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(9)Tj ET /F1 12 Tf BT 1 0 0 1 392.28 140.37 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 423.61 140.37 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 454.95 140.37 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 486.28 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 517.6 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 548.96 140.37 Tm (9)Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 612 792]>> endobj 7 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (2)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 768.28 Tm (Information about the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 31.2 746.8 m 274.61 746.8 l S 0.001 w 1 1 1 RG 20.58 w 276.86 746.8 m 580.25 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 73.32 w 31.2 697.6 m 274.61 697.6 l S 0.001 w 1 1 1 RG 73.32 w 276.86 697.6 m 580.25 697.6 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 648.4 m 274.61 648.4 l S 0.001 w 1 1 1 RG 20.58 w 276.86 648.4 m 580.25 648.4 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 625.57 m 274.61 625.57 l S 0.001 w 1 1 1 RG 20.58 w 276.86 625.57 m 580.25 625.57 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 602.74 m 274.61 602.74 l S 0.001 w 1 1 1 RG 20.58 w 276.86 602.74 m 580.25 602.74 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 579.91 m 274.61 579.91 l S 0.001 w 1 1 1 RG 20.58 w 276.86 579.91 m 580.25 579.91 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 758.22 m 582.46 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 568.49 m 582.46 568.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 759.29 m 30.07 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 275.73 759.29 m 275.73 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 759.29 m 581.38 567.42 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 742.03 Tm (Name of care home:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 742.03 Tm (Victoria Lodge Care Home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 719.2 Tm (Address:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 719.2 Tm (Bent Street )Tj ET /F1 12 Tf BT 1 0 0 1 279.71 701.62 Tm (Brierley Hill)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 684.04 Tm (West Midlands)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 666.46 Tm (DY5 1RB)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 643.63 Tm (Telephone number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 643.63 Tm (01384572567)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 620.8 Tm (Fax number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 620.8 Tm (0138479658)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 597.97 Tm (Email address:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 575.14 Tm (Provider web address:)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 539.2 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 519.71 m 353.25 519.71 l S 0.001 w 1 1 1 RG 20.58 w 355.5 519.71 m 565.9 519.71 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 496.88 m 353.25 496.88 l S 0.001 w 1 1 1 RG 20.58 w 355.5 496.88 m 565.9 496.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 474.05 m 353.25 474.05 l S 0.001 w 1 1 1 RG 20.58 w 355.5 474.05 m 565.9 474.05 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 508.29 m 568.1 508.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 485.46 m 568.1 485.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 531.12 m 568.1 531.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 508.29 m 568.1 508.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 485.46 m 568.1 485.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 462.63 m 568.1 462.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 532.2 m 30.07 461.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 532.2 m 354.37 461.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 532.2 m 567.02 461.55 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 514.93 Tm (Name of registered provider\(s\):)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 514.93 Tm (Select Health Care Limited)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 492.11 Tm (Type of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 492.11 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 469.27 Tm (Number of places registered:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 469.27 Tm (61)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 450.33 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 406.89 m 564.47 406.89 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 419.42 m 567.8 419.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 396.6 m 567.8 396.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 442.26 m 567.8 442.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 419.42 m 567.8 419.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 396.6 m 567.8 396.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 373.77 m 567.8 373.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 443.33 m 30.07 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 420.5 m 298.32 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.52 397.67 m 432.52 372.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 443.33 m 566.72 372.69 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 426.07 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 403.24 Tm (Category\(ies\) :)Tj ET /F1 12 Tf BT 1 0 0 1 302.3 403.24 Tm (Number of places \(if applicable\):)Tj ET /F1 12 Tf BT 1 0 0 1 302.3 380.41 Tm (Under 65)Tj ET /F1 12 Tf BT 1 0 0 1 436.5 380.41 Tm (Over 65)Tj ET 1 1 1 RG 20.58 w 31.2 358.98 m 297.25 358.98 l S 0.001 w 20.58 w 299.5 358.98 m 429.25 358.98 l S 0.001 w 20.58 w 431.5 358.98 m 565.9 358.98 l S 0.001 w 35.16 w 31.2 328.86 m 297.25 328.86 l S 0.001 w 35.16 w 299.5 328.86 m 429.25 328.86 l S 0.001 w 35.16 w 431.5 328.86 m 565.9 328.86 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 347.56 m 568.1 347.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 370.39 m 568.1 370.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 347.56 m 568.1 347.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 310.15 m 568.1 310.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 371.47 m 30.07 309.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.37 371.47 m 298.37 309.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 430.37 371.47 m 430.37 309.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 371.47 m 567.02 309.07 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 354.2 Tm (dementia)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 354.2 Tm (61)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 354.2 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 331.38 Tm (old age, not falling within any other )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 316.8 Tm (category)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 331.38 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 331.38 Tm (61)Tj ET 0.95294 0.95294 0.95294 RG 109.98 w 32.32 232.54 m 564.77 232.54 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 266.95 m 567.8 266.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 244.12 m 568.1 244.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 289.77 m 567.8 289.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 266.95 m 568.1 266.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 244.12 m 568.1 244.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 177.54 m 568.1 177.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 290.85 m 30.07 176.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 290.85 m 566.72 176.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 273.59 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 250.76 Tm (The maximum number of service users to be accommodated is 61.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 227.93 Tm (The registered person may provide personal care \(with nursing - Code N\) and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 213.35 Tm (accommodation for service users of the following gender: Either; whose primary care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 198.77 Tm (needs on admission to the home are within the following categories: - Old age, not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 184.19 Tm (falling within any other category \(OP 61\); Dementia \(DE 61\))Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 162.76 m 315.25 162.76 l S 0.001 w 1 1 1 RG 20.58 w 317.5 162.76 m 346.55 162.76 l S 0.001 w 20.58 w 348.8 162.76 m 377.9 162.76 l S 0.001 w 20.58 w 380.15 162.76 m 409.2 162.76 l S 0.001 w 20.58 w 411.45 162.76 m 440.55 162.76 l S 0.001 w 20.58 w 442.8 162.76 m 471.9 162.76 l S 0.001 w 20.58 w 474.15 162.76 m 503.2 162.76 l S 0.001 w 20.58 w 505.45 162.76 m 534.55 162.76 l S 0.001 w 20.58 w 536.8 162.76 m 565.9 162.76 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 174.17 m 568.1 174.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 151.34 m 568.1 151.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 175.25 m 30.07 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 175.25 m 316.37 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 175.25 m 347.67 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 175.25 m 379.02 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 175.25 m 410.32 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 175.25 m 441.67 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 175.25 m 473.02 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 175.25 m 504.32 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 175.25 m 535.67 150.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 175.25 m 567.02 150.26 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 157.99 Tm (Date of last inspection)Tj ET /F1 12 Tf BT 1 0 0 1 328.2 157.99 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 359.53 157.99 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 390.86 157.99 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 422.18 157.99 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 453.53 157.99 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 484.86 157.99 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 516.18 157.99 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 547.53 157.99 Tm (9)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 139.46 m 565.9 139.46 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 129.84 m 568.1 129.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 130.92 m 30.07 34.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 130.92 m 567.02 34.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 149.09 m 568.1 149.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 129.84 m 568.1 129.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 35.8 m 568.1 35.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 150.17 m 30.07 128.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 150.17 m 567.02 128.76 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 135.9 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 135.9 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 116.65 Tm (Victoria Lodge, a purpose built home was opened in the summer of 2007. It is )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 99.65 Tm (registered to provide personal and nursing care to people who have dementia and )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 82.65 Tm (people who have other care needs associated with old age. It can accommodate a )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 65.65 Tm (maximum of 61 people at any one time. The home is located near to Brierley Hill High )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 48.65 Tm (Street with easy access to main bus routes and a range of shops and other amenities.)Tj ET endstream endobj 8 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 9 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (3)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 776.72 m 565.9 776.72 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 768.18 m 30.07 627.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 768.18 m 567.02 627.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.1 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.85 m 568.1 628.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 766.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 787.43 m 567.02 766.02 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 773.16 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 773.16 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 33.25 756.16 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 33.25 739.16 Tm (The premises consist of three separate floors, with dementia care provided on the first )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 722.16 Tm (floor and nursing care provided on the second floor. Each floor has communal areas, a )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 705.16 Tm (dining room and lounge, bathrooms and toilets. All bedrooms are single occupancy )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 688.16 Tm (with en-suite facilities. There are hoists and pressure relieving equipment available. A )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 671.16 Tm (passenger lift provides assisted access to all floors. There is a main kitchen and small )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 654.16 Tm (kitchenettes on each floor. There are also laundry facilities. The small garden areas are )Tj ET /F1 12 Tf BT 1 0 0 1 33.25 637.16 Tm (accessible to people using wheelchairs.)Tj ET endstream endobj 10 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 11 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (4)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 745.27 Tm (What we found:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 691.53 w 31.2 389.44 m 580.26 389.44 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 736.33 m 582.46 736.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 737.41 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 737.41 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 720.15 Tm (We, the Care quality Commission \(CQC\) undertook three random inspection visits during )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 705.57 Tm (December 2009 to monitor requirements issued at the key unannounced inspection in )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 690.98 Tm (August 2009 relating to the safety and well being of people living at the home. The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 676.41 Tm (service received a poor, zero star quality rating as a result of our key inspection and had )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 661.83 Tm (failed to demonstrate the required improvements at a random inspection in November )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 647.24 Tm (2009. The home had Statutory Regulation Notices served in 2008 for breaches of the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 632.66 Tm (Care Homes Regulations 2001 and although some improvements were made in 2008, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 618.09 Tm (these have not been consistently maintained. The home has a history of considerable )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 603.51 Tm (management instability; six managers in the short time the home has been operating. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 588.92 Tm (The acting manager, who commenced employment in January 2009, left her post without )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 574.34 Tm (notice following our second inspection visit in December 2009.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 559.77 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 545.18 Tm (The series of random inspections were unannounced, which meant the home was not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 530.6 Tm (given notice of our visits. A pharmacist inspector spent nine hours at the first inspection, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 516.03 Tm (a team of three inspectors and a local area manager spent eleven hours at the second )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 501.45 Tm (inspection and an inspector and area manager spent ten hours at the home at the third )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 486.86 Tm (inspection. We looked at aspects of the medication systems, care records, the systems )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 472.29 Tm (for dealing with complaints and safeguarding people, staffing arrangements, staff )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 457.7 Tm (recruitment, management arrangements and the home's quality audits and improvement )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 443.13 Tm (plan. We also looked at how people were supported and given assistance to meet their )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 428.55 Tm (daily needs. We talked with people living at the home, staff and visitors.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 413.96 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 399.39 Tm (At the key inspection on 5 August 2009 we issued a requirement that each person must )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 384.8 Tm (have appropriate and accurate care plans, risk assessments and health care screening )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 370.23 Tm (assessments to maintain their health and well being. The organisation provided us with )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 355.64 Tm (an improvement plan, which told us compliance would be in place, within the timescale )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 341.07 Tm (identified.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 326.48 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 311.9 Tm (At the random inspection on 18 November 2009 the acting manager told us that the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 297.33 Tm (organisation had employed a consultant on a part time basis to re-write all of the care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 282.74 Tm (plans, with the involvement of each person, their relatives or representatives and staff. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 268.17 Tm (She explained that this was a slow and time consuming process, which also included )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 253.59 Tm (mentoring the staff, so that they had a good understanding and could continue to develop )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.01 Tm (care plans when the consultant had completed the work.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 224.43 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 209.85 Tm (At the random inspection on 18 November 2009 we looked at some newly completed )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 195.26 Tm (records, which were comprehensive and person centered. From our observations of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 180.68 Tm (people in the home, they generally looked well presented and dressed appropriately for )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 166.1 Tm (the weather and to maintain their dignity. At that time we received varied views from )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 151.52 Tm (relatives. Some were positive, for example they told us that people living in the home )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 136.95 Tm (were kept clean and dressed appropriately. Others made reference to changes in staffing )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 122.36 Tm (arrangements and staff shortages. This meant staff did not know people's needs and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 107.79 Tm (often staff had to 'think on their feet' to respond to challenging situations. They also )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 93.21 Tm (commented on the mix of acutely frail people and very mobile people with dementia on )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 78.63 Tm (the nursing unit, all with diverse needs, making it difficult for staff to provide care and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 64.04 Tm (supervision.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 49.47 Tm ()Tj ET endstream endobj 12 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 13 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (5)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (At the random inspection on 18 November 2009 the management had failed to put care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (plans in place for the use of 'as and when needed \(PRN\) medication for everyone )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (prescribed this type of medicine.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (At the follow up random inspection visits on 7 and 9 December 2009 we saw examples )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (where this failure had not been rectified. We also saw that some people with infections, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (such as urinary tract infections, did not have short term care plans to give staff guidance )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (for additional care and medication to be provided.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (At the inspection visit on 9 December 2009 we saw that a person recently admitted to the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (ground floor unit, following surgery for a fractured femur, did not have care plans and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (monitoring arrangements in place to assure their recovery. This person was not able to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (sleep comfortably in bed and was spending the majority of time in an armchair, resulting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (in a swollen, painful leg. The staff we spoke to had not monitored this person's condition )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (or referred the symptoms to healthcare professionals for advice or treatment. Staff told )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (us that the person would not be provided with a footstool to elevate their leg because of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (their funding arrangements. This person's condition had deteriorated since admission to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (the home and medical advice had not been sought, putting their health at risk.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (At the inspection visit on 9 December 2009 we saw that a person on the first floor )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (dementia unit had undergone total knee replacement surgery. There was no )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (reassessment of the risks or changes to their needs on readmission to the home. There )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (were no care plans relating to the aftercare required, or for pain relief or exercise )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (treatment regime, as prescribed by the physiotherapist. We saw daily information records )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (dated 27 October 2009 "X came out of hospital 2 pm, Physio came and showed us what )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (exercises to do and recommended we did them hourly." The staff spoken to were unable )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (to tell us how often the exercises should have been carried out. We spoke to a relative )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (who told us that it was the family who made sure the exercises were done regularly, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (when they visited. They told us that they did not believe staff assisted with the exercise )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (programme, with the exception of one member of staff on occasions. The person should )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (have used a footstool to elevate the affected leg and the daily progress recorded stated )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (that the person's son would provide the footstool. A relative disputed this information and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (told us that they were unaware of this and the footstool had not been provided by them. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (They told us that there was only one footstool on the unit and it was rarely available. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (Therefore the leg was not generally elevated.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (At the random inspection on 18 November 2009 we saw that no action was taken when a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (person had episodes of severe diarrhoea and poor appetite. At the inspection visit on 9 )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (December 2009 we saw similar information in another person's daily records stating )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm ('severe diarrhoea' and 'poor appetite', again with no follow up actions taken.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (At previous inspections the management could not show us monitoring and management )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (strategies for people described as having agitated, aggressive or other challenging )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (behaviours. At the inspection on 9 December 2009, though there were some challenging )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (behaviour charts, some records of incidents were incomplete. The charts did not record )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (the use of risk management strategies or administration medication and there was no )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (evaluation. We saw a care plan, for someone with dementia, described as being )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm ('physically resistant to intervention' when being assisted with personal care. The care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (plan stated, "There will be times when 2 care staff will be required to assist X. At all times )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (X will be encouraged to assist with the procedure. However X can be physically )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (aggressive then 2nd care staff member will gently hold her hands to prevent any injury )Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 15 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (occurring to the staff." The care plan 'dealing with problems' stated, "If all fails then give )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (Lorazepam". These instructions to use physical restraint had not been discussed with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (professionals to be in the person's 'best interests' and were not adequate as a plan to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (administer 'as and when needed' antipsychotic PRN medication. We saw daily records and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (challenging behaviour charts, with daily entries describing the person biting, scratching, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (hitting staff but there was no evidence of referral for advice from health and social care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (professionals to make decisions in this person's best interests.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (We had received information from a family that their relative at the home was unwell. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (They were concerned about the care and lack of medication and had taken the person to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (hospital, where he was admitted and treated for serious conditions. We referred this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (matter to the Local Authority as a safeguarding alert.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (At the inspection on 7 December 2009 a CQC pharmacist inspector checked compliance )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (with the requirements relating to medication. We looked at medication storage, some )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (care records and medication administration records. We spoke to staff and the acting )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (manager. Due to concerns found in medicine and healthcare management we undertook )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (a second unannounced inspection on 9 December 2009 when we saw further evidence )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (that the health and well being of people living in the home were at serious risk of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (Medicines were not always given to people safely and securely. For example, on 7 )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (December 2009 we saw that medicines were being given unsafely. On arrival on the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (second floor, the nursing unit, we saw a nurse placing medicines for various people into )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (medicine tots and placing them all into a basket. We saw five medicine tots in the basket. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (Each medicine tot had a piece of paper inside with the name of a person written on it. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (This practice was called secondary dispensing. This was unsafe practice that could )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (potentially cause drug errors placing people using the service at risk of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (At previous inspection were found that medicines were not stored at temperatures in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (accordance with manufacturers' instructions.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (At the inspection visit on 7 December 2009 this had improved and we saw that the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (storage temperatures of medicines were being monitored each day and it was possible to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (ensure that medicines were being stored at the correct temperature. We saw that the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (service had installed new air conditioning units for the first and second floors. We saw )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (records for the room temperature on the second floor, which was between 21 to 25 )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (degrees C. This is within the safe storage temperature for medicines. We looked at the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (temperature records available for the refrigerator. Medication requiring refrigeration )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (should be stored between two to eight degrees centigrade. We saw that the records )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (documented temperatures between three to five degrees C. This meant that it was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (possible to ensure that people's medication was being stored within the recommended )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (temperature ranges.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (At the inspection visit on 7 December 2009 prescribed medication was not available to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (administer according to the directions of a doctor. We saw that four people had not been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (given their prescribed medication as prescribed. For example, we saw a MAR chart for an )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (identified person for a liquid medicine to be given twice a day for emphysema, a chronic )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (breathing condition resulting in severe shortness of breath. On 7 December 2009 we )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (found that the medicine was about to run out and there was enough available for two )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (more doses. There was no more medicine available in the home. When we returned on 9 )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (December 2009 we found that the medicine was not available to give to the person. The )Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 17 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (medicine had not been given for two doses. We were informed by a senior member of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (staff that nobody had informed a doctor that the person was without their prescribed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (medication for emphysema. This meant that the person was at risk of increased )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (shortness of breath and therefore was at risk of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (Information relating to medication to be given 'when required' was not always available. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (For example, we looked at two care plans for people who were prescribed medication )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (used to treat anxiety and agitation when required that can cause sedation and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (drowsiness. The first care plan we looked at did not include a protocol for the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (administration of the 'when required' tablets. The tablet was prescribed as one to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (taken when required up to twice a day. We looked at the MAR chart for the person and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (saw that the tablet had been given at 2200 hours on 11 November 2009. The second )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (care plan we looked at did not include a protocol for the administration of two prescribed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (medicines, which caused drowsiness. One medicine was an antipsychotic and the second )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (medicine was a sedative. We were concerned that two medicines were prescribed with no )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (agreed protocols available to inform staff when the medicines should be given. We spoke )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (to the senior carer who told us that the medicines would be given when the person )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (became 'mithered' but could not distinguish between the two different medicines. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (looked at the MAR chart and saw that both medicines were signed as being given on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (various dates and on one occasion that both medicines had been given on the same day. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (This means that due to a lack of protocols with regard to when required medication )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (people were at increased risk of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (At the inspection visits in December 2009 we discussed our serious concerns about the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (continued failures to plan, monitor and make appropriate provision for each person's )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (health and personal care with the management of the service. We had previously )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (highlighted that the improved care plans would not be effective unless there were actions )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (taken as people's needs changed. We were seriously concerned that staff on each unit )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (were failing to recognise when people's needs changed or when they showed signs of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (deterioration. This meant that assessments, advice and treatment were not sought in a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (timely way, posing risks to people's health and well being. We copied documentary )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (evidence, which may be used in enforcement action.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (We served two Statutory Requirement Notices on the organisation in relation to the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (health and welfare of people living at the home, which included the administration of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (each person's medication. These were used as part of enforcement action to secure )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (improvements and keep people safe.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (The organisation's improvement plan submitted to us in October 2009 had given )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (assurances of compliance with the requirement to ensure staff were appropriately )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (trained, competent and would diligently follow safeguarding procedures. In November )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (2009 we saw evidence of an incident of abusive behaviour between two people living at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (the home. At that time the acting manager told us that the unit manager on the nursing )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (unit had not reported the incident to her. She acknowledged that no Regulation 37 )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (notification had been submitted to us and no referral had been made to the Local )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (Authority to be considered under the safeguarding remit.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (At the inspection on 9 December 2009 we saw daily progress records and challenging )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (behaviour charts with two recorded incidents of physically abusive behaviour between )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (people living at the home; and one complaint from a son, which read, "X complained )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (about Y hitting his mom and pestering her." The record also indicated another relative )Tj ET endstream endobj 18 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 19 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (had made sure her bedroom door was locked. There was no risk assessment relating to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (the locked door. The staff on duty and the management claimed to be unaware of these )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (incidents. There were no records of Regulation 37 notifications or safeguarding referrals )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (and the complaint had not been logged.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (At the inspection visits on 7 and 9 December 2009 we saw during discussions and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (observations that staff did not know about each person's assessed or changing needs. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (Staff on the dementia unit on the first floor were not supervised or directed to meet )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (people's needs. There was little interaction between staff and people living at the home )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (apart from essential tasks, such as personal care and meals. Staff on duty on the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (dementia unit told us they had not received dementia or safeguarding training. At one )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (point during the afternoon of this visit the dementia unit was left with one care assistant, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (who had no formal training. The senior in charge and two other care assistants had gone )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (to the ground floor for various reasons. During this time a person, who was 'wandering' in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (the corridors was saved from falling by the intervention of the home's administration )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (assistant. The care assistant, who was attending to another person elsewhere on the unit, )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (told us that X was unsteady because he had been given his afternoon medication.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (At the inspection on 9 December 2009 we informed the acting manager that the evidence )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (we found demonstrated a lack of compliance with the previous requirement: that the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (number of care staff on duty are skilled and trained and in sufficient numbers to meet the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (needs of people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (At the inspection on 9 December we were told that the unit manager on the nursing unit )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (had been demoted and the deputy manager was managing the nursing unit until a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (replacement could be recruited. We were told that the services of an external consultant )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (were being used to re-write care plans and mentor staff in relation to a more person )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (centred approach. In addition a manager recently recruited for a new home within the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (organisation had been relocated to provide additional managerial support and monitoring. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (There was also administration support was in place.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (At the inspection visit on 9 December the management audits had not identified areas of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (concern as highlighted in this report such as failures to implement important aspects of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (care planning and medication improvements.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (Prior to our visit on 29 December 2009, We informed Select Healthcare that we )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (considered the risks posed to people living at the home were very serious. We required a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (number of assurances from them, including their full co-operation with other agencies )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (such as the Local Authority and Dudley Primary Care Trust. We required the organisation )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (to attend a meeting with us as a matter of urgency where we informed them that we had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (considered what further enforcement action we needed to take to secure improvements )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (for the health, well being and safety of people at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (The organisation told us that the acting manager and Responsible Individual had left their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (employment without notice on 11 December 2009. Select Healthcare told us that an area )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (manager who was registered as a Responsible Individual for other homes in the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (organisation would be taking responsibility for this home and that an another area )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (manager, would be acting as manager for Victoria Lodge and would submit an application )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (to be the registered manager.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (At the inspection visit on 29 December 2009 we looked at the home's records such as )Tj ET endstream endobj 20 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 382.08 w 31.2 594.18 m 580.26 594.18 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 402.02 m 582.46 402.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 400.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 400.94 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (staff training, accident records and Regulation 37 notifications in relation to safeguarding )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (people at the home. The information told us that the management of this service had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (failed to effectively report issues relating to safeguard vulnerable persons. This meant )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (that they were unable to assure us that they had taken action and made improvements )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (to safeguard people living at the home. We took copies of documents, which may be used )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (in future enforcement action.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (At the inspection visit on 29 December 2009 we saw that the new management )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (arrangements were in place. The new Responsible Individual and acting manager )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (acknowledged our findings and assured us that they were willing to work in cooperation )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (with all agencies to make the necessary improvements. We saw that there were small )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (improvements, particularly in notifying agencies when there were concerns about )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (people's health.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (At the unannounced inspection on 29 December 2009 staff reported positive steps had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (been taken to improve the care and welfare of the people living in the home. Most were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (able to describe the difference the new management team have made and reported that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (the new team were approachable and responsive. Training and updating of staff had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (begun and was being planned to ensure staff were skilled to undertake their roles. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (reviewed staffing records which were, in general, well kept. However there were some )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (concerns, for example, the high number of vacant posts which needed to be recruited to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (and a need to assess the competency and skills of existing staff through performance )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (appraisal and development.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (We have informed the organisation that we will continue to undertake inspections to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (monitor the service to safeguard people living at the home.)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 383.95 Tm (What the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 175.95 383.95 Tm (does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 268.44 w 31.2 238.54 m 580.26 238.54 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 373.89 m 582.46 373.89 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 103.19 m 582.46 103.19 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 374.96 m 30.07 102.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 374.96 m 581.38 102.12 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 357.7 Tm (People were generally well presented, with clothing according to their preference and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 343.12 Tm (appropriate for the weather.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 328.54 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 313.96 Tm (The home had a generally friendly and welcoming atmosphere where people were )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 299.38 Tm (encouraged to personalise their rooms to reflect preferences and tastes.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 284.8 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 270.22 Tm (There were communal areas, including a 'pub', where activities and events took place, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 255.64 Tm (which people enjoyed.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 241.06 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 226.48 Tm (There was an open visiting policy and people were welcomed, so people living at the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 211.9 Tm (home were able to maintain important friendships and relationships.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 197.32 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 182.74 Tm (The very recently appointed acting manager had made improvements to the communal )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 168.16 Tm (space on the first floor dementia unit, creating a separate small dining room, so that )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 153.58 Tm (people could use a quiet area.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 139 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 124.42 Tm (Some additional pressure relieving equipment had been purchased to help prevent )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 109.84 Tm (damage to people who were not able to move about.)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 82.88 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 30.26 w 31.2 57.68 m 580.26 57.68 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 73.93 m 582.46 73.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 582.46 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 75.01 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 75.01 m 581.38 40.35 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 57.75 Tm (People's needs must be thoroughly assessed prior to admission and be kept under )Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 23 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 542.46 w 31.2 513.99 m 580.26 513.99 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 241.64 m 582.46 241.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 240.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 240.56 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (review. Reassessments and appropriate referrals must be made to health and social care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (professionals without delay, so that people's heath is not put at risk.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (Care plans must be accurate, up to date and give clear guidance about how to meet the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (needs of each person in the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (Medication practices were potentially unsafe. Storage, administration practices and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (records must be improved.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (The organisation must take action to demonstrate compliance with Statutory Regulations )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (Notices served to secure improvements to safeguard the health and welfare of people at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (Improvements must be made to the policies to safeguard people. All staff must be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (provided with suitable training so that they understand how to protect vulnerable people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (and diligently report concerns to appropriate agencies without delay.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (The management must be able to demonstrate that there are skilled staff in suitable )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (numbers to meet all the needs of the people living at the home. Thorough employment )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (checks and supervision arrangements must be put in place to make sure the people are )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (suitable to work with vulnerable people living at the home. Action must be taken to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (demonstrate that all staff are competent in their work practice.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (Communication systems must be improved so that all staff are fully aware of their role )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (and responsibilities.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (The quality assurance audits must be more robust so that failings are recognised with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (appropriate actions taken to improve the service.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (Any adverse event affecting people living at the home must be notified to us without )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (delay to show that people are safeguarded.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (Records must be more rigorously monitored and improved so that risks are recognised )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (and controlled.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (Fire training must be provided to all staff, especially night staff to make sure people can )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (be kept safe from the risks of fire.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 225.58 Tm (If you want to know what action the person responsible for this care home)Tj ET /F1 12 Tf BT 1 0 0 1 483.55 225.58 Tm (is taking )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 209.58 Tm (following this report, you can contact them using the details set out on page 2.)Tj ET endstream endobj 24 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 26 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 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Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 721.57 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 721.57 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 703.74 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 700.74 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 700.74 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 700.74 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 700.74 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 688.59 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 671.43 Tm (and well being of people )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 656.85 Tm (living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 631.78 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 631.78 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 631.78 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 631.78 Tm (To ensure prescribed )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 617.2 Tm (Allendronic Acid 70mgs )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 602.61 Tm (weekly is administered in )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 588.03 Tm (accordance with special )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 573.46 Tm (instructions, to be taken at )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 558.88 Tm (least half an hour before first )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 544.29 Tm (food or drink and the person )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 529.72 Tm (advised to sit or stand for )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 515.14 Tm (half an hour following )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 500.55 Tm (administration.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 482.98 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 468.39 Tm (This is to safeguard people )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 453.82 Tm (from avoidable side effects )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 439.23 Tm (which may harm their health )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 424.65 Tm (and wellbeing.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 631.78 Tm (01/09/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 401.83 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 401.83 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 401.83 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 401.83 Tm (Medication must be stored )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 387.24 Tm (within the temperature range )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 372.67 Tm (recommended by the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 358.08 Tm (manufacturer to ensure that )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 343.51 Tm (medication does not lose )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 328.92 Tm (potency or become )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 314.35 Tm (contaminated. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 296.77 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 282.18 Tm (This is to safeguard people's )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 267.61 Tm (health and well being.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 401.83 Tm (01/10/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 244.77 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 244.77 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 244.77 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 244.77 Tm (To ensure that variable )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 230.2 Tm (dosages, such as 1 or 2 )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 215.62 Tm (tablets, 5mls or 10mls are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 201.04 Tm (recorded as administered on )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 186.46 Tm (MAR sheets.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 168.88 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 154.29 Tm (This is to ensure that )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 139.71 Tm (people's health and well )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 125.14 Tm (being is safeguarded.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 244.77 Tm (01/09/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 102.31 Tm (10)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 102.31 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 102.31 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 102.31 Tm (Staff who administer )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 87.72 Tm (medication must be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 73.14 Tm (competent and their practice )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 58.56 Tm (must ensure that people )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 102.31 Tm (01/09/2009)Tj ET endstream endobj 32 0 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(Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 700.74 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 688.59 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 671.43 Tm (receive their medication )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 656.85 Tm (safely and correctly.)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 636.28 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 292.3 621.7 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 607.11 Tm (health and wellbeing of )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 592.53 Tm (people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 567.46 Tm (11)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 567.46 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 567.46 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 567.46 Tm (To ensure that all persons )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 552.88 Tm (living at the home receive )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 538.29 Tm (their medication as )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 523.72 Tm (prescribed by their doctor )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 509.14 Tm (and the Medication )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 494.55 Tm (Administration Records must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 479.98 Tm (be accurately completed to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 465.39 Tm (demonstrate either )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 450.82 Tm (medication has administered )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 436.23 Tm (or an appropriate code )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 421.65 Tm (entered to record the reason )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 407.08 Tm (for non administration. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 389.49 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 374.92 Tm (This is to maintain the health )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 360.33 Tm (and well being of people )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 345.76 Tm (living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 567.46 Tm (01/09/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 322.92 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 322.92 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 322.92 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 322.92 Tm (To ensure there are care )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 308.35 Tm (plans in place for the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 293.77 Tm (administration of when and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 279.18 Tm (as needed medication and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 264.61 Tm (staff act appropriately to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 250.02 Tm (monitor and inform the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 235.45 Tm (relevant healthcare )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 220.87 Tm (professionals as needed.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 203.29 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 188.71 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 174.13 Tm (health and well being of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 159.54 Tm (people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 322.92 Tm (01/09/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 136.71 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 136.71 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 136.71 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 136.71 Tm (Risk assessments must be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 122.14 Tm (put in place for any )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 107.56 Tm (medication which is self )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 92.97 Tm (administered, including )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 78.39 Tm (creams, sprays and inhalers.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 60.81 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 46.24 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 136.71 Tm (01/09/2009)Tj ET endstream endobj 34 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 35 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 721.68 w 32.32 423.26 m 564.97 423.26 l S 0.001 w 1 1 1 RG 32.16 w 31.2 665.16 m 91.05 665.16 l S 0.001 w 32.16 w 93.3 665.16 m 197.4 665.16 l S 0.001 w 32.16 w 199.65 665.16 m 289.45 665.16 l S 0.001 w 32.16 w 291.7 665.16 m 473.8 665.16 l S 0.001 w 32.16 w 476.05 665.16 m 566.1 665.16 l S 0.001 w 213.12 w 31.2 540.28 m 91.05 540.28 l S 0.001 w 213.12 w 93.3 540.28 m 197.4 540.28 l S 0.001 w 213.12 w 199.65 540.28 m 289.45 540.28 l S 0.001 w 213.12 w 291.7 540.28 m 473.8 540.28 l S 0.001 w 213.12 w 476.05 540.28 m 566.1 540.28 l S 0.001 w 169.38 w 31.2 346.77 m 91.05 346.77 l S 0.001 w 169.38 w 93.3 346.77 m 197.4 346.77 l S 0.001 w 169.38 w 199.65 346.77 m 289.45 346.77 l S 0.001 w 169.38 w 291.7 346.77 m 473.8 346.77 l S 0.001 w 169.38 w 476.05 346.77 m 566.1 346.77 l S 0.001 w 198.54 w 31.2 160.57 m 91.05 160.57 l S 0.001 w 198.54 w 93.3 160.57 m 197.4 160.57 l S 0.001 w 198.54 w 199.65 160.57 m 289.45 160.57 l S 0.001 w 198.54 w 291.7 160.57 m 473.8 160.57 l S 0.001 w 198.54 w 476.05 160.57 m 566.1 160.57 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 647.96 m 568.3 647.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 432.59 m 568.3 432.59 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 260.96 m 568.3 260.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 683.45 m 30.07 59.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 683.45 m 567.22 59.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.3 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 683.45 m 92.17 59.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 683.45 m 198.52 59.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 683.45 m 290.57 59.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 683.45 m 474.92 59.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.4 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 647.96 m 568.3 647.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 432.59 m 568.3 432.59 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 260.96 m 568.3 260.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 60.17 m 568.3 60.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 716 m 92.12 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 716 m 198.52 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 716 m 290.62 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 716 m 475.02 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 681.29 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 769.15 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 750.72 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 736.15 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 736.15 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 736.15 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 721.57 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 721.57 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 703.74 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 700.74 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 700.74 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 700.74 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 700.74 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 688.59 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 671.43 Tm (health and well being of )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 656.85 Tm (people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 631.78 Tm (14)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 631.78 Tm (18)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 631.78 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 631.78 Tm (To provide appropriate, up to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 617.2 Tm (date policies and procedures, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 602.61 Tm (and safeguarding training for )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 588.03 Tm (all staff, with monitoring )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 573.46 Tm (arrangements to ensure the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 558.88 Tm (home's and 'Safeguard and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 544.29 Tm (Protect' procedures to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 529.72 Tm (protect vulnerable people are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 515.14 Tm (implemented and followed )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 500.55 Tm (diligently at all times.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 482.98 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 468.39 Tm (This is to safeguard all )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 453.82 Tm (persons living at the home )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 439.23 Tm (from risks of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 631.78 Tm (01/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 416.4 Tm (15)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 416.4 Tm (27)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 416.4 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 416.4 Tm (To demonstrate that the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 401.83 Tm (number of staff on duty are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 387.24 Tm (skilled and trained and in )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 372.67 Tm (sufficient numbers to meet )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 358.08 Tm (all of the needs of each )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 343.51 Tm (person using the service.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 325.92 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 311.35 Tm (This is to ensure that the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 296.77 Tm (health, well being and safety )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 282.18 Tm (of people living at the home )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 267.61 Tm (can be assured at all times.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 416.4 Tm (01/10/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 244.77 Tm (16)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 244.77 Tm (29)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 244.77 Tm (19)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 244.77 Tm (To ensure that all staff )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 230.2 Tm (employed at the home are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 215.62 Tm (recruited following robust )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 201.04 Tm (recruitment procedures, with )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 186.46 Tm (documentary evidence to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 171.88 Tm (demonstrate diligent )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 157.29 Tm (compliance with The Care )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 142.71 Tm (Homes Regs 2001, Reg )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 128.13 Tm (19\(1\).)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 110.56 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 95.97 Tm (This is to safeguard people )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 81.39 Tm (living at the home from risks )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 66.82 Tm (of harm.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 244.77 Tm (01/09/2009)Tj ET endstream endobj 36 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 37 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 585.21 w 32.32 491.49 m 564.97 491.49 l S 0.001 w 1 1 1 RG 125.64 w 31.2 618.42 m 91.05 618.42 l S 0.001 w 125.64 w 93.3 618.42 m 197.4 618.42 l S 0.001 w 125.64 w 199.65 618.42 m 289.45 618.42 l S 0.001 w 125.64 w 291.7 618.42 m 473.8 618.42 l S 0.001 w 125.64 w 476.05 618.42 m 566.1 618.42 l S 0.001 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[] 0 d [] 0 d 2.25 w 290.57 683.45 m 290.57 195.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 683.45 m 474.92 195.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.4 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 554.48 m 568.3 554.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 397.43 m 568.3 397.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 196.64 m 568.3 196.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 716 m 92.12 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 716 m 198.52 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 716 m 290.62 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 716 m 475.02 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 681.29 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 769.15 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 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ensure that an application )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 651.6 Tm (is submitted to register the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 637.03 Tm (manager.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 619.45 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 604.86 Tm (This is to ensure that the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 590.28 Tm (home is managed to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 575.71 Tm (safeguard everyone at the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 561.13 Tm (home. )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 666.18 Tm (01/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 538.29 Tm (18)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 538.29 Tm (33)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 538.29 Tm (24)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 538.29 Tm (To implement effective )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 523.72 Tm (quality monitoring systems, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 509.14 Tm (which demonstrate that )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 494.55 Tm (positive quality outcomes are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 479.98 Tm (consistently achieved for all )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 465.39 Tm (persons living at the home. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 447.82 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 433.23 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 418.65 Tm (health, well being and safety )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 404.08 Tm (of people living at the home. )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 538.29 Tm (01/10/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 381.24 Tm (19)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 381.24 Tm (37)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 381.24 Tm (37)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 381.24 Tm (To ensure notifications are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 366.67 Tm (submitted to the Care )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 352.08 Tm (Quality Commission and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 337.51 Tm (Inspection of any incident )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 322.92 Tm (that has affected the health, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 308.35 Tm (safety or wellbeing of the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 293.77 Tm (people at the care home, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 279.18 Tm (without delay. This includes )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 264.61 Tm (medication errors. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 247.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 232.45 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 217.87 Tm (health, well being and safety )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 203.29 Tm (of people living at the home. )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 381.24 Tm (01/09/2009)Tj ET endstream endobj 38 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 39 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 770.27 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 754.85 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 32.32 692.47 m 564.97 692.47 l S 0.001 w 1 1 1 RG 20.58 w 31.2 649.83 m 91.05 649.83 l S 0.001 w 20.58 w 93.3 649.83 m 197.4 649.83 l S 0.001 w 20.58 w 199.65 649.83 m 289.45 649.83 l S 0.001 w 20.58 w 291.7 649.83 m 473.8 649.83 l S 0.001 w 20.58 w 476.05 649.83 m 566.1 649.83 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 662.32 m 30.07 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 662.32 m 567.22 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.3 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 662.32 m 92.17 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 662.32 m 198.52 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 662.32 m 290.57 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 662.32 m 474.92 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 748.78 m 568.4 748.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.4 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 638.41 m 568.3 638.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 749.86 m 30.07 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 694.87 m 92.12 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 694.87 m 198.52 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 694.87 m 290.62 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 694.87 m 475.02 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 749.86 m 567.32 660.17 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 732.6 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 715.02 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 700.44 Tm (The registered person had to meet these within 48 hours.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 682.62 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 679.62 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 679.62 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 679.62 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 679.62 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 667.47 Tm (action)Tj ET 0.95294 0.95294 0.95294 RG 413.39 w 32.32 392.1 m 564.97 392.1 l S 0.001 w 1 1 1 RG 154.8 w 31.2 420.98 m 91.05 420.98 l S 0.001 w 154.8 w 93.3 420.98 m 197.4 420.98 l S 0.001 w 154.8 w 199.65 420.98 m 289.45 420.98 l S 0.001 w 154.8 w 291.7 420.98 m 473.8 420.98 l S 0.001 w 154.8 w 476.05 420.98 m 566.1 420.98 l S 0.001 w 154.8 w 31.2 263.92 m 91.05 263.92 l S 0.001 w 154.8 w 93.3 263.92 m 197.4 263.92 l S 0.001 w 154.8 w 199.65 263.92 m 289.45 263.92 l S 0.001 w 154.8 w 291.7 263.92 m 473.8 263.92 l S 0.001 w 154.8 w 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92.12 533.13 m 92.12 498.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 533.13 m 198.52 498.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 533.13 m 290.62 498.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 533.13 m 475.02 498.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 602.12 m 567.32 498.42 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 587.85 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 567.85 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 553.28 Tm (Standards Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 166.31 553.28 Tm (Regulations 2001 and the National Minimum Standards. The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 538.7 Tm (registered person\(s\) must do this within the timescales we have set.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 520.88 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 517.88 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 517.88 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 517.88 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 517.88 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 505.73 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 483.32 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 483.32 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 483.32 Tm (14)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 483.32 Tm (Each person's needs must be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 468.73 Tm (assessed by a competent )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 454.15 Tm (person, be kept under review )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 439.58 Tm (and be revised at any time )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 424.99 Tm (as necessary in relation to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 410.42 Tm (any changes.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 392.83 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 378.26 Tm (This is to safeguard the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 363.67 Tm (health and well being of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 349.1 Tm (people living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 483.32 Tm (01/02/2010)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 326.27 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 326.27 Tm (38)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 326.27 Tm (23)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 326.27 Tm (All staff, and especially night )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 311.68 Tm (staff must receive fire )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 297.11 Tm (training and attend fire drills )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 282.52 Tm (at frequencies approved by )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 267.95 Tm (the West Midland Fire )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 253.37 Tm (Service.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 235.79 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 221.21 Tm (This is to safeguard people at )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 206.63 Tm (the home from risks of harm )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 192.04 Tm (from fire.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 326.27 Tm (01/02/2010)Tj ET 0.95294 0.95294 0.95294 RG 110.55 w 32.32 107.5 m 564.97 107.5 l S 0.001 w 1 1 1 RG 20.58 w 31.2 63.64 m 91.05 63.64 l S 0.001 w 20.58 w 93.3 63.64 m 197.4 63.64 l S 0.001 w 20.58 w 199.65 63.64 m 566.1 63.64 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 76.13 m 30.07 51.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 76.13 m 567.22 51.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 95.46 m 568.4 95.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 75.06 m 568.3 75.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 76.13 m 92.17 51.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 76.13 m 198.52 51.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 165.02 m 568.4 165.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 95.46 m 568.4 95.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 75.06 m 568.4 75.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 52.22 m 568.3 52.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 166.1 m 30.07 73.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 96.53 m 92.17 73.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.47 96.53 m 198.47 73.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 166.1 m 567.32 73.98 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 148.84 Tm (Recommendations)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 131.26 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 116.68 Tm (Minimum Standards and the registered person\(s\) should consider them as a way of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 102.1 Tm (improving their service.)Tj ET /F1 10 Tf BT 1 0 0 1 34.05 81.28 Tm (No)Tj ET /F1 10 Tf BT 1 0 0 1 96.15 81.28 Tm (Refer to Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.45 81.28 Tm (Good Practice Recommendations)Tj ET endstream endobj 40 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 41 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 768.28 Tm (Reader Information)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 28.35 746.8 m 229.46 746.8 l S 0.001 w 1 1 1 RG 20.58 w 231.71 746.8 m 581.74 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 723.97 m 229.46 723.97 l S 0.001 w 1 1 1 RG 20.58 w 231.71 723.97 m 581.74 723.97 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 701.14 m 229.46 701.14 l S 0.001 w 1 1 1 RG 20.58 w 231.71 701.14 m 581.74 701.14 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 678.31 m 229.46 678.31 l S 0.001 w 1 1 1 RG 20.58 w 231.71 678.31 m 581.74 678.31 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 735.39 m 583.94 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 712.55 m 583.94 712.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 689.72 m 583.94 689.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 758.22 m 583.94 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 735.39 m 583.94 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 712.55 m 583.94 712.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 689.72 m 583.94 689.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 666.9 m 583.94 666.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 759.29 m 27.22 665.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 230.59 759.29 m 230.59 665.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 582.86 759.29 m 582.86 665.82 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.2 742.03 Tm (Document Purpose:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 742.03 Tm (Inspection Report)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 719.2 Tm (Author:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 719.2 Tm (Care Quality Commission)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 696.37 Tm (Audience:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 696.37 Tm (General Public)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 673.54 Tm (Further copies from:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 673.54 Tm (0870 240 7535)Tj ET /F1 12 Tf BT 1 0 0 1 335.41 673.54 Tm (\(telephone order line\))Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 652.59 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 638.01 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 623.42 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 78.9 w 25.8 581.46 m 563.3 581.46 l S 0.001 w /F1 12 Tf BT 1 0 0 1 34.05 605.84 Tm (Our duty to regulate social care services is set out in the Care Standards Act 2000.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 591.27 Tm (Copies of the National Minimum Standards )Tj ET /F1 12 Tf BT 1 0 0 1 303.94 591.27 Tm (Care Homes for Older People can be )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 576.68 Tm (found at www.dh.gov.uk or got from The Stationery Office \(TSO\) PO Box 29, St )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 562.1 Tm (Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 547.53 Tm (the Stationery Office is also available: www.tso.co.uk/bookshop)Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 526.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 509.36 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 494.79 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 480.2 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 34.16 w 25.8 460.61 m 563.3 460.61 l S 0.001 w /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 455.08 Tm (Helpline:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 420.92 Tm (Telephone:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 147.95 420.92 Tm (03000 616161)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 389.27 Tm (Email:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 99.55 389.27 Tm (enquiries@cqc.org.uk)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 357.61 Tm (Web: )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 88.63 357.61 Tm (www.cqc.org.uk)Tj ET /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 327.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 299.21 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 28.35 276.5 Tm (We want people to be able to access this information. If you would like a summary in a )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 259 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F1 18 Tf BT 1 0 0 1 28.35 232.98 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 210.26 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be reproduced )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 192.76 Tm (in whole or in part, free of charge, in any format or medium provided that it is not used for )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 175.27 Tm (commercial gain. This consent is subject to the material being reproduced accurately and )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 157.77 Tm (on proviso that it is not used in a derogatory manner or misleading context. The material )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 140.28 Tm (should be acknowledged as CQC copyright, with the title and date of publication of the )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 122.78 Tm (document specified.)Tj ET endstream endobj 42 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 43 0 obj <>stream %!PS-AdobeFont-1.0: Verdana Typeface and data 1996 Microsoft Corporation. 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. 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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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