Care Home: Scope - The Hollies

What the care home does well The brochure that tells people how the home works is a clear and detailed document and people had their needs assessed before moving into the home. This means that people moving into the home and staff have the necessary information to make a decision about whether the person`s needs can be met by the home. The staff team is well established and staff are keen for high standards to be maintained, so that people who live at The Hollies receive good quality care. Day to day supervision of staff is good and they received regular support from their line manager to make sure they provide good care to the people at The Hollies. Plans of care and individual care records for people who live at The Hollies are well documented so that the staff know what they should do to meet people`s needs. Referrals to the appropriate health care professionals take place when necessary to make sure that people stay as healthy as possible. Meals were varied and reflected people`s references. They are offered a range of choice and variety so that people who are living at the home were able to enjoy a varied diet to keep them well and healthy. People who live at the home told us that the staff treated them well and that the home was clean. Staff said, "I am offered support when I need it", "I am kept informed of changes", "we meet people`s needs as much as possible and we promote their independence", "the home supports the staff well and the training is good" and "we have a good standard of care and we meet people`s social needs. We do most things well". What has improved since the last inspection? The information about how the home works has been improved and now is produced in other formats such as large print and has included pictures as well. This makes it easier for people to read and understand. The minor damage to the door frames had been attended to. What the care home could do better: People who live at the home told us, "activities such as shopping or going to the cinema have to be planned in advance", "we need more drivers so I can go out more in an evening", "we need more staff so that I can go out more" and "activities have to be planned well in advance so that we have the staff and transport available". Staff were asked what they thought could be better at the home and they commented, "provide more social activities for the service users", "more individual time with service users and more lifestyle sessions", "involve the service users more in the community" and "have more staff available for activities". It was suggested that an analysis of the results of the satisfaction surveys is produced and shared with the people who live at The Hollies, their families, the staff team andother interested parties including the commission. A copy of the hard wiring electrical safety certificate should be kept at the home to show that good safe working practices are maintained. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Scope - The Hollies 1 ,2 and 3 The Hollies Halton Brook Avenue Halton Brook Runcorn Cheshire WA7 2FU     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: Maureen Brown     Date: 0 7 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Scope - The Hollies Halton Brook Avenue 1 ,2 and 3 The Hollies Halton Brook Runcorn Cheshire WA7 2FU 01928590168 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) : SCOPE care home 9 Number of places (if applicable): Under 65 Over 65 0 physical disability Additional conditions: 9 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Physical disability - Code PD The maximum number of service users who can be accommodated is: 9 Date of last inspection Brief description of the care home The premises of 1 - 3 The Hollies are owned by Liverpool Housing Trust, and are managed by Scope. The home is located in the Halton Brook area of Runcorn with easy access to local amenities and facilities. The Home is comprised of three bungalows accommodating nine people who are physically disabled. Each bungalow provides three single bedrooms and other shared areas. The staff team consists of the registered manager who is supported by a team leader Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home and seventeen support workers. Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We carried out an unannounced visit to the home on 7 May 2009 and this lasted five hours fifteen minutes. It was done by one inspector. The report will say we when referring to what was done and found at the visit, as it is written on behalf of the Care Quality Commission. The visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to all the people living at the home and staff to find out their views about the home and service provided. Other information received about the home was also reviewed. Care Homes for Adults (18-65 years) Page 6 of 27 During our visit we looked at various records and the premises. We looked at the care records of the people who live in the home, to see how their needs were being met. We spoke to people who live at the home, the acting service manager, the team leader and other staff on duty. They all gave their views about the home. The fees for the home are from 700.69 pounds to 944.07 pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: People who live at the home told us, activities such as shopping or going to the cinema have to be planned in advance, we need more drivers so I can go out more in an evening, we need more staff so that I can go out more and activities have to be planned well in advance so that we have the staff and transport available. Staff were asked what they thought could be better at the home and they commented, provide more social activities for the service users, more individual time with service users and more lifestyle sessions, involve the service users more in the community and have more staff available for activities. It was suggested that an analysis of the results of the satisfaction surveys is produced and shared with the people who live at The Hollies, their families, the staff team and Care Homes for Adults (18-65 years) Page 8 of 27 other interested parties including the commission. A copy of the hard wiring electrical safety certificate should be kept at the home to show that good safe working practices are maintained. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 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, 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 receive enough information about the home for them to make an informed decision about moving in and their needs are assessed before they move in so they know that these can be met at the home. Evidence: A copy of the information that tells people who the service is for, the statement of purpose, was seen in each persons care file and this had been updated in April 2008. A new version of this had been produced in large print with pictures and photographs to help people to understand it more easily. It was suggested that this document be updated each year. The report of our last big inspection at the home was available for people who live there and others to read. There was a document available for staff to use with people before they move into the home, to check on what their needs are. The document covers all personal care and daily living needs and provides information on how many care hours would be needed to provide support for the person. A copy of the needs assessment that social services Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: carry out with the person is also kept in each persons file to provide further information about their needs and show they can be met at the home. There had been no new people moving into the home since the last visit and most people had lived at The Hollies for over fifteen years. Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal care needs of people living in the home are met effectively by the staff and support is provided in a way that ensures peoples privacy, dignity and choice. Evidence: We looked at the care plans of two people who live at the home to check on the care they were receiving. These showed the areas of support that was needed and how this was going to be provided by the staff. Also available were 24-hour summary sheets of daily routines which were very useful to the staff to make sure that people were getting the support they needed each day. Monthly key worker report sheets had been produced to give an account of each persons daily activities and these were well written. Daily record sheets are completed and these were signed by staff to confirm who had written them. They showed the day to day activities and changes in peoples health and well being were also noted. People who live in the home are helped to make their own decisions about their daily Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: lives. Individual choices are recorded in the care records so that staff know what peoples preferences are and how they would like the support to be provided. People who live at The Hollies are supported in managing their own finances and appropriate records are kept regarding this to show it is completed correctly. Staff encouraged the people who live in the home to do whatever they wanted to do. Risks are assessed and assessments are produced to make sure that people are safe in what they do. A wide range of assessments are available and these were up to date with reviews held to make sure they are still appropriate. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at The Hollies were able to take part in a range of activities so they can stay active and staff help people to stay in touch with their families and friends. Evidence: Activities are provided for people who live in the home and these included going out to the local shops, visits to shows, theatres and concerts, visits to a local zoo and the local safari park and holidays and short breaks with family and friends. The manager said that people were getting out and about more into the community and this was confirmed by the people who live in the home. Each person had three lifestyle sessions a week. Activities included sessions on the allotment, music, basic IT, drama, reading, woodwork, cooking, current affairs, and crafts. It was agreed by people who live at The Hollies and the staff that although a variety of activities were provided, they would appreciate more. They felt that to be able to go out at weekends and evenings more Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: often would be good and to not always have to plan things a long way ahead would also be good. People who live in the home are offered choices in various ways, such as in the time they get up or go to bed, what they wear or by deciding what they do each day. Also by deciding on whether or not to join in activities and also by how they wish to be addressed. This gives people some control over their own lives and helps them to stay as independent as possible. A record of what each person eats and drinks is kept and these showed a variety of meals including meat, cheese, fish, pasta, eggs and vegetables. The lunchtime meal tended to be a snack meal with each person often having something different and the main meal was usually in the evening. Care Homes for Adults (18-65 years) Page 16 of 27 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 care needs of the people who live in the home are met by the staff team in a way that promotes the persons independence, privacy and respect. Evidence: The medicines for people who live at the home are supplied in a monitored dosage system, as this helps to make sure that medicines are given correctly at the right time and as prescribed. Medication administration record sheets were completed when medication was given. We looked at a sample of the records and these were completed correctly to show that no errors had been made in giving out the medicines. All staff had received training in medication awareness so they know who to give medication to and are able to do this safely without making mistakes. Visits from health care professionals were recorded and we saw from the records that visits to the GP, dentist, chiropodist, district nurse, and well man and well woman clinics were attended by the people who live in the home. Also annual medication reviews were completed. It was confirmed that healthcare professionals would also visit people at the home if required to make sure that they remain well. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: From discussion with the people who live at the home it was clear that personal support is carried out as each person prefers, so that choice and respect are maintained. Care Homes for Adults (18-65 years) Page 18 of 27 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. The homes procedures for complaints and safeguarding adults are effective so that the concerns of people who live at The Hollies are listened to and they are protected from abuse and harm. Evidence: We looked at some of the staff files and saw that they had completed training on safeguarding adults. The manager confirmed this and showed that he was aware of the policy, procedure and guidance on safeguarding, Other policies were available regarding the protection of vulnerable adults and included physical intervention, whistle blowing, dealing with bullying, and adult protection and prevention from abuse. One safeguarding referral had been made by the home in the year before our visit, under the local authoritys safeguarding procedures. The complaints procedure was satisfactory and contained details of how to contact the commission. The home had not received any complaints since our last inspection there and we had not received any about this home either. People who live at the home said they would speak to the staff or the manager if they had any problems. Care Homes for Adults (18-65 years) Page 19 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, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained so that people who live at The Hollies live in clean, comfortable and safe surroundings. Evidence: We had a look around the home during our visit and saw all the shared (communal) areas and some of the bedrooms. All the bedrooms are single and the standard of decor is very good. People who live at the home explained that they had chosen the decorations within their own bedrooms and this reflected their own personal tastes. They had made their rooms more homely by using pictures, furniture, photographs and by having TVs, DVDs and other equipment that they either brought with them or have purchased since moving into the home. People who live at the home explained that they had all been involved in deciding the colour schemes for the communal areas as well. The overall standard of the decor within the home had significantly improved since our last visit there. The home was clean and had no unpleasant odours. Care Homes for Adults (18-65 years) Page 20 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, 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment procedures are thorough and staff had completed a wide range of training so people who live in the home are protected from poor practices. Evidence: The staff rota showed the staff on duty over the week. The staffing levels appeared to be sufficient to meet peoples needs. People who live in the home confirmed there were usually enough staff around to help them and during the visit we saw that staff were attentive to peoples needs. We checked three staff files to see how they had been recruited. All the necessary preemployment checks had been carried out and these included Criminal Record Bureau checks, health checks, identity checks, references and application forms. The files were in very good order and it was easy to access the relevant information required. The training staff had completed included a full induction which is linked to the Skills for Care training and can be used to lead into National Vocational Qualification (NVQ) level 2 in care. Other courses staff had undertaken included adult protection, food hygiene, health and safety, moving and handling, first aid, diversity, disability awareness, fire awareness and medication training. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Excellent progress has been made with NVQ training. Fourteen out of seventeen staff have obtained this award and three staff are working towards level 3 and the team leader is working towards level 4. This means that a very high percentage of staff have a nationally recognised qualification in care to help them provide good quality support for people who live in the home. Day to day supervision of staff was good and annual appraisals were carried out in July 2008 and these were up to date. Formal supervision sessions had been completed in March 2009 and again all these records were up to date. This enables the staff to have the chance to discuss their work so they can continue to provide good quality care to the people who live in the home. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures within the home are thorough so the health, safety and welfare of the people who live in the home is protected. Staff were supervised and there were processes in place to make sure that the home is run in the best interests of the people who live there. Evidence: At the time of our visit, the manager of The Hollies was overseeing other services for the organisation that runs the home. An acting service manager was in place to ensure that support was available to the team leader and the staff team. There is an established quality assurance process used in the home. This includes meetings for the people who live and work in the home, monthly visits by a senior representative of SCOPE, and satisfaction survey completed by people who use the service, their relatives and visitor satisfaction surveys. The surveys were completed in February 2008 and were due to be distributed again. It was recommended that an analysis of the results be produced and shared with the people living at The Hollies, Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: families, staff and other interested parties and the commission. This would show that the views of the people living in the home were being taken seriously and acted upon. Resident meetings are held in a format that the team leader considers is better for the people who live in the home. He has a one to one session with each person and then brings all the information together to be looked at and dealt with as appropriate. This is completed each month. Staff meetings are held regularly; the last one before our visit was in April 2009 and general issues were discussed. Some policies and procedures were seen during this visit. A file was kept with policies and procedures and staff also have access to these through Scopes intranet. It was recommended that all policies, procedures and other documents be checked to ensure that the commissions details have been brought up to date so that people have access to current information. Monthly visits are made to the home by a representative of the organisation that runs the home, to check how it is running. All the records of these visits were up to date and some minor issues that had been raised were currently being addressed by the home. We saw that safe working practices were in place within the home. There were up to date safety checks on the homes gas installation and portable appliance tests. The electrical hard wire certificate could not be found and it was recommended that a certificate be obtained. The accident book was kept up to date and records seen were stored appropriately. The fire safety equipment test log book was up to date and completed appropriately. A range of polices were available relating to health and safety and these included dealing with hazardous substances, a variety of risk assessments, health and safety, fire safety, food safety and nutrition and smoke free policy. Care Homes for Adults (18-65 years) Page 24 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 Adults (18-65 years) Page 25 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 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 39 An analysis of the satisfaction survey results should be produced and shared with the people living at The hollies, families, staff and other interested parties and the commission, so that people are aware of what the people living at The Hollies think about the service. All polices, procedures and other documents should be checked to ensure that the commissions details have been brought up to date so that people have access to current information. A copy of the electrical hard wire certificate should be kept at the home so that a record is available to ensure all safe working practices are maintained. 2 40 3 42 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 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!