, six relatives, and three health care professionals. • An unannounced visit to the home, which lasted five hours. This included a full tour of the premises by one inspector. • Evidence gained by direct observation during the site visit; which involved talking with people living at the home, the acting manager, operations manager and staff. Inspection of records, including care profiles, medication administration records, staff files and some of the home’s policies and procedures. • What the service does well: Assessments of peoples needs are undertaken and include details of potential risks this ensures that staff know peoples needs and they can be met. Activities being provided are meeting the preferred needs of people living at the home. People stated they receive care in a way that respects their privacy and dignity. Comments received included “ we are kept informed about any changes” and “The care my mum receives at the care home makes it possible for her to live this part of her life in the best way she feels comfortable and secure”. A complaint’s procedure is in place to ensure that any concerns raised are investigated and dealt with thoroughly. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 6 Staff receive training, which helps them to look after people safely. Audits on how the home runs are carried out by the management team to ensure the quality of the service is monitored and any shortfalls identified are dealt with thoroughly. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (6 Not applicable) People who use the service experience good quality outcomes in this area. People are assessed and have information available to them about what the home has to offer, so they can make an informed choice. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People are fully assessed before they are offered a place in the home. Information about peoples preferred social needs and their state of mind is included in the assessment, which is undertaken by staff who are confident and competent. Information is gained from the individual, their relatives and chosen representative, also from discharging hospitals and care management to ensure that the home has a full picture of people’s individual needs and to ensure these can be met. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 9 Prospective individuals are invited with their family to spend time at the home, to ensure that they are aware of the services and facilities available to them. A key worker or member of the management team spends time with them, to answer their questions. Surveys undertaken indicated that people were happy with the information they received about the home. People are provided with information in the “Resident’s Information booklet”. This information is being updated to ensure it reflects fully what the new provider has to offer people. People are invited to stay at the home on a trial period or for short stays to help them make an informed choice about if the home is the right place for them. Intermediate care is not undertaken. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. People’s health care needs are met and their privacy and dignity is respected. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People have their health care needs recorded and these needs are reviewed to ensure that the care people are receiving is relevant. People’s dietary needs are recorded and acted upon. People’s special health care needs are assessed and reviewed, to ensure their needs are met. Risk assessments are in place and reviewed to ensure peoples health and safety is monitored, this includes the risk of falls. People are encouraged and supported to live the life they choose and can get up and go to bed when they like, and follow their chosen routines. A key worker system is in operation this helps people build up strong relationships with staff, which supports them. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 11 People are supported by visiting health care professionals and their local general practitioners. Special equipment is available in the home to ensure that people’s special needs are met. Staff accompany people to hospital appointments, opticians and dentists as required. A health care professional survey stated“ The care service are receptive to the needs of clients within their care. If medical or nursing help is required the staff communicate effectively what is required. I believe the clients dignity and respect is maintained at a high level”. “ I think our new system of “Doctors Rounds” involving both the manager and team leader in the initial discussion is greatly helping my care and understanding of the patients” And “ If there are any queries care staff will seek advice from the district nurse team and or GP”. And “ Staff are not trained nurses but act very appropriately within the level of their training and competence. Residents do have complex medical problems”. Medication systems in operation protect people living there. People could choose to self medicate if they were assessed as being safe to do so. This promotes peoples independence. Comments received from a health care professional were “Only a few residents are able to manage their own medication” And “ Care staff manage the medication of patients effectively, and assist the client in administration of medication”. People were seen to be treated with dignity and respect, addressed by their preferred names and staff knock on bedroom doors prior to entering. Information is available in the home about Advocacy services available to them to ensure their individual rights are respected. One comment received was “ Staff care for residents as individuals with a great deal of patience and respect”. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. People’s social needs are met and they are provided with a nutritious diet. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Peoples preferred social activities are recorded and provided. The activities programme for the month is displayed just through the front door on a large notice board. One to one activities are available, as well as outings. Entertainers also come to the home. People can choose to join in with the activities if they wish. These include Reminiscence bingo where an item from the past such as pears soap is called instead of a number and discussion is held in relation to this. Themed days are commencing such as “ Burns Night” where the meaning of this event will be discussed and haggis will be available. Flower therapy is provided twice a month where people come and make their own flower arrangements, which they take back to their own rooms. A shop is also available at all times selling toiletry’s and refreshments. One relative commented, “ Because my mum stays in her room she isn’t mixing with other residents. We find that during the day all the carers and domestic staff go in to see her several times” This ensures that people who do not wish to take part in activities are still getting social contact. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 13 Special birthdays celebrations occur for people living in the home and the staff. Individualised cakes are made which are specially decorated to have personal meaning to the recipient. A hairdresser attends the home twice a week, and a chiropodist also visits. Local clergy visit the home and Holy Communion is provided once a month for people who wish to attend. Library books are available in large and regular print for people to enjoy. People follow their preferred routines and can watch television in the lounges or sit in reception, the conservatory or dining areas. People are able to sit in the grounds and go out with their relatives and friends if they wish. People receive visitors at any time and they are made welcome, and can have a meal at the home with their relative Resident and relatives meetings are undertaken, so that people can give their views of the home and the services provided. At the last meeting the management team attended to talk to people about the company and to answer any questions people had about their company and how the home would operate under their management. A choice of food is available; people can choose where they wish to eat. The dining area is well presented with table clothes, napkins and fresh flowers. People choose what they would like to have to eat the day before. If they change their minds another choice is available to them. The menu of the day is printed and displayed on the tables. Alcoholic beverages and juices are available at meal times. The food served at lunch looked appetising and nutritious. People said, “ The food is good”. People needing help with their meal were assisted by patient staff to ensure that people were not being rushed. One relative commented “ My relative prefers to stay in their room and this is not a problem, they take all the meals to them”. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 &18 People who use the service experience good quality outcomes in this area. People can be assured that complaints would be dealt with and they are protected from abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a complaints policy displayed in reception. There have been no complaints received since the last inspection. Surveys received indicated that people feel happy to talk about any concerns they might have with the acting manager or staff within the home, and that they feel that issues raised would be investigated and dealt with. The policies and procedures in operation at the home ensure that people are protected from abuse. Staff receive accredited training about safeguarding adults and those questioned about what they would do if an allegation of abuse was to be made knew what action to take. All necessary pre employment checks are carried out to ensure that people are protected from staff that may not be suitable to work within the care industry. Relatives commented, “ If we ever have any problems then we speak directly to the manager who always looks into things and comes back to us”. And “I am very happy with the care the staff at Rosevale give my relative. Any issues that have arisen have always been dealt with without delay”. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 People who use the service experience good quality outcomes in this area. People live in a home, which is homely and well maintained. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is clean and has a homely and inviting feel. Bedrooms are available on the ground and first floor; some have en suite facilities. They are personalised by people in the home to ensure that they represent their home environment. One shared bedroom has a screen provided to ensure peoples privacy and dignity to be maintained. Private phone lines are available in some bedrooms and can be provided in others upon request to ensure people can keep in touch with family and friends. A programme of maintenance and improvements is being undertaken to ensure that the environment remains pleasant for people living in the home. There are plans to improve the conservatory and some décor and in time Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 16 install a passenger lift to the first floor; to replace the two stair lifts. New welcome baskets of toiletries are available in unoccupied bedrooms ready to greet the new occupants. Communal bathrooms and toilets are fitted with adaptations to aid people’s independence and help staff to assist people without placing their health and safety at risk. Laundry procedures ensure that infection control is maintained and hand washing facilities are available throughout the home to ensure people are protected from cross contamination. A relative commented, “ The home provides good caring staff, plenty of sitting areas, a lovely dining room with good selection of food. There are pleasant gardens for use in sunny days. Good laundry systems and always a welcome tray of refreshments provided for me when visiting, long may this continue”. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. People receive care from adequate numbers of well-trained staff. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People are looked after by adequate numbers of well-trained staff. The home does not use agency staff and staff work in different departments to cover peoples sickness and absence. This ensures that staff know peoples needs and the systems in place in each department so that the home is always staffed effectively. Surveys indicated that people were happy with the care they received and that staff listened to them and acted upon their needs. The home has achieved a 50 ratio of care staff who hold the National Vocational Qualification In care at level two or three. This helps to enhance the care given to people and provides staff with good knowledge. Staff receive all necessary training to ensure they are safe to carry out their work. More training in safeguarding adults, role-play, customer care and the company’s policies and procedures have been introduced. Staff spoken with said that they felt supported by the management of the home and were pleased to receive this training. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 18 Staff are recruited using thorough recruitment processes and all pre employment checks are carried out to ensure that people are protected from staff who may not be suitable to work in the care industry. Staff receive induction training, which includes information on safeguarding people, fire, moving and handling and infection control. Each member of staff has a training file which contains information about the training they have received and a new training spread sheet is being completed to ensure that management are aware of training which has occurred and that which is soon to be required. This ensures that the staff are always updating their knowledge and that they can deliver good care. Staff meetings take place regularly and this ensures that the staff’s views are known and can be acted upon. As well as providing any further training highlighted which can improve the care being delivered to people living in the home. A survey from health care professional stated “There is limited experience of dealing with ethnicity and race however care staff are responsive to the needs if their elderly clients irrespective of gender, faith, and or sexual orientation”. And one relative stated, “ Rosevale operates as an efficient and caring team of staff”. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 People who use the service experience good quality outcomes in this area. People live in a home that is well managed and maintenance checks are undertaken to protect people’s health and safety We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The acting manager is applying to the Commission for Social Care Inspection to become the registered manager. She is experienced and has worked at the home as deputy manager for a long time. She is knowledgeable and approachable and has the people using the service’s best interests at the centre of how the home runs. Managerial support is gained from the company’s operation managers and wider management team. The acting manager stated that this has been very Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 20 helpful and beneficial. Working together the management team have ensured that the home continues to run smoothly and effectively. The company have a variety of plans to develop the home and its services in the future. There are two flats in the grounds of the home. Clarification in relation to their registration is required, to ensure that people who may live in these can be supported effectively. The operations manager stated that the company would be prepared to increase their registration and is sending a copy of the contract to the Commission for Social Care Inspection to allow a decision to be made as to the best way forward on this issue. Management should undertake the advice if the Commission for Social Care Inspection in relation to this matter. Quality assurance procedures are in place. Regular audits are undertaken, over the month by visiting management and the acting manager, in relation to different departments to monitor how the home is running. Any shortfalls found are addressed. Notifications required to be sent to the Commission for Social Care Inspection are always sent in a timely manner. This ensures that management are constantly checking that the home is providing services at the required standard to people living in the home. Management issue all staff with two different company policies each month that they have to read and sign. This ensures that staff adhere to policies and helps to provide good practice. Personal allowance accounts are not provided for people living in the home. Health and safety checks and maintenance is routinely undertaken to ensure that people are kept safe. However on the site visit two wedges were holding open two doors. These appeared not to be holding open fire doors. However, following discussion with the acting manager and operations manager, these doors are to be fitted with noise activated door closers, which would activate when the fire alarms sounded. The fire risk assessment for the home will also be updated. Fire alarm testing is carried out, the frequency of this is to be reviewed to ensure peoples health and safety is maintained. Advice is to be gained from North Yorkshire Fire and Rescue Services in relation to these issues. One person surveyed was not happy with their TV reception. The acting manager was already addressing this issue. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X N/A X X 2 Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP31 OP38 Good Practice Recommendations The management team should implement the advice of the Commission for Social Care Inspections Registration Team in relation to the two flats at the home. Advice should be sought from the North Yorkshire Fire and Rescue Service, in relation to safer methods of holding open two doors and fire alarm testing being undertaken to ensure that people’s health and safety is protected. The fire risk assessment should be updated accordingly. Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosevale DS0000070671.V353493.R01.S.doc Version 5.2 Page 24 - 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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