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We )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 769.53 Tm (believe high quality care should)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 749.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 749.53 Tm (Be safe)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 733.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 733.53 Tm (Have the right outcomes, including clinical outcomes)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 717.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 717.53 Tm (Be a good experience for the people that use it)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 701.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 701.53 Tm (Help prevent illness, and promote healthy, independent living)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 685.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 685.53 Tm (Be available to those who need it when they need it.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 651.03 Tm (The first part of the review gives the overall quality rating for the )Tj ET /F2 12 Tf BT 1 0 0 1 427.6 651.03 Tm (care home:)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 631.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 631.04 Tm (3 stars - excellent)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 615.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 615.04 Tm (2 stars - good)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 599.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 599.04 Tm (1 star - adequate)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 583.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 583.04 Tm (0 star - poor)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 551.04 Tm (There is also a bar chart that gives a quick way of seeing the quality of care that the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 534.04 Tm (home provides under key areas that matter to people.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 500.04 Tm (There is a summary of what we think this service does well, what they have improved )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 483.04 Tm (on and, where it applies, what they need to do better.)Tj ET /F2 12 Tf BT 1 0 0 1 364.74 483.04 Tm (We use the national minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 466.04 Tm (standards to describe the outcomes that people should experience.)Tj ET /F2 12 Tf BT 1 0 0 1 443.2 466.04 Tm (National minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 449.04 Tm (standards are written by the Department of Health for each type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 409.54 Tm (After the summary there is more detail about our findings. The following table explains )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 392.05 Tm (what you will see under each outcome area.)Tj ET [] 0 d 0.5 w 0 0 0 RG 22.69 383.86 m 572.15 383.86 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.69 50.22 m 572.15 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.7 383.86 m 22.7 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 572.15 383.86 m 572.15 50.22 l S 0.001 w [] 0 d /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 370.56 Tm (Outcome area \(for example )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 173.59 370.56 Tm (Choice of home\))Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 340.26 Tm (These are the outcomes that people )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 216.34 340.26 Tm (staying in care homes should experience.)Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 435.79 340.26 Tm (They reflect the things )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 328.11 Tm (that people have said are important to them:)Tj ET 0 0 0 RG 0.001 w 0 Tr 1 0.9451 0.76078 RG 82.23 w 30.6 263.37 m 562.45 263.37 l S 0.001 w 0.95294 0.95294 0.95294 RG 39.99 w 29.47 285.61 m 563.57 285.61 l S 0.001 w 1 1 1 RG 39.99 w 29.47 243.37 m 563.57 243.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 306.73 m 565.77 306.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 222.25 m 565.77 222.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 307.81 m 28.35 221.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 307.81 m 564.7 221.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 291.05 Tm (This box tells you the outcomes that we will always inspect against when we do a key )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 273.55 Tm (inspection)Tj ET /F2 10 Tf BT 1 0 0 1 95.78 273.55 Tm (.)Tj ET /F2 12 Tf BT 1 0 0 1 34.87 248.81 Tm (This box tells you any additional outcomes that we may inspect against when we do a )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 231.31 Tm (key inspection.)Tj ET /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 191.8 Tm (This is what people )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 131.32 191.8 Tm (staying in this care home experience:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 154.64 Tm (Judgement:)Tj ET 1 0.9451 0.76078 RG 39.99 w 30.6 123.34 m 562.45 123.34 l S 0.001 w 1 1 1 RG 39.99 w 29.47 124.46 m 563.57 124.46 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 145.58 m 565.77 145.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 103.34 m 565.77 103.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 146.66 m 28.35 102.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 146.66 m 564.7 102.26 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 129.9 Tm (This box tells you our opinion of what we have looked at in this outcome area.)Tj ET /F2 12 Tf BT 1 0 0 1 517.79 129.9 Tm (We )Tj ET /F2 12 Tf BT 1 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30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (3)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (36)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 779.1 Tm (We review the quality of the service against outcomes from the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 762.1 Tm (Standards \(NMS\).)Tj ET /F2 12 Tf BT 1 0 0 1 144.87 762.1 Tm (Those standards are written by the Department of Health for each )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 745.1 Tm (type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 705.6 Tm (Copies of the)Tj ET /F2 12 Tf BT 1 0 0 1 111.71 705.6 Tm (National Minimum Standards )Tj ET /F2 12 Tf BT 1 0 0 1 290.49 705.6 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 302.34 705.6 Tm (Care Homes for Older People)Tj ET /F2 12 Tf BT 1 0 0 1 477.18 705.6 Tm ( can be found )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 688.11 Tm (at www.dh.gov.uk or bought from The Stationery Office \(TSO\) PO Box 29, St Crispins, )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 670.61 Tm (Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 653.11 Tm (Stationery Office is also available: )Tj ET /F2 12 Tf 0 0 1 rg BT 1 0 0 1 238.73 653.11 Tm (www.tso.co.uk/bookshop)Tj ET /F2 12 Tf 0 0 0 rg BT 1 0 0 1 28.35 613.12 Tm (The mission of the Care Quality Commission is to make care better for people by:)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 596.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 596.12 Tm (Regulating health and adult social care services to ensure quality and safety )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 580.12 Tm (standards, drive improvement and stamp out bad practice)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 564.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 564.12 Tm (Protecting the rights of people who use services, particularly the most )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 548.12 Tm (vulnerable and those detained under the Mental Health Act 1983)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 532.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 532.12 Tm (Providing accessible, trustworthy information on the quality of care and )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 516.12 Tm (services so people can make better decisions about their care and so that )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 500.12 Tm (commissioners and providers of services can improve services.)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 484.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 484.12 Tm (Providing independent public accountability on how commissioners and )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 468.12 Tm (providers of services are improving the quality of care and providing value )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 452.12 Tm (for money.)Tj ET /F1 14 Tf BT 1 0 0 1 28.35 390.28 Tm (5HDGHU,QIRUPDWLRQ)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 28.35 368.85 m 224.05 368.85 l S 0.001 w 1 1 1 RG 20.58 w 226.3 368.85 m 567 368.85 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 346.02 m 224.05 346.02 l S 0.001 w 1 1 1 RG 20.58 w 226.3 346.02 m 567 346.02 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 323.19 m 224.05 323.19 l S 0.001 w 1 1 1 RG 20.58 w 226.3 323.19 m 567 323.19 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 300.36 m 224.05 300.36 l S 0.001 w 1 1 1 RG 20.58 w 226.3 300.36 m 567 300.36 l S 0.001 w 0.95294 0.95294 0.95294 RG 137.22 w 28.35 219.21 m 224.05 219.21 l S 0.001 w 1 1 1 RG 137.22 w 226.3 219.21 m 567 219.21 l S 0.001 w 0.95294 0.95294 0.95294 RG 38.16 w 28.35 129.27 m 224.05 129.27 l S 0.001 w 1 1 1 RG 38.16 w 226.3 129.27 m 567 129.27 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 149.47 m 569.2 149.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 380.26 m 569.2 380.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 149.47 m 569.2 149.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 109.06 m 569.2 109.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 381.34 m 27.22 107.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 225.17 381.34 m 225.17 107.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 568.12 381.34 m 568.12 107.99 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 31.2 364.08 Tm (Document Purpose)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 364.08 Tm (Inspection report)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 341.25 Tm (Author)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 341.25 Tm (Care Quality Commission)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 318.42 Tm (Audience)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 318.42 Tm (General public)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 295.59 Tm (Further copies from)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 295.59 Tm (0870 240 7535 \(telephone order line\))Tj ET /F2 12 Tf BT 1 0 0 1 31.2 272.76 Tm (Copyright)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 272.76 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 258.18 Tm (This publication may be reproduced in whole or in part, )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 243.6 Tm (free of charge, in any format or medium provided that )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 229.02 Tm (it is not used for commercial gain. This consent is )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 214.44 Tm (subject to the material being reproduced accurately )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 199.86 Tm (and on proviso that it is not used in a derogatory )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 185.28 Tm (manner or misleading context. The material should be )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 170.7 Tm (acknowledged as CQC copyright, with the title and date )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 156.12 Tm (of publication of the document specified.)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 133.29 Tm (Internet address)Tj ET /F2 12 Tf 1 0 0 rg BT 1 0 0 1 229.15 133.29 Tm (www.cqc.org.uk)Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 15 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (4)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (36)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm 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28.99 664.4 m 567.85 664.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 641.57 m 567.85 641.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 618.74 m 567.85 618.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 785.63 m 567.85 785.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 762.8 m 567.85 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 687.23 m 567.85 687.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 664.4 m 567.85 664.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 641.57 m 567.85 641.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 618.74 m 567.85 618.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 595.91 m 567.85 595.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 786.71 m 30.07 594.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 269.07 786.71 m 269.07 594.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.77 786.71 m 566.77 594.84 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 769.45 Tm (Name of care home:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 769.45 Tm (Lucas Court Nursing Home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 746.62 Tm (Address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 746.62 Tm (Northampton Lane North )Tj ET /F2 12 Tf BT 1 0 0 1 273.05 729.04 Tm (Moulton)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 711.46 Tm (Northampton)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 693.88 Tm (NN3 7RQ)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 671.05 Tm (Telephone number:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 671.05 Tm (\(01604\)493233)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 648.22 Tm (Fax number:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 648.22 Tm (01604493234)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 625.39 Tm (Email address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 625.39 Tm (lucascourt@schealthcare.co.uk)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 602.56 Tm (Provider web address:)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 583.61 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 80.82 w 32.32 532.88 m 564.77 532.88 l S 0.001 w 1 1 1 RG 35.16 w 355.5 556.83 m 565.9 556.83 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 526.71 m 353.25 526.71 l S 0.001 w 1 1 1 RG 20.58 w 355.5 526.71 m 565.9 526.71 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 503.88 m 353.25 503.88 l S 0.001 w 1 1 1 RG 20.58 w 355.5 503.88 m 565.9 503.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 538.13 m 568.1 538.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 515.3 m 568.1 515.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 575.54 m 568.1 575.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 538.13 m 568.1 538.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 515.3 m 568.1 515.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 492.47 m 568.1 492.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 576.61 m 30.07 491.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 576.61 m 354.37 491.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 576.61 m 567.02 491.39 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 559.35 Tm (Name of registered provider\(s\):)Tj ET /F2 12 Tf BT 1 0 0 1 355.5 559.35 Tm (Southern Cross Healthcare )Tj ET /F2 12 Tf BT 1 0 0 1 355.5 544.77 Tm (Services Limited)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 521.94 Tm (Type of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 521.94 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 499.11 Tm (Number of places registered:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 499.11 Tm (60)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 480.17 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 28.35 463.17 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 63.99 w 32.32 420.85 m 564.47 420.85 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 432.26 m 567.8 432.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 455.09 m 567.8 455.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 432.26 m 567.8 432.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 388.85 m 567.8 388.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 456.17 m 30.07 387.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 433.34 m 298.32 387.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 456.17 m 566.72 387.77 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 438.91 Tm (Conditions of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 416.08 Tm (Category\(ies\) :)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 416.08 Tm (Number of places \(if applicable\):)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 395.5 Tm (Under 65)Tj ET /F2 12 Tf BT 1 0 0 1 435.37 395.5 Tm (Over 65)Tj ET 1 1 1 RG 20.58 w 31.2 375.19 m 297.3 375.19 l S 0.001 w 20.58 w 299.55 375.19 m 431.45 375.19 l S 0.001 w 20.58 w 433.7 375.19 m 565.6 375.19 l S 0.001 w 35.16 w 31.2 345.07 m 297.3 345.07 l S 0.001 w 35.16 w 299.55 345.07 m 431.45 345.07 l S 0.001 w 35.16 w 433.7 345.07 m 565.6 345.07 l S 0.001 w 35.16 w 31.2 307.66 m 297.3 307.66 l S 0.001 w 35.16 w 299.55 307.66 m 431.45 307.66 l S 0.001 w 35.16 w 433.7 307.66 m 565.6 307.66 l S 0.001 w 20.58 w 31.2 277.54 m 297.3 277.54 l S 0.001 w 20.58 w 299.55 277.54 m 431.45 277.54 l S 0.001 w 20.58 w 433.7 277.54 m 565.6 277.54 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 254.71 m 565.6 254.71 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 363.77 m 567.8 363.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 326.36 m 567.8 326.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 288.95 m 567.8 288.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 266.12 m 567.8 266.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 243.29 m 567.8 243.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 220.46 m 568.1 220.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 168.47 m 568.1 168.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 131.06 m 568.1 131.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 93.65 m 568.1 93.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 386.6 m 567.8 386.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 363.77 m 567.8 363.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 326.36 m 567.8 326.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 288.95 m 567.8 288.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 266.12 m 567.8 266.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 243.29 m 568.1 243.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 220.46 m 568.1 220.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 168.47 m 568.1 168.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 131.06 m 568.1 131.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 93.65 m 568.1 93.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.47 m 568.1 42.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 387.68 m 30.07 41.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.42 387.68 m 298.42 265.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.57 387.68 m 432.57 265.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 387.68 m 566.72 41.4 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 370.42 Tm (dementia)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 370.42 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 370.42 Tm (28)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 347.59 Tm (mental disorder, excluding learning )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 333.01 Tm (disability or dementia)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 347.59 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 347.59 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 310.18 Tm (old age, not falling within any other )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 295.6 Tm (category)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 310.18 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 310.18 Tm (60)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 272.77 Tm (physical disability)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 272.77 Tm (6)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 272.77 Tm (6)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 249.94 Tm (Additional conditions: )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 227.11 Tm (All service users in the category of DE\(E\) must be accommodated on the first floor.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 204.28 Tm (No one falling in the category of DE\(E\) may be admitted into the home where there are )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 189.7 Tm (28 service users who fall within the category of DE\(E\) already accommodated in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 175.12 Tm (home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 152.29 Tm (No one falling in the category of OP may be admitted in the home where there are 60 )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 137.71 Tm (service users who fall within the category of OP already accommodated in the home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 114.88 Tm (No one falling in the category of PD may be admitted into the home where there are 6 )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 100.3 Tm (service users who fall within the category of PD already accommodated in the home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 77.47 Tm (No one falling in the category of PD\(E\) may be admitted into the home where there are )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 62.89 Tm (6 service users who fall within the category of PD\(E\) already accommodated in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 48.31 Tm (home.)Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 17 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (5)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (36)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 812.84 m 568.1 812.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 775.43 m 568.1 775.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 738.02 m 568.1 738.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.1 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 812.84 m 568.1 812.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 775.43 m 568.1 775.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 738.02 m 568.1 738.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 686.03 m 568.1 686.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 684.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 814.73 m 567.02 684.95 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 796.66 Tm (To be able to admit the named person under 65 years of age named in variation )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 782.08 Tm (application no V000029387 dated 7th February 2006)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 759.25 Tm (To be able to admit the named person under 65 years of age named in Variation )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 744.67 Tm (Application No. V000020533 dated 13th May 2005.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 721.84 Tm (Two named female service users may be accommodated in the category of Mental )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 707.26 Tm (Disorder, until such time as they leave the home. No further service users may be )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 692.68 Tm (admitted in this category)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 673.49 m 315.25 673.49 l S 0.001 w 1 1 1 RG 20.58 w 317.5 673.49 m 346.55 673.49 l S 0.001 w 20.58 w 348.8 673.49 m 377.9 673.49 l S 0.001 w 20.58 w 380.15 673.49 m 409.2 673.49 l S 0.001 w 20.58 w 411.45 673.49 m 440.55 673.49 l S 0.001 w 20.58 w 442.8 673.49 m 471.9 673.49 l S 0.001 w 20.58 w 474.15 673.49 m 503.2 673.49 l S 0.001 w 20.58 w 505.45 673.49 m 534.55 673.49 l S 0.001 w 20.58 w 536.8 673.49 m 565.9 673.49 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 684.91 m 568.1 684.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 662.08 m 568.1 662.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 685.98 m 30.07 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 685.98 m 316.37 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 685.98 m 347.67 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 685.98 m 379.02 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 685.98 m 410.32 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 685.98 m 441.67 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 685.98 m 473.02 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 685.98 m 504.32 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 685.98 m 535.67 661 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 685.98 m 567.02 661 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 668.72 Tm (Date of last inspection)Tj ET /F2 12 Tf BT 1 0 0 1 328.2 668.72 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 359.53 668.72 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 390.86 668.72 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 422.18 668.72 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 453.53 668.72 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 484.86 668.72 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 516.18 668.72 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 547.53 668.72 Tm (9)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 649.08 m 565.9 649.08 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 639.45 m 568.1 639.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 640.53 m 30.07 245.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 640.53 m 567.02 245.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 658.7 m 568.1 658.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 639.45 m 568.1 639.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 246.2 m 568.1 246.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 659.78 m 30.07 638.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 659.78 m 567.02 638.37 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 645.52 Tm (Brief description of the )Tj ET /F2 12 Tf BT 1 0 0 1 177.31 645.52 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 626.27 Tm (Lucas Court is a care home providing personal and nursing care for up to 60 people. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 609.27 Tm (Currently Lucas Court provides care for older people, older people with dementia, older )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 592.27 Tm (people with a mental disorder and people with a physical disability. Southern Cross )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 575.27 Tm (Healthcare owns the home and it is located in the village of Moulton on the outskirts of )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 558.27 Tm (Northampton. The village has some local shops and public houses and is on a bus )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 541.27 Tm (route in to Northampton. The home is a two storey building with the first floor )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 524.27 Tm (allocated for dementia care, and care for people with mental health needs. Fifty of the )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 507.27 Tm (bedrooms are single rooms with forty-eight of these rooms having en-suite facilities. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 490.27 Tm (There are five double rooms in the home. The home has a passenger lift. There is an )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 473.27 Tm (enclosed well-maintained garden to the rear of the home, which is accessible to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 456.27 Tm (wheelchair users. There is also car parking. Fees, confirmed as being correct at the )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 439.27 Tm (time of the inspection in December 2009 were from 550 pounds to 750 per week. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 422.27 Tm (The fees quoted are exclusive of any free nursing contribution, which is collected from )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 405.27 Tm (the Primary Care Trust by Southern Cross Healthcare. Local Authorities who are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 388.27 Tm (funding people are charged at a set rate. These people may be asked for a top up fee, )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 371.27 Tm (which varies according to their ability to pay. The fees include personal care and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 354.27 Tm (where applicable nursing care, meals and accommodation. Chiropody, hairdressing )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 337.27 Tm (services, and newspapers can be arranged and are charged separately. Other costs )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 320.27 Tm (would include clothing and toiletries. Information about the services provided )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 303.27 Tm (including the complaints procedure is displayed in the foyer of the home. This includes )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 286.27 Tm (the statement of purpose, a service user guide and a copy of the most recent )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 269.27 Tm (Commission for Social Care inspection )Tj ET /F2 12 Tf BT 1 0 0 1 270.53 269.27 Tm (report.)Tj ET /F2 12 Tf BT 1 0 0 1 311.78 269.27 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 252.27 Tm ()Tj ET endstream endobj 18 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 19 0 obj <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Length 533/Matrix [1 0 0 1 0 0]>>stream xn1 9eI J qU5ea<>vfTZߍ=s?X)9(\"j_]<7^~[-xώd\bft=|.)j(QE hHI"ͷz`5%x:z^jQ _׃:^Q؂,hnCŰ+J[ uD&,vG}!Ej+Klql=s|b `srDs 9EVՌ%rtu;:mZ4:݅6!TlYU3QPN]#];p֒]\6ٻ(9G%VՄCݏɋI\^ܝn-j:ק݁.nu"׾7;;6 ތëi:Oj,ޚ2 UN%/W9{G.3…5\x8`G-zB1L8@~~9M {QѣH i{ZKP,c3oWny~qf endstream endobj 20 0 obj<> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm (6XPPDU\\)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 774.7 Tm (This is an overview of what we found during the inspection.)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 754.22 m 381.05 754.22 l S 0.001 w 1 1 1 RG 20.58 w 383.3 754.22 m 566.2 754.22 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 765.64 m 568.4 765.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.81 m 568.4 742.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 766.71 m 30.07 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 382.17 766.71 m 382.17 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 766.71 m 567.32 741.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 749.45 Tm (The quality rating for this )Tj ET /F2 12 Tf BT 1 0 0 1 191.92 749.45 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 255.59 749.45 Tm ( is:)Tj ET /F2 12 Tf BT 1 0 0 1 410.5 749.45 Tm (zero star poor service)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 717.31 Tm (2XUMXGJHPHQWIRUHDFKRXWFRPH)Tj ET /F2 10 Tf BT 1 0 0 1 212.29 641.27 Tm (Choice of home)Tj ET /F2 10 Tf BT 1 0 0 1 164.41 601.02 Tm (Health and personal care)Tj ET /F2 10 Tf BT 1 0 0 1 145.18 560.77 Tm (Daily life and social activities)Tj ET /F2 10 Tf BT 1 0 0 1 157.95 520.52 Tm (Complaints and protection)Tj ET /F2 10 Tf BT 1 0 0 1 226.36 480.27 Tm (Environment)Tj ET /F2 10 Tf BT 1 0 0 1 251.17 440.02 Tm (Staffing)Tj ET /F2 10 Tf BT 1 0 0 1 127.47 399.77 Tm (Management and administration)Tj ET q 0.75227 0 0 0.75161 305.05 334.32 cm /Xf1 Do Q 1 1 1 RG 20.58 w 31.2 283.08 m 567.85 283.08 l S 0.001 w 206.51 w 32.32 167.28 m 566.72 167.28 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 271.66 m 567.85 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 271.66 m 568.92 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 62.9 m 568.92 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 272.74 m 31.2 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 272.74 m 567.85 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 278.3 Tm (How we did our inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 35.17 255.48 Tm (Standards identified as 'key' standards and highlighted through the report were )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 240.9 Tm (inspected. The key standards are those considered by the Commission to have a )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 226.32 Tm (particular impact on outcomes for people who use the service. Inspection of the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 211.74 Tm (standards was achieved through review of existing evidence, one unannounced and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 197.15 Tm (one announced inspection visit.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 182.57 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 167.99 Tm (Prior to the inspection we reviewed the information we had received about the service )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 153.41 Tm (which included reports of previous inspections and correspondence and contact with )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 138.84 Tm (the service and people associated with the service. The last inspection was carried out )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 124.25 Tm (in May 2009. We decided to bring this inspection forward as a result of information we )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 109.68 Tm (had received through a complaint that indicated that the improvements found in May )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 95.1 Tm (2009 may not have been sustained. We were also informed that the manager was )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 80.51 Tm (leaving and the deputy manager had left.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 65.93 Tm ()Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 23 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 644.52 w 32.32 490.27 m 566.72 490.27 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.12 813.65 m 568.92 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 166.88 m 568.92 166.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 814.73 m 31.2 165.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 814.73 m 567.85 165.81 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 32.92 802.72 Tm (The first inspection visit on 26th November 2009 was unannounced and carried out by )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 788.14 Tm (two inspectors over a period of a day. One inspector returned by arrangement on the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 773.56 Tm (1st December 2009 to complete the inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 758.98 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 744.4 Tm (The inspection was carried out by 'case tracking', which involves selecting samples of )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 729.82 Tm (records for people using the service to look at their care and experiences. We spoke )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 715.24 Tm (with people using the service, staff and relatives about the care provided. Because )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 700.66 Tm (Lucas Court provides care for people with dementia and they are not always able to tell )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 686.08 Tm (us about their experiences, observations and views from other people were particularly )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 671.5 Tm (important in helping us understand their experiences. We observed interactions )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 656.92 Tm (between staff and people who use the service and looked at how people's dignity was )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 642.34 Tm (protected.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 627.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 613.18 Tm (The management of people's medication was checked through reviewing prescribed )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 598.6 Tm (medication for a sample of people. A project manager was in the process of carrying )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 584.02 Tm (out a full medication audit, which was partially completed at the time of the inspection. )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 569.44 Tm (We discussed these initial findings and planned actions with the project manager.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 554.86 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 540.28 Tm (A sample of staff files were reviewed to check the adequacy of the recruitment )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 525.7 Tm (procedures in safeguarding people who use the service and looked at the training staff )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 511.12 Tm (receive. We also looked at a sample of records to see what action had been taken )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 496.54 Tm (following concerns or complaints.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 481.96 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 467.38 Tm (Shared areas such as lounges and dining rooms and a sample of people's bedrooms )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 452.8 Tm (were looked at during the inspection. We looked at what action had been taken to )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 438.22 Tm (address a requirement about the timely repair/replacement of equipment and whether )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 423.64 Tm (two baths which had been out of order at the inspection in May had been repaired or )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 409.06 Tm (replaced.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 394.48 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 379.9 Tm (We looked at staffing arrangements and the effectiveness of these in meeting the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 365.32 Tm (needs of people using the service.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 350.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 336.16 Tm (We took into account the findings of this inspection when considering the effectiveness )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 321.58 Tm (of the management and quality assurance systems. In particular we were looking to )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 307 Tm (see if improvements in the quality of care had been sustained.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 292.42 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 277.84 Tm (Detailed verbal feedback was given to the project manager and the operations )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 263.26 Tm (manager during the inspection. This enabled Southern Cross Managers to develop an )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 248.68 Tm (action plan to address the concerns raised prior to the production of this report.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 234.1 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 219.52 Tm (We have made requirements in this report to ensure that there is clarity about the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 204.94 Tm (regulations that have not been complied with. As some of these requirements have )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 190.36 Tm (been made in previous inspection reports and compliance has not been sustained, the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 175.78 Tm (Care Quality Commission are considering further enforcement action. )Tj ET endstream endobj 24 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 25 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 20.58 w 31.2 786.36 m 567.85 786.36 l S 0.001 w 180.96 w 32.32 683.34 m 566.72 683.34 l S 0.001 w 20.58 w 32.7 580.32 m 569.35 580.32 l S 0.001 w 224.7 w 33.82 455.43 m 568.22 455.43 l S 0.001 w 20.58 w 33.45 330.54 m 570.1 330.54 l S 0.001 w 253.98 w 34.57 191.01 m 568.97 191.01 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 774.95 m 567.85 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 774.95 m 568.92 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 591.74 m 568.92 591.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 776.03 m 31.2 590.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 591.74 m 569.35 591.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 568.91 m 569.35 568.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 568.91 m 570.42 568.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 341.96 m 570.42 341.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 319.13 m 570.1 319.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 341.96 m 570.1 341.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 319.13 m 571.17 319.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 62.9 m 571.17 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 569.99 m 32.7 340.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 320.21 m 33.45 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 776.03 m 567.85 590.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 569.35 569.99 m 569.35 340.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 320.21 m 570.1 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 781.59 Tm (What the )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 90.52 781.59 Tm (care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 154.2 781.59 Tm ( does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 567.85 784.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.76 Tm (People who use the service benefit from the flexible visiting arrangements which allows )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.18 Tm (their friends and relatives to visit when convenient. We saw people were enjoying )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.6 Tm (contact and conversation with their, and other people's visitors.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.02 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.44 Tm (People are offered a choice of meal and the lunch time meal was hot and well )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 685.86 Tm (presented and people told us that they were happy with the meals.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.28 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.7 Tm (The layout of the building is suitable for meeting the needs of the people who live )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.12 Tm (there. Bedrooms are of a good size with en-suite toilets and there are several areas )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.54 Tm (that can be used as lounges and dining rooms. There is a pleasant enclosed garden )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 612.96 Tm (which has level entry access allowing wheelchair users who can mobilise independently )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.38 Tm (to go in and out as they wish.)Tj ET /F2 10 Tf BT 1 0 0 1 568.97 681.79 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 578.21 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 32.7 575.55 Tm (What has improved since the last inspection?)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 569.35 578.77 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 453.88 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 552.72 Tm (We were unable to identify many improvements during this inspection. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 538.14 Tm (improvements that we reported on in May 2009 have not been sustained.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 523.56 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 508.98 Tm (The carpet in the lounge near the entrance to the dementia unit had been replaced )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 494.4 Tm (with wood flooring which staff thought had been the source of the odour we have )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 479.82 Tm (noticed previously. The room had been decorated and was clean, comfortable and )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 465.24 Tm (there were no unpleasant odours.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 450.66 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 436.08 Tm (There has been an improvement in that there are now some cleaning staff working at )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 421.5 Tm (the weekends.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 406.92 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 392.34 Tm (People's care files included information about whether the person had been admitted )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 377.76 Tm (for residential or nursing care. There had been some confusion at a previous inspection )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 363.18 Tm (as to whether nursing care for someone was to be provided by the District Nurse or )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 348.6 Tm (nurses at Lucas Court. )Tj ET /F2 10 Tf BT 1 0 0 1 570.47 453.88 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 328.99 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 33.45 325.77 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 31.2 189.46 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 302.94 Tm (Improvements are needed in all of the outcome areas, all of which have an impact on )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 288.36 Tm (people using the service. Everyone admitted to Lucas Court needs to have care plans in )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 273.78 Tm (place which identify their needs and guide staff in meeting them. These plans and )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 259.2 Tm (other associated care records need to be kept up to date and be an accurate reflection )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 244.62 Tm (of people's current needs and preferences.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 230.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 215.46 Tm (Medication management needs to be improved to ensure that people receive their )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 200.88 Tm (medication as prescribed. Staff need a better understanding of recognising and )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 186.3 Tm (managing pain for people with dementia.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 171.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 157.14 Tm (The quality of people's lives would be improved by more opportunities for interaction )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 142.56 Tm (and conversation. Improvements are needed in the way that some staff treat people )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 127.98 Tm (who use the service. Some need to be reminded of the need to speak with, and engage )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 113.4 Tm (with people while assisting them to help ensure that people feel valued and respected.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 98.82 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 84.24 Tm (More consideration about the way dementia care is provided and increased )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 69.66 Tm (opportunities for stimulation between scheduled activities may also improve the quality )Tj ET endstream endobj 26 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 27 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 294.6 w 34.57 665.23 m 568.97 665.23 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 32.37 813.65 m 571.17 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 516.8 m 571.17 516.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 814.73 m 33.45 515.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 814.73 m 570.1 515.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.17 802.72 Tm (of peoples lives.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 788.14 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 773.56 Tm (We have made requirements about the need for equipment to be ordered, repaired or )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.98 Tm (replaced in a more timely manner. We have continued to find that it is necessary to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.4 Tm (prompt this and even when assurances have been given action has not always been )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.82 Tm (taken.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.24 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.66 Tm (People told us that some staff were very good and caring but that others weren't and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 686.08 Tm (were often rushed and sometimes short tempered. Staff rotas, staff recruitment, )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.5 Tm (training and support and overall management of staff are all areas where )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.92 Tm (improvements are needed. This is to help ensure there are sufficient trained and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.34 Tm (competent staff who are committed to providing a good quality of care.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 613.18 Tm (There needs to be less reliance on regulatory bodies and other external agencies to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.6 Tm (identify risk and poor outcomes for people using the service. Effective management )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 584.02 Tm (and oversight of Lucas Court would seem to be the key to improving outcomes for )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 569.44 Tm (people using the service. People who use the service and their relatives need to be )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 554.86 Tm (given confidence of consistent good quality care. Reassurance also needs to be )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 540.28 Tm (provided to commissioners of services who have again ceased making new admissions )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 525.7 Tm (to Lucas Court.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 502.24 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 482.25 Tm (If you want to know what action the person responsible for this )Tj ET /F2 12 Tf BT 1 0 0 1 416.37 482.25 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 480.04 482.25 Tm ( is taking )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 464.75 Tm (following this report, you can contact them using the details on page 4.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 444.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 424.76 Tm (The report of this inspection is available from our website )Tj ET /F2 12 Tf BT 1 0 0 1 380.85 424.76 Tm (www.cqc.org.uk.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 404.76 Tm (You can get printed copies from )Tj ET /F2 12 Tf BT 1 0 0 1 225.22 404.76 Tm (enquiries@cqc.org.uk or by telephoning our)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 384.77 Tm (order line 0870 240 7535.)Tj ET endstream endobj 28 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 29 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 777.09 Tm (Details of our findings)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 26 w 31.2 744.15 m 565.9 744.15 l S 0.001 w /F1 12 Tf BT 1 0 0 1 34.05 741.14 Tm (&RQWHQWV)Tj ET 1 1 1 RG 16 w 28.35 700.15 m 566.93 700.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 696.09 Tm (Choice of home \(standards 1 - 6\))Tj ET 16 w 28.35 678.15 m 566.93 678.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 674.09 Tm (Health and personal care \(standards 7 - 11\))Tj ET 16 w 28.35 656.15 m 566.93 656.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 652.09 Tm (Daily life and social activities \(standards 12 - 15\))Tj ET 16 w 28.35 634.15 m 566.93 634.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 630.09 Tm (Complaints and protection \(standards 16 - 18\))Tj ET 16 w 28.35 612.15 m 566.93 612.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 608.09 Tm (Environment \(standards 19 - 26\))Tj ET 16 w 28.35 590.15 m 566.93 590.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 586.09 Tm (Staffing \(standards 27 - 30\))Tj ET 16 w 28.35 568.15 m 566.93 568.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 564.09 Tm (Management and administration \(standards 31 - 38\))Tj ET /F2 12 Tf BT 1 0 0 1 28.35 544.09 Tm (Outstanding statutory requirements)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 522.22 Tm (Requirements and recommendations from this inspection)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 33 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (11)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Choice of home )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 206.25 w 32.32 610.38 m 562.53 610.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 119 w 31.2 567.88 m 563.65 567.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 507.25 m 565.85 507.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 506.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 506.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People are confident that the care home can support them. This is because there is an )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (accurate assessment of their needs that they, or people close to them, have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (involved in. This tells the home all about them and the support they need. People who )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (stay at the home only for intermediate care, have a clear assessment that includes a )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (plan on what they hope for and want to achieve when they return home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People can decide whether the care home can meet their support and accommodation )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (needs. This is because they, or people close to them, have been able to visit the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and have got full, clear, accurate and up to date information about the home. If they )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (decide to stay in the home they know about their rights and responsibilities because )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (there is an easy to understand contract or statement of terms and conditions between )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (them and the care home that includes how much they will pay and what the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 513.32 Tm (provides for the money.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 489 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 467 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 467 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 444.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 386.74 m 562.54 386.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 431.17 m 564.79 431.17 l S 0.001 w 84.36 w 33.47 375.5 m 563.66 375.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 418.8 m 565.87 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 419.88 m 32.35 331.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 419.88 m 564.79 331.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 418.8 m 564.79 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 332.19 m 565.87 332.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 427.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 403.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 403.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 403.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 385.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.75 Tm (The assessment and admission process is not sufficiently thorough to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 341.25 Tm (people's needs are going to be met following admission to Lucas Court.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 316.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 224.3 w 34.6 194.17 m 562.54 194.17 l S 0.001 w 1 1 1 RG 22.5 w 32.35 297.32 m 564.79 297.32 l S 0.001 w 202.93 w 33.47 182.36 m 563.66 182.36 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 284.95 m 565.87 284.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 286.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 286.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 284.95 m 564.79 284.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 294.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 269.27 Tm (There is a system in place whereby people's needs are assessed prior to admission to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 251.77 Tm (the home and this information is then used to develop a pre-admission draft care plan. )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 234.27 Tm (The process is that more detailed care plans are then developed on admission to guide )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.78 Tm (staff in the care and support that they need to give to people.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 199.28 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.79 Tm (We found that the systems and procedures in place to help ensure that people's needs )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 164.29 Tm (are properly assessed and can be met following admission, were not in all cases being )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.79 Tm (followed. Records were not fully completed and in some cases not dated, which meant )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 129.3 Tm (that it was difficult to establish what people's needs were and the care that they )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.8 Tm (needed.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 94.31 Tm ()Tj ET endstream endobj 35 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 36 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (12)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 511.26 w 34.6 555.78 m 562.54 555.78 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 489.89 w 33.47 543.96 m 563.66 543.96 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 296.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 296.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 297.89 m 565.87 297.89 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (We looked at the draft care plan for someone with dementia who was unable to tell us )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (about themselves and their needs. We would have expected this care plan to tell us )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (about the persons physical and medical care needs and also about them, their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (interests and family and friends to enable staff to engage with them and provide the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (care and support they needed. Most of these relevant areas of the draft care plan had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (not been completed. Where parts of the plan had been completed, information was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (basic. For example it told us that the person could be unpredictable with personal )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (care. It was not clear what this meant, how much and what type of assistance the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (person needed, or what their preferences were in relation to personal care and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (grooming.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (As part of the assessment process it is also important to establish any specific risks )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (such as the risk of pressure ulcers, risk of falls and risk of malnutrition to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (appropriate measures can be put in place to reduce these risks. Staff need information )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (to guide them when they start to care for someone. The daily records for one person )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (identify that a visiting professional found that six days after the persons admission, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (that admission paperwork, care plans and risk assessments were not in place.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (At our last inspection in May 2009 we were not able to check compliance with a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (requirement about the admission process as there had been no admissions to Lucas )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (Court from the date for compliance. The requirement was about ensuring that there )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (was clarity about whether people had been admitted for residential or nursing care. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (This requirement arose as a result of staff not being clear if someone had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (admitted for residential or nursing care and whether their nursing needs should be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (met by the District nurse or a nurse from Lucas Court. During this inspection we found )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (that the category of admission was now recorded on the care files.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (Intermediate care is not provided at Lucas Court therefore standard six has not been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (assessed.)Tj ET endstream endobj 37 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 38 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Health and personal care )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 172.25 w 32.32 627.38 m 562.53 627.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 102 w 31.2 663.63 m 563.65 663.63 l S 0.001 w 1 1 1 RG 68 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 541.25 m 565.85 541.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 540.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 540.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Peoples health, personal and social care needs are met. The home has a plan of care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (that the person, or someone close to them, has been involved in making. If they take )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (medicine, they manage it themselves if they can. If they cannot manage their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (medicine, the care home supports them with it, in a safe way. Peoples right to privacy )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (is respected and the support they get from staff is given in a way that maintains their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (dignity.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (If people are approaching the end of their life, the care home will respect their choices )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and help them feel comfortable and secure. They, and people close to them, are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (reassured that their death will be handled with sensitivity, dignity and respect, and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (take account of their spiritual and cultural wishes. )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 523 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 501 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 501 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 478.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 420.74 m 562.54 420.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 465.17 m 564.79 465.17 l S 0.001 w 84.36 w 33.47 409.5 m 563.66 409.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 452.8 m 565.87 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 453.88 m 32.35 365.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 453.88 m 564.79 365.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 452.8 m 564.79 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 366.19 m 565.87 366.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 461.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 437.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 437.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 437.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 419.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 392.75 Tm (People are not able to rely on receiving care which meets their assessed needs in a )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.25 Tm (way that respects them and their dignity.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 350.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 258.3 w 34.6 211.17 m 562.54 211.17 l S 0.001 w 1 1 1 RG 22.5 w 32.35 331.32 m 564.79 331.32 l S 0.001 w 236.93 w 33.47 199.36 m 563.66 199.36 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 318.95 m 565.87 318.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 320.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 320.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 318.95 m 564.79 318.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 328.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 303.27 Tm (We looked at a sample of peoples care plans to see how their care is planned and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 285.77 Tm (supported. Care plans are considered to be important documents to help to guide staff )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.27 Tm (in the care that they need to provide, based on people's assessed needs. We found )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 250.78 Tm (that the care planning systems are not always used effectively to support people's )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.28 Tm (care.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 215.79 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.29 Tm (Records were not in all cases dated, and one persons care plans had been back dated )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 180.79 Tm (which meant that it was difficult to track and monitor changes to their health. A body )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.3 Tm (map identified that they had a pressure ulcer but there was no care plan, wound )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 145.8 Tm (assessment or evaluation record to show the current condition of the wound and how )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.31 Tm (this was being treated. The project manager reviewed this persons care and found )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 110.81 Tm (that the pressure ulcer had healed and put in place a revised care plan to take account )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.31 Tm (of preventative measures. The persons overall care needs were reviewed by the )Tj ET endstream endobj 39 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 40 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (14)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (project manager which resulted in care plans being re-written to be more specific )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (about the persons health care needs. The project manager also identified that this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (person required closer monitoring by staff due to a risk of choking.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (In another care file viewed we found that a pressure care plan had been put in place )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (as soon as the start of a pressure ulcer had been identified. The ulcer had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (treated and had healed, though there was no plan for prevention of further pressure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (ulcers. We found that this person had a pressure relieving mattress on their bed, but )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (found that this was set incorrectly for the persons weight which if not adjusted may )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (increase the risk of pressure ulcers. When we pointed this out, the nurse adjusted the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (setting. The nurse on duty understood that checks on mattress settings were the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (responsibility of the night staff, but she could find no evidence of any checks being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (made.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (Discussion with staff about the needs of someone with dementia and review of their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (care file identified that staff were having difficulty meeting their needs. A 'challenging )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (behaviour care plan' stated that the person is very resistive and aggressive at times, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (kicking, scratching and squeezing the staffs arms especially during the morning when )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (washing and dressing. We looked at the care plan for personal care and found that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (there was no guidance for staff as to the best way to approach this person and assist )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (them with personal care. As a result, staff were adopting their own strategies such as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (the use of a hoist for movement and handling. It was agreed during the inspection )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (that the Operations manager would arrange for this persons care and care plans to be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (reviewed, and for advice to be sought from the Community Psychiatrist and guidance )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (given to staff. Following the inspection we made a safeguarding vulnerable adults alert )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (in order that Northamptonshire County Council could look at the way care to this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (person was being provided.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (Records are in place to show that reviews of peoples care are taking place, though )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (information exchanged during the reviews, in some cases is not accurate and in others )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (is not taken into account as part of the care provided. For example a relative told us )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (that they have spoken at review meetings about preferences in relation to the way )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (someone wishes to be dressed and the amount of bedding they like to have so that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (they are warm enough but that nothing ever seems to get done. None of this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (information was recorded in the care plans and the review stated that the family were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (happy with the care. A record of a review which involved a Community Psychiatric )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (Nurse stated that no concerns were expressed by staff, which contradicted the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (information within the persons daily records.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (A member of staff told us that someone has two showers per week and this was )Tj ET endstream endobj 41 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 42 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (recorded in the care plan. The records showed 'full body wash' but no showers were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (recorded.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (Someone who uses the service told us that they were in pain. A nurse told us that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (person has dementia and often complains of pain in the mornings. We looked at the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (medication administration record to see what pain relief had been given and found )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (that pain relief was prescribed to be given as and when required up to four times a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (day. There were no entries for November up to the 26th \(date of inspection.\) and it )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (had only been given on six occasions during October 2009. There was no care plan for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (the management of pain or evidence of the cause of pain in the mornings being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (investigated. On our second inspection visit \(1st December 2009\), the project )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (manager told us that she had put in place a pain assessment tool for this person. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (have also made a safeguarding vulnerable adults alert to Northamptonshire County )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (Council.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (We looked at the records and medication for one person on the dementia unit on 26th )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (November 2009. A check of controlled drugs held on this unit confirmed that the stock )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (corresponded with the records. Medication administration records for one person )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (identified that there were occasions when they refused medication. These records did )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (not tally with the record for medication returned or destroyed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (On the 1st December 2009, the project manager was in the process of carrying out a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (full medication audit. Records for medication received were being checked against )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (medication signed as being administered and medication in stock. The audit process )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (was thorough and was identifying discrepancies which indicated that prescribed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (medication had in some cases been signed as given when it had not, which meant that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (people would not have had all of their prescribed medication.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (Following the inspection the project manager has confirmed that her audit has been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (completed and that she has established the quantities of each medication held, and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (that regular checks will be carried out to ensure that any discrepancies can be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (identified and dealt with quickly. A pharmaceutical adviser from the primary care trust )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (visited Lucas Court on 1st December 2009 to offer advice and support with the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (management of medications.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (We observed some good examples of people being treated with dignity and respect. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (For example an agency worker made a point at the beginning of the shift of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (introducing themselves to people on the dementia unit where they were working. In )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (contrast a relative told us that they had witnessed staff "feeding residents like robots" )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (with no eye contact and they commented that "it doesn't cost anything to smile and )Tj ET endstream endobj 43 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 44 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 196.33 w 34.6 713.24 m 562.54 713.24 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 174.96 w 33.47 701.43 m 563.66 701.43 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 611.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 611.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 612.82 m 565.87 612.82 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (talk to people".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (We witnessed examples similar to those described by the relative. One example was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (two members of staff who were giving two people a drink from a plastic feeding )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (beaker in one of the lounges. The people were seated, with staff standing beside the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (chair bending occasionally to put the beaker to the persons mouth. The staff members )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (did not speak to the people or interact in any way. On completion of the task one )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (member of staff left the room again without speaking or looking at the person. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (other member of staff was replaced by someone who came and bent down to the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (persons level, smiled and chatted to them as they were assisting.)Tj ET endstream endobj 45 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 46 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Daily life and social activities )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 138.25 w 32.32 644.38 m 562.53 644.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 119 w 31.2 655.13 m 563.65 655.13 l S 0.001 w 1 1 1 RG 17 w 31.2 584.88 m 563.65 584.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 575.25 m 565.85 575.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 574.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 574.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Each person is treated as an individual and the care home is responsive to his or her )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (race, culture, religion, age, disability, gender and sexual orientation. They are part of )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (their local community. The care home supports people to follow personal interests and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (activities. People are able to keep in touch with family, friends and representatives. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (They are as independent as they can be, lead their chosen lifestyle and have the )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (opportunity to make the most of their abilities. People have nutritious and attractive )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 600.57 Tm (meals and snacks, at a time and place to suit them.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 557 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 535 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 535 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 512.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 124.35 w 34.6 446 m 562.54 446 l S 0.001 w 1 1 1 RG 22.5 w 32.35 499.17 m 564.79 499.17 l S 0.001 w 101.85 w 33.47 434.75 m 563.66 434.75 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 486.8 m 565.87 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 487.88 m 32.35 381.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 487.88 m 564.79 381.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 486.8 m 564.79 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 382.7 m 565.87 382.7 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 495.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 471.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 471.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 471.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 453.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 426.75 Tm (The quality of people's daily lives, particularly those who need more support varies )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 409.25 Tm (according to which staff are caring for them and people's ability to state their )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 391.76 Tm (preferences.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 367.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 274.8 w 34.6 219.43 m 562.54 219.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 347.83 m 564.79 347.83 l S 0.001 w 253.43 w 33.47 207.62 m 563.66 207.62 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 335.45 m 565.87 335.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 336.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 336.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 335.45 m 564.79 335.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 344.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 319.77 Tm (People at Lucas Court have a wide range of different needs, with some people more )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 302.27 Tm (able to express those needs than others. We have given advice at previous inspections )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 284.78 Tm (about the need to consider each individual and their social and daily living needs. At )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 267.28 Tm (the inspection in May 2009 there was some evidence that care plans were starting to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 249.79 Tm (become more personalised and that people were being asked about their preferences, )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 232.29 Tm (which would give them more choice and control over their lives. These improvements )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 214.79 Tm (do not appear to have been sustained. For example where preferences have been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 197.3 Tm (expressed such as how people wish to be dressed these have not always been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 179.8 Tm (recorded as part of the care plan or followed.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 162.31 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 144.81 Tm (There are staff who are employed as activity organisers and they arrange some social )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 127.31 Tm (events and group activities and also some individual time with people. On the day of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 109.82 Tm (inspection a 'happy hour' took place. In one of the lounges on the dementia unit we )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 92.32 Tm (observed that a selection of drinks were offerred which included some alcoholic drinks. )Tj ET endstream endobj 47 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 48 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 651.23 w 34.6 485.79 m 562.54 485.79 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 629.86 w 33.47 473.98 m 563.66 473.98 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 156.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 156.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 157.93 m 565.87 157.93 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (Some visitors were present and there was a fairly buoyant atmosphere during this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (period. Due to the numbers of people and the range of needs activity organisers are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (not able to spend much time with each individual on a daily basis. They therefore )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (cannot be relied on entirely for instigating conversation and providing social and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (emotional support for people.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (We had recommended at the last inspection that resources be provided to give people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (opportunities to engage in meaningful occupation as and when they choose and at any )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (time of the day. We could not see any evidence of this recommendation being acted )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (on. During the 'happy hour' in a smaller lounge on the dementia unit we saw three )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (people sitting in chairs. There were two carers in the room, one was completing care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (records, while the other carer was observed to be flicking through a magazine. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (observed very little interaction taking place between the staff and people in this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (lounge and there was no other stimulation for them. During this inspection, while we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (observed some staff to interact well with people and engage in conversation, we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (observed others who didn't interact at all. People have told us how important this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (conversation and contact is as part of their daily lives. Visiting arrangements are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (flexible and people were enjoying contact and conversation with their, and other )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (people's visitors.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (People told us that they were happy with the meals provided. At breakfast time we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (saw that some people had a cooked breakfast which looked freshly cooked and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (appetising. During the morning the cook asked people what they wanted for the lunch )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (time meal. The choices on offer were savoury mince or cornish pasties. We saw the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (lunch time meal being served and noted that it was hot, looked appetising and was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (well presented.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (On the dementia unit at lunch time some staff went to assist people, who are nursed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (in bed, with their meals . They were reminded by a staff member to hurry as other )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (people needed assistance in the dining room. During the inspection we heard someone )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (in their room to be calling out, staff said they always do this. We asked if staff spend )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (time with this person who is nursed in bed. The staff responded by saying they go in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (to feed her and to wash and change her, when asked if they spend time with her to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (offer company they said no. There seemed to be a lack of understanding of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (importance of human contact and emotional support required for people who are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (nursed in bed and who are at greater risk of social isolation.)Tj ET endstream endobj 49 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 50 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (19)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Complaints and protection )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 87.25 w 32.32 669.88 m 562.53 669.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 68 w 31.2 680.63 m 563.65 680.63 l S 0.001 w 1 1 1 RG 17 w 31.2 635.88 m 563.65 635.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 626.25 m 565.85 626.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 625.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 625.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (If people have concerns with their care, they or people close to them know how to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (complain. Any concern is looked into and action taken to put things right. The care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (home safeguards people from abuse and neglect and takes action to follow up any )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (allegations.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (Peoples legal rights are protected, including being able to vote in elections.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 608 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 586 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 586 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 563.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 505.74 m 562.54 505.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 550.17 m 564.79 550.17 l S 0.001 w 84.36 w 33.47 494.5 m 563.66 494.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 537.8 m 565.87 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 538.88 m 32.35 450.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 538.88 m 564.79 450.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 537.8 m 564.79 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 451.19 m 565.87 451.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 546.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 522.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 522.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 522.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 504.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 477.75 Tm (Complaints are taken seriously, though people using the service are not very confident )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.25 Tm (in using the complaint procedure.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 435.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 343.3 w 34.6 253.67 m 562.54 253.67 l S 0.001 w 1 1 1 RG 22.5 w 32.35 416.32 m 564.79 416.32 l S 0.001 w 321.93 w 33.47 241.86 m 563.66 241.86 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 403.95 m 565.87 403.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 405.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 405.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 403.95 m 564.79 403.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 413.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 388.27 Tm (There is a complaint procedure, which is detailed in the statement of purpose, and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 370.77 Tm (also available in the foyer. This provides names and contact numbers within the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.27 Tm (service and also at a higher level within Southern Cross. We found that people were )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 335.78 Tm (not all aware of the complaint procedure and the operations manager confirmed that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.28 Tm (she would make sure everyone had access to a copy.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 300.79 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.29 Tm (In November 2009, the Commission for Social Care Inspection were made aware of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 265.79 Tm (some concerns about staffing levels, poor standards of cleanliness, a strong odour and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.3 Tm (lack of staff understanding of infection control. We referred these concerns to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 230.8 Tm (Southern Cross for investigation. We received a written response which indicated that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.31 Tm (the concerns were taken seriously. The response confirmed that the concerns had )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 195.81 Tm (been looked into and that a project manager and a new operations manager had been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.31 Tm (put in place to oversee the home.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 160.82 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.32 Tm (Our discussions with people who use the service and relatives highlighted that they )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 125.83 Tm (were not confident in raising concerns or confident that they would be properly )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.33 Tm (addressed. The operations manager acknowledged the need to ensure that people )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 90.83 Tm (were aware of the complaints procedure and that their confidence that concerns would )Tj ET endstream endobj 51 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 52 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (20)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 248.82 w 34.6 686.99 m 562.54 686.99 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 227.45 w 33.47 675.18 m 563.66 675.18 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 559.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 559.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 560.34 m 565.87 560.34 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (be dealt with is restored. As part of this process she has offerred individual )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (appointments to relatives to discuss any concerns that they might have.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (Training statistics provided during the inspection identify that some staff have not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (received training in safeguarding of vulnerable adults \(SOVA\). Managers )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (acknowledged that this is an important part of helping to safeguard people who use )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (the service and on 27th November 2009 had updated a training plan which included )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (SOVA training. They also confirmed that they would be taking steps to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (staff who have not previously attended this training do.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (Some of the care practices we witnessed and were informed about during this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (inspection, indicate that some staff lack understanding of their responsibilities of their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (responsibilities in relation to safeguarding vulnerable adults.)Tj ET endstream endobj 53 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 54 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (21)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Environment )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 34 w 31.2 697.63 m 563.65 697.63 l S 0.001 w 1 1 1 RG 68 w 31.2 644.38 m 563.65 644.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People stay in a safe and well-maintained home that is homely, clean, pleasant and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (hygienic. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 666.32 Tm (People stay in a home that has enough space and facilities for them to lead the life )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 649.32 Tm (they choose and to meet their needs. The home makes sure they have the right )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (specialist equipment that encourages and promotes their independence. Their room )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (feels like their own, it is comfortable and they feel safe when they use it.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 124.35 w 34.6 480 m 562.54 480 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 101.85 w 33.47 468.75 m 563.66 468.75 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 415.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 415.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 416.7 m 565.87 416.7 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 505.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.75 Tm (Lucas Court provides a comfortable place for people to live, however there are )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm (ongoing problems with the provision of, and repairs/replacement of equipment to )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 425.76 Tm (meet peoples needs. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 401.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 308.8 w 34.6 236.43 m 562.54 236.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 381.83 m 564.79 381.83 l S 0.001 w 287.43 w 33.47 224.62 m 563.66 224.62 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 369.45 m 565.87 369.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 370.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 370.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 369.45 m 564.79 369.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 378.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.77 Tm (Shared areas of the home such as lounges and dining rooms and a sample of people's )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.27 Tm (bedrooms were seen during the inspection. The layout of the building is suitable for )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.78 Tm (meeting the needs of the people who live there. Bedrooms are of a good size with )Tj ET /F2 12 Tf BT 1 0 0 1 537.41 318.78 Tm (en-)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm (suite)Tj ET /F2 12 Tf BT 1 0 0 1 65.59 301.28 Tm ( toilets and there are several areas that can be used as lounges and dining )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (rooms. Not all of these areas are fully utilised.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm (People on the first floor, which is the dementia unit, are able to, where mobility )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (allows, wander freely. We noticed on both floors that some rooms had peoples names )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (on them, or a picture which was recognisable to the person occupying the room. We )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm (found other rooms without any identification which would make it difficult for some )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm (people to identify their room, particularly given the size of the home.This may also )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm (present difficulties for any new or agency staff as it appears that the room is not )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (occupied.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm (There have been ongoing problems with odour particularly on the dementia unit. On )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (this inspection we noticed that there were no unpleasant odours and that the carpet in )Tj ET endstream endobj 56 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 57 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (22)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 651.23 w 34.6 485.79 m 562.54 485.79 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 629.86 w 33.47 473.98 m 563.66 473.98 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 156.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 156.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 157.93 m 565.87 157.93 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (the lounge closest to the entrance on the dementia unit had been replaced with wood )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (flooring. The room had been re-decorated and was clean with comfortable seating and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (a new large screen television.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (There is a pleasant enclosed garden at the rear of Lucas Court with patio and lawned )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (areas and an aviary. The garden has level entry access, which enables wheelchair )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (users who can mobilise independently, to go in and out as they wish.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (In May 2009, we reported that there had been some excessive delays in replacing )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (equipment and highlighted in particular the fact that there were two assisted baths out )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (of use. One had been out of action for three to four weeks prior to this inspection and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (the other for two years. Following that inspection in May we received reassurances )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (that this work would be done. One of the baths was fitted only a few weeks prior to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (this inspection and a purchase order for the other was not raised until 27/11/09 after )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (we reminded managers about this on 26/11/09.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (We were also concerned that an assessment of someone's needs had identified that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (they needed a suction machine in their room. This was not in place on our visit of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (26/11/09 but was then ordered and in place by our second inspection visit on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (02/12/09. Following discussion about equipment we were provided on 02/12/09 with a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (list of equipment that had been identified as needed following the first inspection visit )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (and had been ordered.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (We have found that equipment is not always used correctly. In the health and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (personal care section we have reported that a pressure relieving mattress was set )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (incorrectly for the persons weight. This issue has arisen on previous inspections and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (we have previously been assured of systems being put in place to ensure regular )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (checking.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (Some measures were observed to be in place to reduce the risk of infection. For )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (example disposable gloves and aprons were available and staff were observed to be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (using them. In May 2009 training statistics showed 80% of staff as having attended )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (training in infection control, this figure has since dropped to 56%. Records show that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (some staff have not had the training at all, while others require updates. A general )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (requirement has been made about the need for staff training which is important for all )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (areas and in this case for helping to reduce the risk of infection.)Tj ET endstream endobj 58 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 59 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (23)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Staffing )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 17 w 31.2 618.88 m 563.65 618.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have safe and appropriate support as there are enough competent staff on duty )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (at all times. They have confidence in the staff at the home because checks have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (done to make sure that they are suitable to care for them. Their needs are met and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (they are cared for by staff who get the relevant training and support from their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (managers.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 488.74 m 562.54 488.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 84.36 w 33.47 477.5 m 563.66 477.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 433.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 433.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 434.19 m 565.87 434.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 505.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.75 Tm (Arrangements for ensuring there are sufficient trained and competent staff who are )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm (supported to meet peoples needs are inadequate.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 418.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 326.3 w 34.6 245.17 m 562.54 245.17 l S 0.001 w 1 1 1 RG 22.5 w 32.35 399.32 m 564.79 399.32 l S 0.001 w 304.93 w 33.47 233.36 m 563.66 233.36 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 386.95 m 565.87 386.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 388.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 388.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 386.95 m 564.79 386.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 396.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 371.27 Tm (This inspection has continued to identify shortfalls in staffing arrangements which lead )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.77 Tm (to poor outcomes and risk for people using the service. Signs of improvement were )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.27 Tm (identified at our inspection in May 2009, however these improvements have not been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.78 Tm (continued or sustained.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (Prior to the inspection concerns had been raised about the sufficiency of staff to meet )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm (people's needs. We looked at staff rotas which were poorly completed, and a )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm (considerable amount of time was spent trying to establish which staff had worked )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (when, and in what role they had worked. The rotas indicated significant shortfalls in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (staffing levels on some days and identified a lack of planning and oversight. For )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm (example the number of carers on duty in the afternoon on the first floor varied )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm (between two and six.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (We were concerned at our last inspection that there had been no cleaning staff )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm (working at weekends. Staff rotas show that there is now one cleaner working at the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm (weekend. We discussed the adequacy of this for the size of the home and needs of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (people using the service with the operations manager who confirmed that )Tj ET endstream endobj 60 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 61 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (24)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 686.22 w 34.6 468.3 m 562.54 468.3 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 664.85 w 33.47 456.48 m 563.66 456.48 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 121.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 121.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 122.93 m 565.87 122.93 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (arrangements were being made to increase the number of cleaners at a weekend.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (People told us that the quality of care they receive is very dependent on which staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (provide their care. Our observations during the inspection support the fact that there )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (are inconsistencies in the way that staff respond and interact with people using the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (service. Although some of the interactions between staff and people using the service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (were very good, we observed situations which we have described in the health and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (personal care section of this report, of staff assisting people without speaking to them. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (The operations manager also observed one of these incidents and confirmed that she )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (would address this with staff and monitor staff practice.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (We looked at the recruitment process for two recently recruited staff and found that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (references had been obtained and checks made against the Independent Safeguarding )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (Authority \(ISA\) register, to ensure the people were not on a list of people barred from )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (working with vulnerable adults. Criminal Record Bureau clearances had been applied )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (for and the member of staff who had actually started work was working under )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (supervision until this clearance was received. Following discussion the operations )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (manager advised that they would implement clearer supervision arrangements for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (staff starting work prior to receipt of criminal record bureau clearances.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (Our inspection identified shortfalls in the ongoing supervision, management and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (monitoring of staff. For example we noted that in two instances staff have declared )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (health conditions, which in one case had resulted in a request for a change to working )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (arrangements which would reduce the number of hours worked. The rota showed that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (this person had been working a high number of hours. There was no evidence of any )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (action being taken to establish if or how this may affect the staff member in carrying )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (out their duties or the need for any additional support. We were informed by the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (operations manager of an investigation being carried out into the circumstances which )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (lead to a registered nurse working outside the conditions of their registration.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (In May 2009 we identified that training records continued to show gaps in staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (training, but acknowledged that some of the staff were relatively new and that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (new manager had booked training. A staff training matrix provided on the day of this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (inspection continues to identify shortfalls in basic training. In some cases staff are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (overdue for refresher training, and in some cases they have not received basic )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (training such as fire safety, moving and handling, health and safety, safeguarding )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (vulnerable adults. All of this training is important in helping to ensure that staff are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (able to identify and reduce risks to themselves and people using the service. )Tj ET endstream endobj 62 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 63 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (25)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Management and administration )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.25 w 32.32 618.88 m 562.53 618.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 102 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 524.25 m 565.85 524.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 523.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 523.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have confidence in the care home because it is led and managed appropriately. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (People control their own money and choose how they spend it. If they or someone )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (close to them cannot manage their money, it is managed by the care home in their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (best interests. The environment is safe for people and staff because appropriate health )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (and safety practices are carried out.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People get the right support from the care home because the manager runs it )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (appropriately with an open approach that makes them feel valued and respected. The )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (people staying at the home are safeguarded because it follows clear financial and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (accounting procedures, keeps records appropriately and ensures their staff understand )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (the way things should be done. They get the right care because the staff are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (supervised and supported by their managers.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 506 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 484 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 484 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 461.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 403.74 m 562.54 403.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 448.17 m 564.79 448.17 l S 0.001 w 84.36 w 33.47 392.5 m 563.66 392.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 435.8 m 565.87 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 436.88 m 32.35 348.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 436.88 m 564.79 348.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 435.8 m 564.79 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 349.19 m 565.87 349.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 444.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 420.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 420.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 420.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 402.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.75 Tm (Management arrangements have not adequately improved and maintained the quality )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.25 Tm (of care provided.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 333.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 241.3 w 34.6 202.67 m 562.54 202.67 l S 0.001 w 1 1 1 RG 22.5 w 32.35 314.32 m 564.79 314.32 l S 0.001 w 219.93 w 33.47 190.86 m 563.66 190.86 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 301.95 m 565.87 301.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 303.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 303.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 301.95 m 564.79 301.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 311.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 286.27 Tm (Standard 31 relates specifically to the role of registered manager. There was no )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.77 Tm (registered manager in post at the time of the inspection, however the management )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 251.27 Tm (arrangements are considered critical in the quality of care and in safeguarding the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.78 Tm (health and welfare of people who use the service and are reported on in that context.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.28 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.79 Tm (There has been no registered manager managing the service since our inspection in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.29 Tm (July 2008. In our report of the inspection carried out in May 2009 we reported that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.79 Tm (since the inspection in July 2008 there had been several changes of manager. A new )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.3 Tm (manager had been appointed in April 2009 just before our last inspection but left in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.8 Tm (November 2009 just prior to this inspection. A project manager was put in place to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.31 Tm (manage the service and at the time of inspection had been replaced by a second )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.81 Tm (project manager. We were informed that a new manager cannot be recruited until a )Tj ET endstream endobj 64 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 65 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (26)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (company re-organisation has been completed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (We also reported in May 2009 that in addition to the changes in home managers, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (there had been changes in three levels of management above the home manager. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (were informed that the latest re-organisation involves changes to the roles of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (managers currently supporting Lucas Court which includes project managers, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (operations managers and operations directors. The number of management changes )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (continues to cause us concern in relation to consistent management and oversight of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (the service.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (We have repeatedly reported that there needs to be a more proactive approach to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (identifying and acting on shortfalls to improve standards of care and sustain )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (improvements for all people who use the service. Senior managers have been quick to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (acknowledge and accept concerns raised by the Commission and placing authorities )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (and provide assurances that action will be taken. The care people receive cannot be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (reliant on concerns being identified by others.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (No evidence could be found of a review of the quality assurance process or attempts )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (to establish why there had been reoccurring failures in identifying shortfalls and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (improving the quality of care in a timely way. The findings of this inspection have once )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (again identified serious shortfalls in the effectiveness of quality assurance systems. It )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (has been necessary to make requirements about issues that have been raised at )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (previous inspections.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (Southern Cross have very comprehensive quality assurance systems and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (documentation which we would have expected should have alerted the organisation to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (some of the concerns. There are audit systems and an Operations Manager carries out )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (unannounced visits at least once a month to check on and report to the organisation )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (on standards of care. Records could not be found for all of the monthly visits and it )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (was not clear if these had been carried out or not. Where issues were identified there )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (is no evidence of what if any action was taken to address them.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (The improvements identified in May 2009 resulted in a change of quality rating from )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (0* poor to 1* adequate and the Commission reducing inspection activity and allowing )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (the organisation time to rely on their own quality assurance processes as a basis for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (making and sustaining improvements. Northamptonshire County Council \(NCC\) and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (the Primary Care Trust \(PCT\) have again ceased making placements at Lucas Court )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (and are carrying out regular visits to monitor the care people are receiving and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (prompt improvements. Due to continued failures in sustaining compliance with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (regulations the Care Quality Commission will consider further enforcement action.)Tj ET endstream endobj 66 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 67 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (27)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 406.28 w 34.6 608.26 m 562.54 608.26 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 384.91 w 33.47 596.45 m 563.66 596.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 401.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 401.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 402.87 m 565.87 402.87 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (Some people leave small amounts of money for safekeeping to assist with paying for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (services such as hairdressing and chiropody. This is kept in a central bank )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (account,which accrues interest and is added to each individual account. During our )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (inspection we looked at records for one person and found that records were in place )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (for transactions and receipts are kept to verify these. This helps to safeguard staff and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (people who use the service.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (The staffing section of this report gives examples of poor supervision and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (management of the staff team and a lack of support. These include the lack of day to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (day supervision and monitoring against codes of conduct and also the lack of checks )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (on ongoing fitness of staff to carry out their duties.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (The Care homes regulations 2001 require that certain records are kept. Some of these )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (records are required to support peoples care, while others relate to the management )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (of the service. We found through this inspection examples of poor record keeping, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (withthat records such as staff rotas could not be relied on for accuracywere not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (accurate)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (Training records identified that not all staff had received training in safe working )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (practices such as movement and handling and others required updates to help ensure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (that they have the necessary knowledge and skills and reduce the risk of injury.)Tj ET endstream endobj 68 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 70 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (28)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.99216 0.9451 0.76078 RG 36.25 w 29.47 793.28 m 564.97 793.28 l S 0.001 w 0.95294 0.95294 0.95294 RG 17 w 28.35 804.03 m 566.1 804.03 l S 0.001 w 17 w 28.35 784.78 m 422.1 784.78 l S 0.001 w 17 w 424.35 784.78 m 467.1 784.78 l S 0.001 w 1 1 1 RG 17 w 469.35 784.78 m 494.1 784.78 l S 0.001 w 0.95294 0.95294 0.95294 RG 17 w 496.35 784.78 m 539.1 784.78 l S 0.001 w 1 1 1 RG 17 w 541.35 784.78 m 566.1 784.78 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 794.4 m 568.3 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 813.65 m 568.3 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 794.4 m 568.3 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 775.15 m 568.3 775.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 814.73 m 27.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 423.22 795.48 m 423.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 468.22 795.48 m 468.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 495.22 795.48 m 495.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 540.22 795.48 m 540.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 814.73 m 567.22 774.08 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 33.75 800.47 Tm (Are there any outstanding requirements from the last inspection?)Tj ET /F2 12 Tf BT 1 0 0 1 429.75 781.22 Tm (Yes)Tj ET /F7 12 Tf BT 1 0 0 1 476.37 783.16 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 501.75 781.22 Tm (No)Tj ET /F7 12 Tf BT 1 0 0 1 546.75 783.16 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 415.83 w 32.32 509.49 m 564.97 509.49 l S 0.001 w 1 1 1 RG 140.22 w 31.2 544.44 m 91.05 544.44 l S 0.001 w 140.22 w 93.3 544.44 m 197.4 544.44 l S 0.001 w 140.22 w 199.65 544.44 m 289.45 544.44 l S 0.001 w 140.22 w 291.7 544.44 m 473.8 544.44 l S 0.001 w 140.22 w 476.05 544.44 m 566.1 544.44 l S 0.001 w 169.38 w 31.2 387.39 m 91.05 387.39 l S 0.001 w 169.38 w 93.3 387.39 m 197.4 387.39 l S 0.001 w 169.38 w 199.65 387.39 m 289.45 387.39 l S 0.001 w 169.38 w 291.7 387.39 m 473.8 387.39 l S 0.001 w 169.38 w 476.05 387.39 m 566.1 387.39 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 473.2 m 568.3 473.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 616.75 m 30.07 300.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 616.75 m 567.22 300.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 648.22 m 568.4 648.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 615.67 m 568.3 615.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 616.75 m 92.17 300.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 616.75 m 198.52 300.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 616.75 m 290.57 300.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 616.75 m 474.92 300.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 719.65 m 568.4 719.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 648.22 m 568.4 648.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 615.67 m 568.4 615.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 473.2 m 568.3 473.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 301.57 m 568.3 301.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 720.73 m 30.07 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 649.3 m 92.12 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 649.3 m 198.52 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 649.3 m 290.62 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 649.3 m 475.02 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 720.73 m 567.32 614.6 l S 0.001 w [] 0 d /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 702.45 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 684.03 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 669.45 Tm (been met.)Tj ET /F2 12 Tf BT 1 0 0 1 95.57 669.45 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 104.02 669.45 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 654.87 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 637.05 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 634.05 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 634.05 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 634.05 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 634.05 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 621.9 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 602.49 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 599.49 Tm (21)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 599.49 Tm (23)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 599.49 Tm (Equipment which includes )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 584.91 Tm (specialist baths must be )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 570.33 Tm (maintained and kept in good )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 555.75 Tm (working order, with repairs )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 541.17 Tm (or replacement carried out in )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 526.59 Tm (a timely manner.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 509.01 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 494.43 Tm (To enable people's needs to )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 479.85 Tm (be met.)Tj ET /F2 12 Tf BT 1 0 0 1 478.9 599.49 Tm (31/07/2009)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 460.02 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 457.02 Tm (33)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 457.02 Tm (24)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 457.02 Tm (A full review of the quality )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 442.44 Tm (assurance process at Lucas )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 427.86 Tm (Court must be carried out to )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 413.28 Tm (establish why there have )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 398.7 Tm (been failures in identifying )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 384.12 Tm (and improving the quality of )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 369.54 Tm (care in a timely way. )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 351.96 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 337.38 Tm (This is to help prevent a )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 322.8 Tm (deterioration in the care )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 308.22 Tm (people receive in the future. )Tj ET /F2 12 Tf BT 1 0 0 1 478.9 457.02 Tm (31/07/2009)Tj ET endstream endobj 71 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 72 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (29)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 797.57 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 782.15 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 108.12 w 32.32 719.78 m 564.97 719.78 l S 0.001 w 1 1 1 RG 20.58 w 31.2 677.13 m 91.05 677.13 l S 0.001 w 20.58 w 93.3 677.13 m 197.4 677.13 l S 0.001 w 20.58 w 199.65 677.13 m 289.45 677.13 l S 0.001 w 20.58 w 291.7 677.13 m 473.8 677.13 l S 0.001 w 20.58 w 476.05 677.13 m 566.1 677.13 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 689.63 m 30.07 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 689.63 m 567.22 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.3 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 689.63 m 92.17 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 689.63 m 198.52 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 689.63 m 290.57 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 689.63 m 474.92 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 776.09 m 568.4 776.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.4 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 665.72 m 568.3 665.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 777.17 m 30.07 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 722.18 m 92.12 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 722.18 m 198.52 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 722.18 m 290.62 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 722.18 m 475.02 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 777.17 m 567.32 687.47 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 759.9 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 742.32 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 727.74 Tm (The registered person had to meet these within 48 hours.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 709.92 Tm (No.)Tj ET /F2 10 Tf BT 1 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0 d [] 0 d 2.25 w 28.99 527.93 m 568.4 527.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 389.68 m 568.3 389.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 217.43 m 568.3 217.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 61.78 m 568.3 61.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 630.55 m 30.07 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 561.56 m 92.12 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 561.56 m 198.52 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 561.56 m 290.62 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 561.56 m 475.02 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 630.55 m 567.32 526.85 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 616.28 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 596.28 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 581.7 Tm (Standards Act 2000, Care Homes)Tj ET /F2 12 Tf BT 1 0 0 1 239.77 581.7 Tm (Regulations 2001 and the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 567.12 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 549.3 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 546.3 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 546.3 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 546.3 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 546.3 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 534.15 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 514.74 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 514.74 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 514.74 Tm (14)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 514.74 Tm (A thorough assessment of )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 497.74 Tm (people's needs must be )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 480.74 Tm (carried out prior to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 463.74 Tm (admission.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 446.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 429.74 Tm (This is to help ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 412.74 Tm (the care and support people )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 395.74 Tm (need is clearly identified.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 514.74 Tm (04/02/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 514.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 376.49 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 376.49 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 376.49 Tm (14)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 376.49 Tm (The assessment of people's )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 359.49 Tm (needs must be kept under )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 342.49 Tm (review and be revised as )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 325.49 Tm (and when their needs or )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 308.49 Tm (circumstances change.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 291.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 274.49 Tm (This is to help ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 257.49 Tm (there is accurate and current )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 240.49 Tm (information about people's )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 223.49 Tm (needs.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 376.49 Tm (04/02/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 376.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 204.24 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 204.24 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 204.24 Tm (15)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 204.24 Tm (Care plans must be revised )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 187.24 Tm (following review with the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 170.24 Tm (service user or their )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 153.24 Tm (representative and they )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 136.24 Tm (must be notified of the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 119.24 Tm (revision.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 204.24 Tm (04/02/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 204.24 Tm ()Tj ET endstream endobj 73 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 74 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (30)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 746.25 w 32.32 438.28 m 564.97 438.28 l S 0.001 w 1 1 1 RG 68 w 31.2 676.99 m 91.05 676.99 l S 0.001 w 68 w 93.3 676.99 m 197.4 676.99 l S 0.001 w 68 w 199.65 676.99 m 289.45 676.99 l S 0.001 w 68 w 291.7 676.99 m 473.8 676.99 l S 0.001 w 68 w 476.05 676.99 m 566.1 676.99 l S 0.001 w 238 w 31.2 521.74 m 91.05 521.74 l S 0.001 w 238 w 93.3 521.74 m 197.4 521.74 l S 0.001 w 238 w 199.65 521.74 m 289.45 521.74 l S 0.001 w 238 w 291.7 521.74 m 473.8 521.74 l S 0.001 w 238 w 476.05 521.74 m 566.1 521.74 l S 0.001 w 221 w 31.2 289.99 m 91.05 289.99 l S 0.001 w 221 w 93.3 289.99 m 197.4 289.99 l S 0.001 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290.57 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 713.19 m 474.92 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.4 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 744.66 m 568.4 744.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 712.11 m 568.4 712.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 641.86 m 568.3 641.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 401.61 m 568.3 401.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 178.36 m 568.3 178.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 62.9 m 568.3 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 745.74 m 92.12 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 745.74 m 198.52 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 745.74 m 290.62 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 745.74 m 475.02 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 814.73 m 567.32 711.04 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 800.47 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 780.47 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 765.89 Tm (Standards Act 2000, Care Homes)Tj ET /F2 12 Tf BT 1 0 0 1 239.77 765.89 Tm (Regulations 2001 and the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 751.31 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 733.49 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 730.49 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 730.49 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 730.49 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 730.49 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 718.34 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 295.8 701.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 295.8 684.18 Tm (This is to help ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 667.18 Tm (people's preferences are )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 650.18 Tm (taken into account.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 628.68 Tm (4)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 628.68 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 628.68 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 628.68 Tm (Care plans for people who )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 611.68 Tm (due to their assessed needs )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 594.68 Tm (are resistive to care, must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 577.68 Tm (provide clear and proper )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 560.68 Tm (guidance to staff, to ensure )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 543.68 Tm (that care provision is )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 526.68 Tm (appropriate to the persons )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 509.68 Tm (needs and respects their )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 492.68 Tm (dignity.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 475.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 458.68 Tm (This is to help ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 441.68 Tm (their needs are met in a safe )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 424.68 Tm (and dignified way and their )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 407.68 Tm (rights are protected.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 628.68 Tm (04/02/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 628.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 388.43 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 388.43 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 388.43 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 388.43 Tm (Pain management care plans )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 371.43 Tm (should be implemented)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 354.43 Tm (where appropriate and )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 337.43 Tm (particularly in cases where )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 320.43 Tm (people)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 303.43 Tm (are not able to verbally )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 286.43 Tm (communicate to staff that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 269.43 Tm (they are)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 252.43 Tm (in pain and all complaints of )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 235.43 Tm (pain, must be investigated.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 218.43 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 201.43 Tm (This is to help people to be )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 184.43 Tm (pain free.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 388.43 Tm (04/02/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 388.43 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 165.18 Tm (6)Tj ET 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If you would like a summary in a )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 662.12 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 622.62 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 605.13 Tm (reproduced in whole or in part, free of charge, in any format or medium provided that it )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 587.63 Tm (is not used for commercial gain. This consent is subject to the material being )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 570.13 Tm (reproduced accurately and on proviso that it is not used in a derogatory manner or )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 552.64 Tm (misleading context. The material should be acknowledged as CQC copyright, with the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 535.14 Tm (title and date of publication of the document specified.)Tj ET endstream endobj 88 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 89 0 obj[6 0 R/XYZ 0 318.87 0] endobj 90 0 obj <>stream  cvt gxfpgm;_glyfˬ ^head< H6hhea$ $hmtx ploca76maxp 1t prepF 8}11c1bbDu1c111D1>}1(111{-1(3c1J`7]1bP2Jb2(11124bb(()_b{8P>2;IV`bbz!&BF7>>TtNmmn{{(hxAYiU\.t/J\cx{{{ ""(/23>CFHPSfijkrsx,.88AMP\ik| ,,Alx=>o:BX~9`/111:<JJLWstx  ((-WYZZZZprr."+`x =.:WX]]SlCcM*SclAq],C]"D>;KeJPBQLQLT7Z\WU:rrE@78743210/.-,+*)('&%$#"!  ,E#F` &`&#HH-,E#F#a &a&#HH-,E#F` a F`&#HH-,E#F#a ` &a a&#HH-,E#F`@a f`&#HH-,E#F#a@` &a@a&#HH-, <<-, E# D# ZQX# D#Y QX# MD#Y &QX# D#Y!!-, EhD ` EFvhE`D-, C#Ce -, C#C -,F#pF>F#pFE: -,EJ#DEI#D-, E%EadPQXED!!Y-,Cc#b#B+-, EC`D-,CCe -, i@a ,b`+ d#da\XaY-,E+G#DGz-,TX CTXJIDDYY-,CXE+#DzEi #D QX+#Dz!zYY-,-,KRX!ED#E %ERXD!!YY-,/-, %EI#DEJ#DEe#E %`j #B#hj`a Ry!J@JE TX#!?#YaDRyI@ IE TX#!?#YaD-,C#C -,C#C -, C#C -, C#Ce -,C#Ce -,C#Ce -,KRXED!!Y-, %#I@` c RX#%8#%e8c8!!!!!Y-,Ei C`:-,%# `#-,%# a#-,%-, ` <<-, a <<-,++**-,CC -,>**-,5-,vK#p KE PXaY:/-,!! d#d@b-,!QX d#d b@/+Y`-,!QX d#dUb/+Y`-, d#d@b`#!-,&&&&Eh:-,&&&&Ehe:-,E# E %PX&a&`YD-,F#F`F# F`ab# #KKpE` PXa@Yh:-,3+**-,CXY-,CXY-#@/?103!%!!8 P@+  { /999?999/10&''&&'632!!!!67`,9) KgJ*JJ&J (""" """ zJzJee") """"!!""+ ]+PV =`9PPPP""""""""""""""""""""""kk4!!!!!!!!!!!!o!!!!!!!o!!!!!!!!!po==!!!!!!!!!!!!!!!!!!b!Q!?!.!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!}!&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&`9_@ FF@H H2 %H2 #H2 "H2 !H2  H2 H2 H2 H2 @[H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 yH2 nH2 dH2 _H2 ]H2 ZH2 XH2 H2 H2 H2 H2 H2 H2 H2 @LH2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 \H2& & 7E@CzweaWU$"   KKSBKcKb S# QZ#BKKTB8+TXCXYY++++++++++++++++++++++++++++++++KPyAP*&+++++KSyAP*&+++++P2Ka`+++++++++++++++++++++++++++++++++++++++++++++++++++++++++EiSBKPXBYC\XBY CX`!YBp>CX;!~ +Y #B #BCX-A-A +Y#B#BCX~;! +Y#B#B endstream endobj 91 0 obj<> endobj 92 0 obj<>/Subtype/CIDFontType2/Type/Font/W [53[891]133[891]]/CIDToGIDMap/Identity/DW 1000>> endobj 93 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0035><0085> endcodespacerange 2 beginbfrange <0035><0035><0052> <0085><0085><00a3> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 69 0 obj<> endobj 94 0 obj <>stream %!PS-AdobeFont-1.0: TimesNewRomanPSMT Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Fri Oct 10 11:48:26 2008 % Converted from TrueType font 'TIMES.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Times New Roman) readonly def /FamilyName (Times New Roman) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -109 def /UnderlineThickness 49 def end readonly def /FontName /TimesNewRomanPSMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-77 -216 1009 877} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put 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232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B TcJ6*]h[zeKq)ƷW0jlBIf14%B[tnqNOדe{fC;1I^7^r5=[ySwF 5ZUͧ@;J7{Phx ғ*⿅΅V1lCd3Dk9+ ~Iic*x 2YC.eKgt_"t!Ztb$~iS[xdw +P7)%g9/-awT=JK/{ Q'y!kA,7 Α$?H}Om"s*5aks*HRUufn6i?kɝ=-0X%lϧQ4ݡ`rџ~D&#&:t]=.ok &DZђԺŠRq [j@3a*42K]sjϖjG_n 4Ϛ5. *Ly^w`ܮ64r/:!?u:};ߜ`dӤJY2R'wbTCI2CRNY2uD-.Y9y:2Cʸ`ͻq5dBpQŰ: TimM;f ]+ozY0,(Fh^ GirY E W| -R̵vVP ce޾'zH+1= PU~}fIa 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All Rights Reserved %%CreationDate: Thu Oct 09 15:25:10 2008 % Converted from TrueType font 'VERDANA.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.35) readonly def /Notice (Typeface and data 1996 Microsoft Corporation. All Rights Reserved) readonly def /FullName (Verdana) readonly def /FamilyName (Verdana) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -88 def /UnderlineThickness 59 def end readonly def /FontName /Verdana def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-30 -207 1447 1000} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /middot put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B Tc gPUcOx {OqqQF4-UټXODU8o\kswKami%ޗﶥB$S/1LW~'T^<T4PX+ԯ({A34.KUĖn%*R_g!g(F4%ٸD K~ɕy8e!lcx# |< -}^^i(XlŨ3K a[y3E7Oz,߉1N6+Pj)cpS-mR\7߃Ra0bRTl,SQYKO׏C8y'߭sU5d}DҰMۭT[I[(㏭AK9%+,E B`6P( :8|NoYo>XImF;:Bŀÿ Kt,!fa"X0*Im Srߋ{8w;Ҵ+DIZy41Żp m`Z# 2;7aޗ8~$6<+p Uk!i͢m~~ I[z)*a0wmNQ ^\تw?@ċ=0}Ơ6YWUfo&|*aGѤrvʧ:q9h@) 6u%sBo$N?J6(Ah:m~\ZXݐ^NR(>^;:i~f6{'Y &'W|-}犁$$S Cp`Ӎ+Wǧ`q4{W_E&9YXs1sZQ<*`(SaD~e 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Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Thu Oct 09 15:49:19 2008 % Converted from TrueType font 'ARIAL.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Arial) readonly def /FamilyName (Arial) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -106 def /UnderlineThickness 73 def end readonly def /FontName /ArialMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-46 -210 1000 896} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B T13҂uGFsnA S1_ z.H@sV-umQ/ rgrVFcSctóinuk̾uA M[\b y9_ )(ib]o7PaZk=JI4wr QeR-ӐhX}Qt 1ݫja@K^ }= j"D3XU:*u?| 6&f]'(VY k?YODn7Or>TɩZfZvZ7N-N}.^1>dL,͝0n8^|0~ZPFP^̵x} Tj9th ?H2wr=\aK&cE"*X8)nXZI- Rҿ mRdokh_`V#wp; նגdRyf,jL%>lzr{,V\d6koXp a~( q;(I9zF<2(u4Z+(9%%W# )3Z+B gmMJۿ;5t2&M}wP-B*' lC7AEÐ-XaTu:RD/ ~Xmv@JO"Ⲕ!d #\8_A#~#aMzNNZ2>ieec5+#TMg]Ⴤ]p9jqe^alǣ̏:Ϯ6~O(SW™^tpTeͦVzĻ[ 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!k@^B\Xi\M'}lb7zȋ_xU-$y/'gv+i;0J~]Z*e}O<\jry싯Gf#٩sdJŢʨ'{x@W,ک! pն_ ep׼!c&uLA{`\ 9Ia.c4 <6Z%^66853y̌{0rf\F3O<Յb4 2 0Uj~em&A$؜P_kqaM}x]|#&m.}?{- { ٔbDBw'n|Our 7=xKs_H./bɞob#p{Xkc*b yꍋQB_u}~?ށ8i<ֳ,#Rlw>g钑yLu$]UþCi Rhr+9aa9wuA&DKw^Qe|Z 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 cleartomark endstream endobj 99 0 obj<> endobj 32 0 obj<> endobj 100 0 obj <>stream  cvt bfpgmIglyf headg "6hheao"$hmtxłc#locaBmaxp b prep~ϚbcxdYV`jv^gakwL}g# CCw|}44 \wCXLkr/:FRb3AJMjiH\shhSn +j1 bLz fYY-`#)kkcyfVfZc/M\AyoV@@TH:<;:9876543210/.-,+*)('&%$#"!  ,CX+!!!Y-,CX+!!!Y-,CX%!!!!Y-,CX+!!!Y-,CX+!!!Y-,CX+!!!Y-,CX+!!!Y-,NF#CD%F!M-,CXEdj#EiCd``F#D# F/!!!!Y-, C#Ce -, C#C -,F#pF>F#pFE: -,+%E%Ej@`%#D!!!-,+%E%Ej`%#D!!!-,+!!!-,+!!!-,CCe -, i@a ,b`+ d#da\XaY-,%EhTX%E%E`h %#D%#D% Eh #D%Eh`%#DY-,% Eh #D%Eh`%#D-, CX!CXE+G#DGzEi G#D QX+G#DGz!GzYYY-, E#Eh`D-,EjB-,/-,!!-,%E%Ed`j%Eja %Ej e%#D%#D!!-,Eh#Eia%Eja %Ej e%#D%#D!!-,Ed#EdadB-,%C@T%CTZX% E@aDY%CT%C@TZX% E@`DY!!!!-,KRXC%E#aD!!Y-,KRXC%E#`D!!Y-,KRXED!!Y-, %#I@` c RX#%8#%e8c8!!!!!Y-,KPXED!!Y-,%# `#-,%# a#-,%-,F#F`F# F`ab# #KKpE` PXaFY`h:-, E%FRX?!Y-, E%FPX?!Y-,CC -,KRX%%I%%Ia TX! CUXY@TX CTXY CTX%8YYYY!!!!-,KRXCe8!!Y-,KRXC8!!Y-,!! d#d@b-,!QX d#d b@/+Y`-,!QX d#dUb/+Y`-, d#d@b`#!-,&&&&Eh:-,&&&&Ehe:-,CXY-,CXY-, +# <+-,(+# #+X59O4v" % A6O;*0Ș}-.$ ]G-#) C@/44 4CC CSVf B @  qn22????10]4&#"326%#"&'!!6632mfj/]-#G#}fT|F^Mi: &(8BR4*e@)$!;3!DO KE'* 7@ 7@7@ $@ 7$$@ $@ 7$$,p+3/+3?3/+?3/+10++]"&'&&54676632#&&'&&#"32676673UT^fWT{]^-=$&`;Bd$#2-O)3YFIIݖIFC+/0- " 6#C@-; ;L Lp#* 7* 7A!B o% p$22????10++]!!5#"4676632!&&#"326"W!*R9LC=aXqK^T~eq.^u@> PIU%'"' $4%g@#% 4 AOA S$sz* 7%< ">7@ 7@  q''% p&2]3/?3/++]?9/10+] ! !32676673&&#"<8.-xG=v1+I%+G>9yadfs0H~Ni,otziTY@<@ ?  0 @  /  /]3/]/2/9/]??32?2/10#&&#"!!!#5354632TU&jML0 Nk o 6Y9p@Q<K@C$pyzp6)* 7 7* 7* 79A4 B+ 0p!A 7(o;@.p:3/]22?3/]???10++++]&&#"326#"&'332676655#"46766327!%L&~Q?/[ZNNڅpJ)G$+R+Yw;RIA>_V8 Sb Ie'&' Ü=>7  %"#_H4?"JGM,%29@$4 E p D o`  n2]??D?C?B?A?@??5233554455@!5 6@q::6q@q 6ppo@o6n@n 6pfff@g 6ed@;d 6@ ?_  k@khhhPh`ha0[@[[[8@ 6@@ +*p*,--  C! C <$e2"H/ 0@PpP`p0/?o /?o 7 7 **& 9999PKKTBKKSB 2+KdRBKRXYKTXYKSXY++++++++st+ststEEha#DsEEha#DsEEha#DEh#Dst++tu++++u+++++++++s+++++++++ss++sssstssssss+ss+s+u+us+u++s+++++++++++++++++++++++++++ss+s+sss++s+s++s+++++ss+++s+++s+++++ts+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ endstream endobj 101 0 obj<> endobj 102 0 obj<>/Subtype/CIDFontType2/Type/Font/W [3[292]29[363]38[667]44[483]46[696]50[770]53[726 633 612]68[598 631 527 629 593 382 629 640 301 362]79[301 953 640 617 629]85[433 514 415 640]90[889 604 575]]/CIDToGIDMap/Identity/DW 1000>> endobj 103 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0003><005c> endcodespacerange 31 beginbfrange <0003><0003><0020> <001d><001d><003a> <0026><0026><0043> <002c><002c><0049> <002e><002e><004b> <0032><0032><004f> <0035><0035><0052> <0036><0036><0053> <0037><0037><0054> <0044><0044><0061> <0045><0045><0062> <0046><0046><0063> <0047><0047><0064> <0048><0048><0065> <0049><0049><0066> <004a><004a><0067> <004b><004b><0068> <004c><004c><0069> <004d><004d><006a> <004f><004f><006c> <0050><0050><006d> <0051><0051><006e> <0052><0052><006f> <0053><0053><0070> <0055><0055><0072> <0056><0056><0073> <0057><0057><0074> <0058><0058><0075> <005a><005a><0077> <005b><005b><0078> <005c><005c><0079> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 3 0 obj<> endobj 104 0 obj <>stream %!PS-AdobeFont-1.0: SymbolMT Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Fri Oct 10 11:50:06 2008 % Converted from TrueType font 'SYMBOL.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 1.60) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Symbol) readonly def /FamilyName (Symbol) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -109 def /UnderlineThickness 49 def end readonly def /FontName /SymbolMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {0 -220 1113 1005} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /universal put dup 35 /numbersign put dup 36 /existential put dup 37 /percent put dup 38 /ampersand put dup 39 /suchthat put dup 40 /parenleft put dup 41 /parenright put dup 42 /asteriskmath put dup 43 /plus put dup 44 /comma put dup 45 /minus put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /congruent put dup 65 /Alpha put dup 66 /Beta put dup 67 /Chi put dup 68 /Delta put dup 69 /Epsilon put dup 70 /Phi put dup 71 /Gamma put dup 72 /Eta put dup 73 /Iota put dup 74 /theta1 put dup 75 /Kappa put dup 76 /Lambda put dup 77 /Mu put dup 78 /Nu put dup 79 /Omicron put dup 80 /Pi put dup 81 /Theta put dup 82 /Rho put dup 83 /Sigma put dup 84 /Tau put dup 85 /Upsilon put dup 86 /sigma1 put dup 87 /Omega put dup 88 /Xi put dup 89 /Psi put dup 90 /Zeta put dup 91 /bracketleft put dup 92 /therefore put dup 93 /bracketright put dup 94 /perpendicular put dup 95 /underscore put dup 96 /radicalex put dup 97 /alpha put dup 98 /beta put dup 99 /chi put dup 100 /delta put dup 101 /epsilon put dup 102 /phi put dup 103 /gamma put dup 104 /eta put dup 105 /iota put dup 106 /phi1 put dup 107 /kappa put dup 108 /lambda put dup 109 /mu put dup 110 /nu put dup 111 /omicron put dup 112 /pi put dup 113 /theta put dup 114 /rho put dup 115 /sigma put dup 116 /tau put dup 117 /upsilon put dup 118 /omega1 put dup 119 /omega put dup 120 /xi put dup 121 /psi put dup 122 /zeta put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /similar put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /.notdef put dup 131 /.notdef put dup 132 /.notdef put dup 133 /.notdef put dup 134 /.notdef put dup 135 /.notdef put dup 136 /.notdef put dup 137 /.notdef put dup 138 /.notdef put dup 139 /.notdef put dup 140 /.notdef put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /.notdef put dup 146 /.notdef put dup 147 /.notdef put dup 148 /.notdef put dup 149 /.notdef put dup 150 /.notdef put dup 151 /.notdef put dup 152 /.notdef put dup 153 /.notdef put dup 154 /.notdef put dup 155 /.notdef put dup 156 /.notdef put dup 157 /.notdef put dup 158 /.notdef put dup 159 /.notdef put dup 160 /.notdef put dup 161 /Upsilon1 put dup 162 /minute put dup 163 /lessequal put dup 164 /fraction put dup 165 /infinity put dup 166 /florin put dup 167 /club put dup 168 /diamond put dup 169 /heart put dup 170 /spade put dup 171 /arrowboth put dup 172 /arrowleft put dup 173 /arrowup put dup 174 /arrowright put dup 175 /arrowdown put dup 176 /degree put dup 177 /plusminus put dup 178 /second put dup 179 /greaterequal put dup 180 /multiply put dup 181 /proportional put dup 182 /partialdiff put dup 183 /bullet put dup 184 /divide put dup 185 /notequal put dup 186 /equivalence put dup 187 /approxequal put dup 188 /ellipsis put dup 189 /arrowvertex put dup 190 /arrowhorizex put dup 191 /carriagereturn put dup 192 /aleph put dup 193 /Ifraktur put dup 194 /Rfraktur put dup 195 /weierstrass put dup 196 /circlemultiply put dup 197 /circleplus put dup 198 /emptyset put dup 199 /intersection put dup 200 /union put dup 201 /propersuperset put dup 202 /reflexsuperset put dup 203 /notsubset put dup 204 /propersubset put dup 205 /reflexsubset put dup 206 /element put dup 207 /notelement put dup 208 /angle put dup 209 /gradient put dup 210 /registerserif put dup 211 /copyrightserif put dup 212 /trademarkserif put dup 213 /product put dup 214 /radical put dup 215 /dotmath put dup 216 /logicalnot put dup 217 /logicaland put dup 218 /logicalor put dup 219 /arrowdblboth put dup 220 /arrowdblleft put dup 221 /arrowdblup put dup 222 /arrowdblright put dup 223 /arrowdbldown put dup 224 /lozenge put dup 225 /angleleft put dup 226 /registersans put dup 227 /copyrightsans put dup 228 /trademarksans put dup 229 /summation put dup 230 /parenlefttp put dup 231 /parenleftex put dup 232 /parenleftbt put dup 233 /bracketlefttp put dup 234 /bracketleftex put dup 235 /bracketleftbt put dup 236 /bracelefttp put dup 237 /braceleftmid put dup 238 /braceleftbt put dup 239 /braceex put dup 240 /.notdef put dup 241 /angleright put dup 242 /integral put dup 243 /integraltp put dup 244 /integralex put dup 245 /integralbt put dup 246 /parenrighttp put dup 247 /parenrightex put dup 248 /parenrightbt put dup 249 /bracketrighttp put dup 250 /bracketrightex put dup 251 /bracketrightbt put dup 252 /bracerighttp put dup 253 /bracerightmid put dup 254 /bracerightbt put dup 255 /.notdef put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B T=:[RXz:F.V0zjQ 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