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We )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 769.53 Tm (believe high quality care should)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 749.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 749.53 Tm (Be safe)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 733.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 733.53 Tm (Have the right outcomes, including clinical outcomes)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 717.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 717.53 Tm (Be a good experience for the people that use it)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 701.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 701.53 Tm (Help prevent illness, and promote healthy, independent living)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 685.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 685.53 Tm (Be available to those who need it when they need it.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 651.03 Tm (The first part of the review gives the overall quality rating for the )Tj ET /F2 12 Tf BT 1 0 0 1 427.6 651.03 Tm (care home:)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 631.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 631.04 Tm (3 stars - excellent)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 615.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 615.04 Tm (2 stars - good)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 599.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 599.04 Tm (1 star - adequate)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 583.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 583.04 Tm (0 star - poor)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 551.04 Tm (There is also a bar chart that gives a quick way of seeing the quality of care that the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 534.04 Tm (home provides under key areas that matter to people.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 500.04 Tm (There is a summary of what we think this service does well, what they have improved )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 483.04 Tm (on and, where it applies, what they need to do better.)Tj ET /F2 12 Tf BT 1 0 0 1 364.74 483.04 Tm (We use the national minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 466.04 Tm (standards to describe the outcomes that people should experience.)Tj ET /F2 12 Tf BT 1 0 0 1 443.2 466.04 Tm (National minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 449.04 Tm (standards are written by the Department of Health for each type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 409.54 Tm (After the summary there is more detail about our findings. The following table explains )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 392.05 Tm (what you will see under each outcome area.)Tj ET [] 0 d 0.5 w 0 0 0 RG 22.69 383.86 m 572.15 383.86 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.69 50.22 m 572.15 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.7 383.86 m 22.7 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 572.15 383.86 m 572.15 50.22 l S 0.001 w [] 0 d /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 370.56 Tm (Outcome area \(for example )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 173.59 370.56 Tm (Choice of home\))Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 340.26 Tm (These are the outcomes that people )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 216.34 340.26 Tm (staying in care homes should experience.)Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 435.79 340.26 Tm (They reflect the things )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 328.11 Tm (that people have said are important to them:)Tj ET 0 0 0 RG 0.001 w 0 Tr 1 0.9451 0.76078 RG 82.23 w 30.6 263.37 m 562.45 263.37 l S 0.001 w 0.95294 0.95294 0.95294 RG 39.99 w 29.47 285.61 m 563.57 285.61 l S 0.001 w 1 1 1 RG 39.99 w 29.47 243.37 m 563.57 243.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 306.73 m 565.77 306.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 222.25 m 565.77 222.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 307.81 m 28.35 221.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 307.81 m 564.7 221.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 291.05 Tm (This box tells you the outcomes that we will always inspect against when we do a key )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 273.55 Tm (inspection)Tj ET /F2 10 Tf BT 1 0 0 1 95.78 273.55 Tm (.)Tj ET /F2 12 Tf BT 1 0 0 1 34.87 248.81 Tm (This box tells you any additional outcomes that we may inspect against when we do a )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 231.31 Tm (key inspection.)Tj ET /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 191.8 Tm (This is what people )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 131.32 191.8 Tm (staying in this care home experience:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 154.64 Tm (Judgement:)Tj ET 1 0.9451 0.76078 RG 39.99 w 30.6 123.34 m 562.45 123.34 l S 0.001 w 1 1 1 RG 39.99 w 29.47 124.46 m 563.57 124.46 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 145.58 m 565.77 145.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 103.34 m 565.77 103.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 146.66 m 28.35 102.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 146.66 m 564.7 102.26 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 129.9 Tm (This box tells you our opinion of what we have looked at in this outcome area.)Tj ET /F2 12 Tf BT 1 0 0 1 517.79 129.9 Tm (We )Tj ET /F2 12 Tf BT 1 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30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (3)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (39)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 779.1 Tm (We review the quality of the service against outcomes from the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 762.1 Tm (Standards \(NMS\).)Tj ET /F2 12 Tf BT 1 0 0 1 144.87 762.1 Tm (Those standards are written by the Department of Health for each )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 745.1 Tm (type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 705.6 Tm (Copies of the)Tj ET /F2 12 Tf BT 1 0 0 1 111.71 705.6 Tm (National Minimum Standards )Tj ET /F2 12 Tf BT 1 0 0 1 290.49 705.6 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 302.34 705.6 Tm (Care Homes for Older People)Tj ET /F2 12 Tf BT 1 0 0 1 477.18 705.6 Tm ( can be found )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 688.11 Tm (at www.dh.gov.uk or bought from The Stationery Office \(TSO\) PO Box 29, St Crispins, )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 670.61 Tm (Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 653.11 Tm (Stationery Office is also available: )Tj ET /F2 12 Tf 0 0 1 rg BT 1 0 0 1 238.73 653.11 Tm (www.tso.co.uk/bookshop)Tj ET /F2 12 Tf 0 0 0 rg BT 1 0 0 1 28.35 613.12 Tm (The mission of the Care Quality Commission is to make care better for people by:)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 596.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 596.12 Tm (Regulating health and adult social care services to ensure quality and safety )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 580.12 Tm (standards, drive improvement and stamp out bad practice)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 564.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 564.12 Tm (Protecting the rights of people who use services, particularly the most )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 548.12 Tm (vulnerable and those detained under the Mental Health Act 1983)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 532.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 532.12 Tm (Providing accessible, trustworthy information on the quality of care and )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 516.12 Tm (services so people can make better decisions about their care and so that )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 500.12 Tm (commissioners and providers of services can improve services.)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 484.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 484.12 Tm (Providing independent public accountability on how commissioners and )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 468.12 Tm (providers of services are improving the quality of care and providing value )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 452.12 Tm (for money.)Tj ET /F1 14 Tf BT 1 0 0 1 28.35 390.28 Tm (5HDGHU,QIRUPDWLRQ)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 28.35 368.85 m 224.05 368.85 l S 0.001 w 1 1 1 RG 20.58 w 226.3 368.85 m 567 368.85 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 346.02 m 224.05 346.02 l S 0.001 w 1 1 1 RG 20.58 w 226.3 346.02 m 567 346.02 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 323.19 m 224.05 323.19 l S 0.001 w 1 1 1 RG 20.58 w 226.3 323.19 m 567 323.19 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 300.36 m 224.05 300.36 l S 0.001 w 1 1 1 RG 20.58 w 226.3 300.36 m 567 300.36 l S 0.001 w 0.95294 0.95294 0.95294 RG 137.22 w 28.35 219.21 m 224.05 219.21 l S 0.001 w 1 1 1 RG 137.22 w 226.3 219.21 m 567 219.21 l S 0.001 w 0.95294 0.95294 0.95294 RG 38.16 w 28.35 129.27 m 224.05 129.27 l S 0.001 w 1 1 1 RG 38.16 w 226.3 129.27 m 567 129.27 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 149.47 m 569.2 149.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 380.26 m 569.2 380.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 149.47 m 569.2 149.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 109.06 m 569.2 109.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 381.34 m 27.22 107.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 225.17 381.34 m 225.17 107.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 568.12 381.34 m 568.12 107.99 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 31.2 364.08 Tm (Document Purpose)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 364.08 Tm (Inspection report)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 341.25 Tm (Author)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 341.25 Tm (Care Quality Commission)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 318.42 Tm (Audience)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 318.42 Tm (General public)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 295.59 Tm (Further copies from)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 295.59 Tm (0870 240 7535 \(telephone order line\))Tj ET /F2 12 Tf BT 1 0 0 1 31.2 272.76 Tm (Copyright)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 272.76 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 258.18 Tm (This publication may be reproduced in whole or in part, )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 243.6 Tm (free of charge, in any format or medium provided that )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 229.02 Tm (it is not used for commercial gain. This consent is )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 214.44 Tm (subject to the material being reproduced accurately )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 199.86 Tm (and on proviso that it is not used in a derogatory )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 185.28 Tm (manner or misleading context. The material should be )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 170.7 Tm (acknowledged as CQC copyright, with the title and date )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 156.12 Tm (of publication of the document specified.)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 133.29 Tm (Internet address)Tj ET /F2 12 Tf 1 0 0 rg BT 1 0 0 1 229.15 133.29 Tm (www.cqc.org.uk)Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 15 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (4)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (39)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm 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28.99 664.4 m 567.85 664.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 641.57 m 567.85 641.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 618.74 m 567.85 618.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 785.63 m 567.85 785.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 762.8 m 567.85 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 687.23 m 567.85 687.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 664.4 m 567.85 664.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 641.57 m 567.85 641.57 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 618.74 m 567.85 618.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 595.91 m 567.85 595.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 786.71 m 30.07 594.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 269.07 786.71 m 269.07 594.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.77 786.71 m 566.77 594.84 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 769.45 Tm (Name of care home:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 769.45 Tm (West Abbey House)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 746.62 Tm (Address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 746.62 Tm (Stourton Way )Tj ET /F2 12 Tf BT 1 0 0 1 273.05 729.04 Tm (Yeovil)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 711.46 Tm (Somerset)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 693.88 Tm (BA21 3UA)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 671.05 Tm (Telephone number:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 671.05 Tm (01935411136)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 648.22 Tm (Fax number:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 648.22 Tm (01935420829)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 625.39 Tm (Email address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 625.39 Tm (westabbey@barchester.net)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 602.56 Tm (Provider web address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 602.56 Tm (www.barchester.com)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 583.61 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 540.17 m 564.77 540.17 l S 0.001 w 1 1 1 RG 20.58 w 355.5 564.12 m 565.9 564.12 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 541.29 m 353.25 541.29 l S 0.001 w 1 1 1 RG 20.58 w 355.5 541.29 m 565.9 541.29 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 518.46 m 353.25 518.46 l S 0.001 w 1 1 1 RG 20.58 w 355.5 518.46 m 565.9 518.46 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 552.71 m 568.1 552.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 529.88 m 568.1 529.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 575.54 m 568.1 575.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 552.71 m 568.1 552.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 529.88 m 568.1 529.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 507.05 m 568.1 507.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 576.61 m 30.07 505.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 576.61 m 354.37 505.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 576.61 m 567.02 505.97 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 559.35 Tm (Name of registered provider\(s\):)Tj ET /F2 12 Tf BT 1 0 0 1 355.5 559.35 Tm (Barchester Healthcare Homes Ltd)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 536.52 Tm (Type of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 536.52 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 513.69 Tm (Number of places registered:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 513.69 Tm (97)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 494.75 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 28.35 477.75 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 63.99 w 32.32 435.43 m 564.47 435.43 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 446.84 m 567.8 446.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 469.67 m 567.8 469.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 446.84 m 567.8 446.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 403.43 m 567.8 403.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 470.75 m 30.07 402.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 447.92 m 298.32 402.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 470.75 m 566.72 402.36 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 453.49 Tm (Conditions of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 430.66 Tm (Category\(ies\) :)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 430.66 Tm (Number of places \(if applicable\):)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 410.08 Tm (Under 65)Tj ET /F2 12 Tf BT 1 0 0 1 435.37 410.08 Tm (Over 65)Tj ET 1 1 1 RG 20.58 w 31.2 388.64 m 297.3 388.64 l S 0.001 w 20.58 w 299.55 388.64 m 431.45 388.64 l S 0.001 w 20.58 w 433.7 388.64 m 565.6 388.64 l S 0.001 w 35.16 w 31.2 358.52 m 297.3 358.52 l S 0.001 w 35.16 w 299.55 358.52 m 431.45 358.52 l S 0.001 w 35.16 w 433.7 358.52 m 565.6 358.52 l S 0.001 w 20.58 w 31.2 328.4 m 297.3 328.4 l S 0.001 w 20.58 w 299.55 328.4 m 431.45 328.4 l S 0.001 w 20.58 w 433.7 328.4 m 565.6 328.4 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 305.57 m 565.6 305.57 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 377.23 m 567.8 377.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 339.82 m 567.8 339.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 316.99 m 567.8 316.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 294.16 m 567.8 294.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 271.33 m 568.1 271.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 400.06 m 567.8 400.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 377.23 m 567.8 377.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 339.82 m 567.8 339.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 316.99 m 567.8 316.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 294.16 m 568.1 294.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 271.33 m 568.1 271.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 190.18 m 568.1 190.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 401.13 m 30.07 189.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.42 401.13 m 298.42 315.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.57 401.13 m 432.57 315.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 401.13 m 566.72 189.1 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 383.87 Tm (dementia)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 383.87 Tm (32)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 383.87 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 361.04 Tm (old age, not falling within any other )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 346.46 Tm (category)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 361.04 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 361.04 Tm (55)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 323.63 Tm (physical disability)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 323.63 Tm (10)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 323.63 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 300.8 Tm (Additional conditions: )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 277.97 Tm (The maximum number of service users who can be accommodated is 97.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 255.14 Tm (The registered person may provide the following category of service: Care home with )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 240.56 Tm (nursing - Code N to service users of either gender whose primary care needs on )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 225.98 Tm (admission to the home are within the following categories: Dementia \(Code DE\) )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 211.4 Tm (maximum of 32 places Physical disability \(Code PD\) maximum of 10 places Old age, )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 196.82 Tm (not falling within any other category \( Code OP \) maximum of 55 places)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 175.39 m 315.25 175.39 l S 0.001 w 1 1 1 RG 20.58 w 317.5 175.39 m 346.55 175.39 l S 0.001 w 20.58 w 348.8 175.39 m 377.9 175.39 l S 0.001 w 20.58 w 380.15 175.39 m 409.2 175.39 l S 0.001 w 20.58 w 411.45 175.39 m 440.55 175.39 l S 0.001 w 20.58 w 442.8 175.39 m 471.9 175.39 l S 0.001 w 20.58 w 474.15 175.39 m 503.2 175.39 l S 0.001 w 20.58 w 505.45 175.39 m 534.55 175.39 l S 0.001 w 20.58 w 536.8 175.39 m 565.9 175.39 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 186.8 m 568.1 186.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 163.97 m 568.1 163.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 187.88 m 30.07 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 187.88 m 316.37 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 187.88 m 347.67 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 187.88 m 379.02 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 187.88 m 410.32 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 187.88 m 441.67 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 187.88 m 473.02 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 187.88 m 504.32 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 187.88 m 535.67 162.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 187.88 m 567.02 162.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 170.62 Tm (Date of last inspection)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 152.1 m 565.9 152.1 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 142.47 m 568.1 142.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 143.55 m 30.07 39.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 143.55 m 567.02 39.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 161.72 m 568.1 161.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 142.47 m 568.1 142.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 40.22 m 568.1 40.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 162.8 m 30.07 141.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 162.8 m 567.02 141.4 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 148.54 Tm (Brief description of the )Tj ET /F2 12 Tf BT 1 0 0 1 177.31 148.54 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 129.29 Tm (West Abbey is located in a residential area on the outskirts of Yeovil. It was purpose )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 112.29 Tm (built as a nursing home in 1994.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 95.29 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 78.29 Tm (In the main building is a 66-bedded unit for service users requiring general nursing )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 61.29 Tm (care and this is located on two floors. There is one 13-person lift to the first floor. The )Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 17 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (5)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (39)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 804.03 m 565.9 804.03 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 794.4 m 568.1 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 795.48 m 30.07 604.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 795.48 m 567.02 604.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.1 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 794.4 m 568.1 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 605.15 m 568.1 605.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 793.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 814.73 m 567.02 793.33 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 800.47 Tm (Brief description of the )Tj ET /F2 12 Tf BT 1 0 0 1 177.31 800.47 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 33.25 783.47 Tm (corridors are wide and can accommodate people who mobilise using a wheelchair. The )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 766.47 Tm (home has accessible and pleasant garden areas.)Tj ET /F2 12 Tf BT 1 0 0 1 33.25 749.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 732.47 Tm (The majority of the service users in the main wing are older people. The home is also )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 715.47 Tm (registered to take up to 10 younger people \(18-65\).)Tj ET /F2 12 Tf BT 1 0 0 1 33.25 698.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 681.47 Tm (In a separate wing there is a single storey 28 bedded unit \(Lyde\) for older people with )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 664.47 Tm (mental health needs. The Lyde unit has it's own central courtyard garden.)Tj ET /F2 12 Tf BT 1 0 0 1 33.25 647.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 630.47 Tm (The home's current fees are 550 per week plus free nursing care,and for younger )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 613.47 Tm (people fees are in line with their individual care needs assessment.)Tj ET endstream endobj 18 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 19 0 obj <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Length 534/Matrix [1 0 0 1 0 0]>>stream xn0 ~ K&R%7+S6P4n"] C%E)3 ZJ+h05yJdYmp7 lI{v$uW÷fMɈD!RX}ʚS&{=xi}%jBkvkjOϚ]UZiM`'A|j`7(|V?c_"̊lZvxS+ZNNUuGю9FH^|x;:'-J^)dT/;R%gĪd 1tɶ1Jv^pҲQ0{sd\'rsTfUQvX=tnth6]];i>|/(&7 ތû_q:_LJb,ޚUn%/W95|GO<3k,b}f`_E Pvq٣jEoGrέm\bY+Y_vgk3̃a endstream endobj 20 0 obj<> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm (6XPPDU\\)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 774.7 Tm (This is an overview of what we found during the inspection.)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 754.22 m 381.05 754.22 l S 0.001 w 1 1 1 RG 20.58 w 383.3 754.22 m 566.2 754.22 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 765.64 m 568.4 765.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.81 m 568.4 742.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 766.71 m 30.07 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 382.17 766.71 m 382.17 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 766.71 m 567.32 741.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 749.45 Tm (The quality rating for this )Tj ET /F2 12 Tf BT 1 0 0 1 191.92 749.45 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 255.59 749.45 Tm ( is:)Tj ET /F2 12 Tf BT 1 0 0 1 410.5 749.45 Tm (zero star poor service)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 717.31 Tm (2XUMXGJHPHQWIRUHDFKRXWFRPH)Tj ET /F2 10 Tf BT 1 0 0 1 212.29 641.27 Tm (Choice of home)Tj ET /F2 10 Tf BT 1 0 0 1 164.41 601.02 Tm (Health and personal care)Tj ET /F2 10 Tf BT 1 0 0 1 145.18 560.77 Tm (Daily life and social activities)Tj ET /F2 10 Tf BT 1 0 0 1 157.95 520.52 Tm (Complaints and protection)Tj ET /F2 10 Tf BT 1 0 0 1 226.36 480.27 Tm (Environment)Tj ET /F2 10 Tf BT 1 0 0 1 251.17 440.02 Tm (Staffing)Tj ET /F2 10 Tf BT 1 0 0 1 127.47 399.77 Tm (Management and administration)Tj ET q 0.75227 0 0 0.75161 305.05 334.32 cm /Xf1 Do Q 1 1 1 RG 20.58 w 31.2 283.08 m 567.85 283.08 l S 0.001 w 206.51 w 32.32 167.28 m 566.72 167.28 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 271.66 m 567.85 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 271.66 m 568.92 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 62.9 m 568.92 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 272.74 m 31.2 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 272.74 m 567.85 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 278.3 Tm (How we did our inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 35.17 255.48 Tm (This Key unannounced inspection was carried out over two days by two inspectors. The )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 240.9 Tm (Manager was available on the day of the inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 226.32 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 211.74 Tm (The inspector would like to thank the manager and the duty staff for their time and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 197.15 Tm (hospitality shown to the inspector during their visit.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 182.57 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 167.99 Tm (The home last had a Key inspection in 2008 and an Annual Service Review was )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 153.41 Tm (completed January 2009. At this time the home was assessed a two stars "good".)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 138.84 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 124.25 Tm (This inspection was conducted in response to a number of concerns that have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 109.68 Tm (raised to us and to Somerset County Council. As a result of these concerns we have )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 95.1 Tm (bought forward the key inspection. Due to the timescales of this inspection, surveys )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 80.51 Tm (were not sent out to people living at the home, relatives, staff or healthcare )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 65.93 Tm (professionals. The home last completed an annual quality assurance assessment )Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 23 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 338.34 w 32.32 643.36 m 566.72 643.36 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.12 813.65 m 568.92 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 473.06 m 568.92 473.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 814.73 m 31.2 471.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 814.73 m 567.85 471.99 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 32.92 802.72 Tm (\(AQAA\) in January 2009. Surveys were received at this time from staff who work at the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 788.14 Tm (home.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 773.56 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 758.98 Tm (The concerns raised with us will be investigated under the Somerset Safeguarding )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 744.4 Tm (policy and procedures. We will share the findings of this inspection with Somerset )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 729.82 Tm (County Council under the information sharing policy.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 715.24 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 700.66 Tm (The focus of this inspection visit was to inspect relevant key standards under the CQC )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 686.08 Tm (Inspecting for Better Lives 2 framework. This focuses on outcomes for service users )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 671.5 Tm (and measures the quality of the service under four general headings. These are: )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 656.92 Tm (excellent, good, adequate and poor. These judgment descriptors for the seven chapter )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 642.34 Tm (outcome groups are given in the report.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 627.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 613.18 Tm (Records examined during the inspection were care and support plans as part of the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 598.6 Tm (case tracking process, medication administration records, staffing rosters, menus, the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 584.02 Tm (home's complaint's file, staff recruitment files, staff training records and staff )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 569.44 Tm (supervision records. We also conducted a tour of the premises.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 554.86 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 540.28 Tm (The quality rating for this service is 0 star. This means the people who use this service )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 525.7 Tm (experience poor quality outcomes.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 511.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 496.54 Tm (The following is a summary of the inspection findings and should be read in conjunction )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 481.96 Tm (with the whole of the report.)Tj ET endstream endobj 24 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 25 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 20.58 w 31.2 786.36 m 567.85 786.36 l S 0.001 w 210.12 w 32.32 668.76 m 566.72 668.76 l S 0.001 w 20.58 w 32.7 551.16 m 569.35 551.16 l S 0.001 w 35.16 w 33.82 521.04 m 568.22 521.04 l S 0.001 w 20.58 w 33.45 490.92 m 570.1 490.92 l S 0.001 w 414.36 w 34.57 271.2 m 568.97 271.2 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 774.95 m 567.85 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 774.95 m 568.92 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 562.58 m 568.92 562.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 776.03 m 31.2 561.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 562.58 m 569.35 562.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 539.75 m 569.35 539.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 539.75 m 570.42 539.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 502.34 m 570.42 502.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 479.51 m 570.1 479.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 502.34 m 570.1 502.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 479.51 m 571.17 479.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 62.9 m 571.17 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 540.83 m 32.7 501.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 480.59 m 33.45 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 776.03 m 567.85 561.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 569.35 540.83 m 569.35 501.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 480.59 m 570.1 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 781.59 Tm (What the )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 90.52 781.59 Tm (care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 154.2 781.59 Tm ( does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 567.85 784.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.76 Tm (During the Annual service review which was conducted in January 2009 Surveys were )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.18 Tm (taken to the home for distribution. We received comments from staff in all )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.6 Tm (departments. Their feedback indicated that pre employment checks are undertaken )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.02 Tm (before people come to work at the home. Staff indicated that they receive a tailored )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.44 Tm (induction to the role they will hold and have on going training. Staff indicated that very )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 685.86 Tm (specific training requested is not always delivered. Staff said they work well in teams )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.28 Tm (and offer and deliver a good standard care at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.12 Tm (The home is light and airy with wide corridors. The home, on the whole, was clean and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.54 Tm (tidy . People are able to bring in furniture and personal belongings to personalise their )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 612.96 Tm (private room.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.38 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 583.8 Tm (Resident and staff meetings have been held)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 569.22 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 568.97 667.21 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 549.05 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 32.7 546.39 Tm (What has improved since the last inspection?)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 569.35 549.61 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 519.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 523.56 Tm (At the last inspection a number of requirements were made. These have yet to be )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 508.98 Tm (addressed by the management team and remain outstanding at this inspection. )Tj ET /F2 10 Tf BT 1 0 0 1 570.47 519.49 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 489.37 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 33.45 486.15 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 31.2 269.65 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 463.32 Tm (A number of issues were identified during this inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 448.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 434.16 Tm (The care planning process needs to be developed to ensure that it adequately reflects )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 419.58 Tm (the current care needs of the people living at the home. This should include ensuring )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 405 Tm (that risk assessments are up to date. Consideration needs to be given to developing a )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 390.42 Tm (risk assessment for ingestion of chemicals)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 375.84 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 361.26 Tm (The management need to ensure that the health care needs of people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 346.68 Tm (home are met in all areas. This includes a regular change of position to prevent )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 332.1 Tm (pressure damage to skin, regular oral hygiene and access to fluids and a nurse call )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 317.52 Tm (bell. Medication is not well managed.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 302.94 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 288.36 Tm (Meals and mealtimes need to more organized to ensure that these are a pleasant )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 273.78 Tm (experience for all and that people living at the home receive adequate diet and fluids.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 259.2 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 244.62 Tm (The management need to consider increasing the social and recreational opportunities )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 230.04 Tm (at the home particularly for those with dementia. The staff need to ensure that they )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 215.46 Tm (engage and interact with people living at the home. A large number of people were )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 200.88 Tm (nursed in bed. The majority of these people did not have access to music or television. )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 186.3 Tm (Due to this the days must seem very long and unstimulated. The staff must consider )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 171.72 Tm (the social stimulation of people in these circumstances.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 157.14 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 142.56 Tm (The privacy and dignity of people living at the home is not always maintained. through )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 127.98 Tm (lack of screening on doors, double rooms and by the institutional practices of staff.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 113.4 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 98.82 Tm (During the tour of the building it was identified that some areas had a very strong )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 84.24 Tm (malodour smell. The management need to review this as a matter of urgency)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 69.66 Tm ()Tj ET endstream endobj 26 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 27 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 192.54 w 34.57 716.26 m 568.97 716.26 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 32.37 813.65 m 571.17 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 618.86 m 571.17 618.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 814.73 m 33.45 617.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 814.73 m 570.1 617.79 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.17 802.72 Tm (The health and safety of people living at the home may be compromised by poor )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 788.14 Tm (systems with regard to moving and handling and pushing people in wheelchairs without )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 773.56 Tm (footplate's. The care plans seen did not contain enough detail in this area. This now )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.98 Tm (requires urgent attention.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.4 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.82 Tm (People at the home were at risk of the ingestion of chemicals such as toiletries. These )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.24 Tm (were not securely stored for periods during the inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.66 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 686.08 Tm (Staffing levels need to be reviewed in line with the dependency of people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.5 Tm (home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.92 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.34 Tm (The management need to ensure that they inform us of all incidents in line with )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.76 Tm (Regulation 37 of the Care Home Regulations 2000 )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 604.3 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 584.31 Tm (If you want to know what action the person responsible for this )Tj ET /F2 12 Tf BT 1 0 0 1 416.37 584.31 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 480.04 584.31 Tm ( is taking )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 566.81 Tm (following this report, you can contact them using the details on page 4.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.82 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 526.82 Tm (The report of this inspection is available from our website )Tj ET /F2 12 Tf BT 1 0 0 1 380.85 526.82 Tm (www.cqc.org.uk.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 506.82 Tm (You can get printed copies from )Tj ET /F2 12 Tf BT 1 0 0 1 225.22 506.82 Tm (enquiries@cqc.org.uk or by telephoning our)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 486.83 Tm (order line 0870 240 7535.)Tj ET endstream endobj 28 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 29 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 777.09 Tm (Details of our findings)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 26 w 31.2 744.15 m 565.9 744.15 l S 0.001 w /F1 12 Tf BT 1 0 0 1 34.05 741.14 Tm (&RQWHQWV)Tj ET 1 1 1 RG 16 w 28.35 700.15 m 566.93 700.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 696.09 Tm (Choice of home \(standards 1 - 6\))Tj ET 16 w 28.35 678.15 m 566.93 678.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 674.09 Tm (Health and personal care \(standards 7 - 11\))Tj ET 16 w 28.35 656.15 m 566.93 656.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 652.09 Tm (Daily life and social activities \(standards 12 - 15\))Tj ET 16 w 28.35 634.15 m 566.93 634.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 630.09 Tm (Complaints and protection \(standards 16 - 18\))Tj ET 16 w 28.35 612.15 m 566.93 612.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 608.09 Tm (Environment \(standards 19 - 26\))Tj ET 16 w 28.35 590.15 m 566.93 590.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 586.09 Tm (Staffing \(standards 27 - 30\))Tj ET 16 w 28.35 568.15 m 566.93 568.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 564.09 Tm (Management and administration \(standards 31 - 38\))Tj ET /F2 12 Tf BT 1 0 0 1 28.35 544.09 Tm (Outstanding statutory requirements)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 522.22 Tm (Requirements and recommendations from this inspection)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 33 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (11)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Choice of home )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 206.25 w 32.32 610.38 m 562.53 610.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 119 w 31.2 567.88 m 563.65 567.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 507.25 m 565.85 507.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 506.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 506.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People are confident that the care home can support them. This is because there is an )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (accurate assessment of their needs that they, or people close to them, have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (involved in. This tells the home all about them and the support they need. People who )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (stay at the home only for intermediate care, have a clear assessment that includes a )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (plan on what they hope for and want to achieve when they return home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People can decide whether the care home can meet their support and accommodation )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (needs. This is because they, or people close to them, have been able to visit the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and have got full, clear, accurate and up to date information about the home. If they )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (decide to stay in the home they know about their rights and responsibilities because )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (there is an easy to understand contract or statement of terms and conditions between )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (them and the care home that includes how much they will pay and what the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 513.32 Tm (provides for the money.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 489 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 467 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 467 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 444.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 386.74 m 562.54 386.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 431.17 m 564.79 431.17 l S 0.001 w 84.36 w 33.47 375.5 m 563.66 375.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 418.8 m 565.87 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 419.88 m 32.35 331.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 419.88 m 564.79 331.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 418.8 m 564.79 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 332.19 m 565.87 332.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 427.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 403.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 403.12 Tm (good)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 403.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 385.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.75 Tm (Pre admission assessments are made to assess that care needs can be met at West )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 341.25 Tm (Abbey before an admission to the home is accepted. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 316.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 224.3 w 34.6 194.17 m 562.54 194.17 l S 0.001 w 1 1 1 RG 22.5 w 32.35 297.32 m 564.79 297.32 l S 0.001 w 202.93 w 33.47 182.36 m 563.66 182.36 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 284.95 m 565.87 284.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 286.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 286.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 284.95 m 564.79 284.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 294.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 269.27 Tm (The standards under this outcome area were not assessed on this ocassion. At the last )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 251.77 Tm (key inspection which was conducted in January 2008 it was reported that "Care plans )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 234.27 Tm (were sampled including one recent admission to the home. The homes manager had )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.78 Tm (undertaken a pre admission assessment. Details were taken from the hospital about )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 199.28 Tm (the person's health and well being and risks to their health. The community single )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.79 Tm (assessment document \(SAP\) had been received at the home to inform the pre )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 164.29 Tm (admission assessment.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.79 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 129.3 Tm (Identified risks had been assessed and the care planning detailed measures to monitor )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.8 Tm (and reduce these risks.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 94.31 Tm ()Tj ET endstream endobj 35 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 36 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (12)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 266.32 w 34.6 678.25 m 562.54 678.25 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 244.94 w 33.47 666.44 m 563.66 666.44 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 541.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 541.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 542.84 m 565.87 542.84 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (The commission had received a copy of the homes pack 'Resident's terms and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (conditions', a Barchester company wide document that is very detailed. There is a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm ('Residents admission agreement' in this which gives a clear indication of admission )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (service detail, costs, method of payment and is signed as an agreement either by the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (resident or other person responsible for the payment of fees, when the place is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (accepted.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (One relative spoken with confirmed having visited the home to look around before )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (making this their choice.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (Contracts were sampled, one identified a pre admission assessment, it was not clear )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (that this person who was funded by a county council had received terms and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (conditions of residency. One other had the 'resident's admission agreement' with the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (breakdown of the funding and payment arrangements.")Tj ET endstream endobj 37 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 38 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Health and personal care )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 172.25 w 32.32 627.38 m 562.53 627.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 102 w 31.2 663.63 m 563.65 663.63 l S 0.001 w 1 1 1 RG 68 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 541.25 m 565.85 541.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 540.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 540.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Peoples health, personal and social care needs are met. The home has a plan of care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (that the person, or someone close to them, has been involved in making. If they take )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (medicine, they manage it themselves if they can. If they cannot manage their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (medicine, the care home supports them with it, in a safe way. Peoples right to privacy )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (is respected and the support they get from staff is given in a way that maintains their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (dignity.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (If people are approaching the end of their life, the care home will respect their choices )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and help them feel comfortable and secure. They, and people close to them, are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (reassured that their death will be handled with sensitivity, dignity and respect, and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (take account of their spiritual and cultural wishes. )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 523 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 501 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 501 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 478.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 211.83 w 34.6 368.26 m 562.54 368.26 l S 0.001 w 1 1 1 RG 22.5 w 32.35 465.17 m 564.79 465.17 l S 0.001 w 189.33 w 33.47 357.01 m 563.66 357.01 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 452.8 m 565.87 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 453.88 m 32.35 260.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 453.88 m 564.79 260.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 452.8 m 564.79 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 261.22 m 565.87 261.22 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 461.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 437.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 437.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 437.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 419.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 392.75 Tm (The care planning process needs to be developed to ensure that they reflect the care )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.25 Tm (needs of people living at the home and give clear guidance to staff.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 357.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 340.26 Tm (The staff need to ensure that all aspects of peoples health and hygiene needs are met. )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 322.77 Tm (This should include regular access to fluids, oral hygiene and a regular change of )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 305.27 Tm (position .)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 287.77 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 270.28 Tm (Medication is not well managed)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 245.53 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 153.32 w 34.6 158.69 m 562.54 158.69 l S 0.001 w 1 1 1 RG 22.5 w 32.35 226.35 m 564.79 226.35 l S 0.001 w 131.95 w 33.47 146.88 m 563.66 146.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 213.98 m 565.87 213.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 215.05 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 215.05 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 213.98 m 564.79 213.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 223.04 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.29 Tm (During the inspection we reviewed the care notes of four people who live in the area )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 180.79 Tm (providing dementia care , the care notes for three people with general nursing needs )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.3 Tm (and the care notes for two younger people. We case tracked a number of these people )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 145.8 Tm (during the inspection. Case tracking involves identifying individuals at the beginning of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.31 Tm (the inspection and comparing the care and support they receive with the needs )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 110.81 Tm (identified in the care plan. In addition we also viewed the bedrooms of a number of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.31 Tm (people living at the home.)Tj ET endstream endobj 39 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 40 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (14)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (It was very clear that in the majority of the assessments and associated care plans )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (that had been completed did not contain adequate information to give clear guidance )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (to the staff on the current needs of the people living at the home. A number of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (assessments that had been completed had not been reviewed and no longer reflected )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (the current care needs of the individual. For example one person living at the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (had been in hospital resulting in a significant change to his mobility requirements. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (falls risk assessment had been completed by staff in November 2008. This assessment )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (stated that the individual was fully mobile and was able to walk. When we reviewed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (this individual it was very clear that this was no longer the case. A moving and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (handling assessment had been completed in July 2009. This assessment did not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (clearly demonstrate the individuals change in condition nor the changes to the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (equipment required to safely help the individual transfer or change position. This lack )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (of information may have placed both the individual and staff at risk. It is particularly )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (important for new staff and those who come to work at the home from an agency that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (they have relevant and up to date information in the care plans.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (A waterlow assessment \(to assess the risk of pressure damage caused by staying in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (one place for too long\) had been completed in July 2009. This stated that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (individual was at high risk of sustaining pressure damage. The associated care plan )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (\(that had been reviewed by staff in July 2009\) however contradicted this information )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (stating that the waterlow score was only 8. The care plan stated that equipment was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (in use to help in the prevention of pressure ulcers. On observation however the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (individual was on a different pressure relieving mattress for that stated in the care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (records.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (As a result of becoming frailer the individual had lost some weight \(9 kg in three )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (months\). Advise had been given by the dietitian with regard to this weight loss and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (staff had developed a care plan for this aspect of the the individuals care needs. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (care plan however was ambiguous and did not give clear guidance to staff. The care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (plan stated "record fluid and food intake" and "give snacks between meals". In )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (addition the plan stated "weight to be completed weekly". On viewing the care records )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (it was clear that weights had not been completed on a weekly basis. The care records )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (should also state the amounts of fluids the individual should be consuming on a daily )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (basis. The individual had received some surgery during their stay in hospital and as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (such had a wound. In order to aid healing a high protein diet would be required. A diet )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (high in calories would also be required to help prevent additional weight loss. The care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (plan should have therefore stated what snacks the staff should have being giving )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (between meals and also should make reference to ensuring that any main meals eaten )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (should have been fortified with such things as cream and butter. A nutritional risk )Tj ET endstream endobj 41 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 42 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (assessment had not been completed for this individual despite the recent weight loss. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (The completion of the risk assessment would help staff to ascertain if the actions that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (they completed were being effective and/or if they should review the care and support )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (that they are giving.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (Pressure ulcers develop when a person spends too long sitting or lying in one position. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (People who are frail or who have underlying health issues are more at risk of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (developing these ulcers. The care plan stated that this individual had developed a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (pressure ulcer. staff had developed a care plan for this however again this needs to be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (completed in more detail. The plan stated the frequency and type of wound dressing )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (to be used. The plan however did not give details of when the staff were going to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (review the effectiveness of the treatment and consider changing the dressing used.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (The care plan for another person living in the dementia care unit also showed failures )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (in the care planning process. A range of assessments had been completed but had not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (been reviewed on a monthly basis. For example a Waterlow assessment had last been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (reviewed in June 2009 \(despite being assessed as high risk\), the moving and handling )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (assessment in March 2009 and the falls risk assessment in November 2008. It was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (therefore difficult to assess if the information contained in these assessments was still )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (valid or relevant.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (A range of care plans had been developed for this individual. The person has dementia )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (and as such requires help and support with aspect of personal hygiene. The care plan )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (made no references to the individuals needs in this area. It was not clear how staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (would know how to assist or promote independence. The plan made little reference to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (the persons likes and dislikes for example how do they like their hair to e done, do )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (they like to wear makeup or a particular perfume. The plan only stated "likes to wear )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (a dress". Again this plan had not been reviewed since June 2009 and we were unable )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (to ascertain if their individual care needs had changed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (A tissue viability care plan had been developed which stated that the individuals skin )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (was intact. Although it was then clear in the plan that dressings were being applied to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (a skin tear on her leg. The care plan stated that the person was at high risk of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (developing pressure ulcers. Again th plan was not specific in this area. The plan stated )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (" check skin regularly and report any broken areas" The plan did not state how often )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (staff should check the skin and what should they be looking for. \(There are usually )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (signs a sore is going develop prior to the skin being broken\))Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (Other similar shortfalls were noted in the other care plans viewed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm ()Tj ET endstream endobj 43 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 44 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (During the inspection we observed the care and support afforded to some people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (living at the home. One person was case tracked who was nursed in bed. As )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (previously stated people who spend long periods in one position are at risk of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (developing Pressure ulcers \(sometimes called bed sores\). For the individual observed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (a positional change chart had been commenced by staff. This showed that staff had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (not supported to change position regularly. To prevent the development of pressure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (ulcers a person should be supported to change position two to three hourly. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (positional change chart was viewed for a three day period. This demonstrated that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (staff supported the individual to change position about every five hours. In one case )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (the individual had been supported to change position at 02:15 Hrs. The next change )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (of position was at 12:00 \(a period of 12 hours\). This could significantly increase the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (risk of developing pressure ulcers. On observation the individual was seen sat up in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (bed however had slid down slightly so the his feet were pressing on the end of the bed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (with his heels pressing onto the mattress. Again pressure to the heels of this type for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (a sustained period could increase the risk of the development of pressure ulcers. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (individual did not have a change of position for 5 hours on this occasion. The care plan )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (for this individual was viewed. This demonstrated that a waterlow assessment had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (been completed and the had been assessed as high risk. Staff should therefore have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (been more proactive in ensuring a regular change of position.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (The care records for some people with dementia were viewed. Again these lacked )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (detail particularly with regard to their dementia care needs. On person was identified )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (who could at times become aggressive to wards staff and other people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (home. The care plan did not state clearly the actions that staff should take in these )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (circumstances. Aids such as diversion are commonly used in caring for people with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (dementia or those showing aggressive behaviours. These were not discussed in detail )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (in the plan.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (During a tour of the building it was noted that a number of people had no toothbrush )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (or toothpaste in their rooms or that the toothpaste and brush were hard and dry. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (leads us to believe that staff had not supported people to maintain their oral hygiene. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (Dentist recommend that the most effective way of maintaining oral hygiene in frail )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (people is to use a small amount toothpaste and a toothbrush \(even if this is a child's )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (soft brush\).)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (It was also observed that the majority of individuals did not have access to fluids or a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (nurse call bell during the inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (During the first day of the inspection it was noted that one lady had not eaten her )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (lunch. The care records for this individual were viewed on the second day of the )Tj ET endstream endobj 45 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 46 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (inspection. The records showed no evidence that staff had recorded this. The care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (records also showed that the individual had some recent weight loss and so staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (should have been more vigilant in supporting and monitoring this individual.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (Medication was viewed during the inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (Lorazepam is used for the management of anxiety disorders or for the short-term )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (relief of the symptoms of anxiety. During the review of the medication it was noted )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (that one person was prescribed this medication on a "as required basis \(this is called )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (PRN\). It would be given therefore by staff when the individual was anxious. It was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (noted that on the Medication Administration Record that this was being given regularly )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (by staff. The care records including the daily reports were viewed for the period when )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (the medication had been given. The running records showed or record no incidence of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (the person appearing anxious or concerned. We could not therefore ascertain why the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (medication had been given. Giving medication in this manner contraindicates the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (Nursing and Midwifery guidelines. In addition the over use of sedation can be seen as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (abusive practice. All Nursing staff must be reminded of their responsibilities and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (accountabilities. The most common side effects associated with lorazepam are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (sedation , dizziness weakness and unsteadiness. On observation the individual in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (question looked extremely tired. He told us that he was "shattered". On viewing the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (care records that this person had had a fall on two occasion while taking the drug )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (regularly. These falls may have been caused by the over use of the medication when it )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (was not required.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (Creams and lotions are prescribed by the GP and therefore should be treated as any )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (other medication. The creams and lotions seen in the majority of people's bedrooms )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (had not been prescribed for that individual. In some cases the prescription label had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (been torn off and in other a new name had been written by hand. As creams and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (lotions are prescribed a signature is required on the Medication Administration record )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (\(MAR\) to confirm that they have been applied as per the prescription. This not seen on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (th day of the inspection visits.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (On viewing the MAR's it was evident that the prescription for one person had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (changed. It could not be confirmed who had changed this record. The change related )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (to the frequency of lactulose. In order to be effective lactulose needs to be given at )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (regular intervals. The lactulose dose had been changed to "as required" thus making )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (in ineffective.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (During the inspection it was noted that on the Lyde unit some people were supported )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (to have a bath in the afternoon. It could not be confirmed if people had chosen to )Tj ET endstream endobj 47 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 48 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 458.77 w 34.6 582.02 m 562.54 582.02 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 437.4 w 33.47 570.21 m 563.66 570.21 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 349.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 349.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 350.38 m 565.87 350.38 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (have a bath at this time. Following their baths all people were supported to dress in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (their night clothes. This was between the hours of 15:30 and 16:45. Staff need to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (consider how this impacts on people's dignity and self esteem. This situation caused at )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (least one person distress. The individual was crying to staff "I want to get dressed, I )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (will get a cold dressed like this" staff told the individual that her "clothes were in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (wash so she could not get dressed". This does not respect the rights of people living at )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (the home as an individual. People with dementia sometimes have difficulty in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (orientating themselves to the time of day. Getting dressed in night clothes in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (afternoon may exacerbate this for some people.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (during the inspection it was noted that some of the rooms are shared. In two of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (double rooms seen screening between the beds was inadequate. In one room no )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (screening was available. In the other both occupants were being nursed in bed. For )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (one person in this room the bed clothes had fallen revealing the bottom part of her )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (body. Screening in the form of a mobile curtain was available but this had not been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (put in place by the staff.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (In the Lyde unit the doors to all the bedrooms have a glass viewing panel. In a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (number of the bedrooms the screening to the doors were broken or were not in place. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (These aspects do not maintain the dignity and privacy of people at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (The home employs a physiotherapist who develops a plan for the care staff to then )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (follow. It was aslo reported that the physiotherapist also completes some life skills )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (with some people at the home. It was reported to us by staff that the physio spends )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (the majoity of thier time with the younger people living at the home.)Tj ET endstream endobj 49 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 50 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (19)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Daily life and social activities )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 138.25 w 32.32 644.38 m 562.53 644.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 119 w 31.2 655.13 m 563.65 655.13 l S 0.001 w 1 1 1 RG 17 w 31.2 584.88 m 563.65 584.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 575.25 m 565.85 575.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 574.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 574.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Each person is treated as an individual and the care home is responsive to his or her )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (race, culture, religion, age, disability, gender and sexual orientation. They are part of )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (their local community. The care home supports people to follow personal interests and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (activities. People are able to keep in touch with family, friends and representatives. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (They are as independent as they can be, lead their chosen lifestyle and have the )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (opportunity to make the most of their abilities. People have nutritious and attractive )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 600.57 Tm (meals and snacks, at a time and place to suit them.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 557 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 535 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 535 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 512.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 246.82 w 34.6 384.76 m 562.54 384.76 l S 0.001 w 1 1 1 RG 22.5 w 32.35 499.17 m 564.79 499.17 l S 0.001 w 224.33 w 33.47 373.51 m 563.66 373.51 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 486.8 m 565.87 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 487.88 m 32.35 259.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 487.88 m 564.79 259.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 486.8 m 564.79 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 260.23 m 565.87 260.23 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 495.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 471.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 471.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 471.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 453.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 426.75 Tm (People living at the home do not have opportunities for their social and recreational )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 409.25 Tm (interests to be met.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 391.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 374.26 Tm (People living at the home are able to meet friends and family.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 356.77 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 339.27 Tm (The opportunity to make choices is limited with regard to social and recreational )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 321.77 Tm (opportunities and with regard to some aspects of personal care.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 304.28 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 286.78 Tm (Meals and mealtimes are on the whole a pleasant experience for all except those on )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 269.29 Tm (the Lyde Unit.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 244.54 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 152.33 w 34.6 158.19 m 562.54 158.19 l S 0.001 w 1 1 1 RG 22.5 w 32.35 225.36 m 564.79 225.36 l S 0.001 w 130.96 w 33.47 146.38 m 563.66 146.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 212.98 m 565.87 212.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 214.06 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 214.06 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 212.98 m 564.79 212.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 222.04 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 197.3 Tm (West Abbey provides care and support for a wide range of people with differing needs )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 179.8 Tm (and therefore the range of activities available needs to reflect this.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 162.31 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 144.81 Tm (During the inspection visit we observed the social and recreational opportunities of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 127.31 Tm (people living on the Lyde unit. It was noted that although the area had an activities )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 109.82 Tm (organiser doing some activities with a small minority of people, the majority of people )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 92.32 Tm (had limited opportunities to engage in leisure opportunities. This was in part due to )Tj ET endstream endobj 51 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 52 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (20)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (the lack of availability of staff. There were periods of time when the lounge area was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (unsupervised with no staff available. In addition no television or radio was on for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (people to listen to.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (When a member of staff was available in the lounge we did not observe any )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (meaningful interaction from some staff other than to assist with tasks and prevent )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (accidents \(two staff were observed to have excellent interactions with people\). One )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (person living in this area is receiving 1:1 support from staff. It was observed that one )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (staff member did not interact with the individual for a period of nearly an hour. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (was despite the individual trying to initiate conversation with the staff member. One )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (person was observed being transferred in the lounge from wheelchair to armchair. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (This transfer involved the use of a hoist. This can be a frightening experience for some )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (people particularly those with short term memory loss who may not remember )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (instructions previously given to them by staff. Staff were observed to give the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (individual no reassurance nor did they explain what they were going to do.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (The Lyde unit has access to a safe garden area however despite the weather being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (nice on the day of the inspection visit the doors to the garden were closed. The garden )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (is maintained to a very high standard and staff should try to use this area with people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (living at the home as much as possible. Comments made in the outcome area for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (health and personal care with regard to choices around bathing should be noted.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (Over the two day inspection some physically disabled younger adults had no access to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (sensory stimulation beyond personal care tasks. When sitting out of bed in adapted )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (seating some younger adults were positioned in the foyer of the home with seats )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (tilted, making their eye line focus on the ceiling. This is concerning as there needs to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (be an improvement in the activity and sensory input for younger adults in order to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (satisfy their social care needs. As previously stated the physiotherapist does spend )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (sometime developing the life skills of two of the younger people who live at the home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (In addition music therapy is available. The younger adult area has it's own kitchen and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (living area. On reviewing the care records for this group of people it would appear )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (however that social and recreational opportunities outside of the home with peers are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (limited.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (No activities were observed for people with general nursing needs. The home has )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (offered some trips out which one relative told us was enjoyed. Trips out have included )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (to West bay, weymouth and stourhead.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (A hairdresser visits the home regularly and was visiting the home on the day of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (inspection.)Tj ET endstream endobj 53 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 54 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (21)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (Visitors were seen at the home throughout the inspection. The majority of people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (stated that they were made to feel welcome by staff. \(see outcome group for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (complaints and protection\))Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (The home has regular visits from visiting clergy and communion is held regularly)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (Lunch was observed on both days of the inspection. The daily menu is displayed in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (foyer of the home. A choice of main meal is routinely available to people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (home. The dining areas in the general nursing part of the home were set to a high )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (standard with tablecloths, glasses and napkins. The meal in this area was nicely )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (served in a calm and peaceful environment. People with the highest needs appeared )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (to have their meal in the upper floor dining area. This area appeared to be less calm )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (than the lower ground floor but was still conducted to an adequate standard.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (The lunch time meal on the lyde unit was observed. This appeared to be chaotic and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (less organised. The tables were set by a member of the hotel staff at 12:00. As )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (previously stated people with dementia may need help and support to orientate )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (themselves to the activities of daily living and time. It is advised therefore that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (tables are not set until the meal is due to be served. The meal arrived from the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (kitchen in a hot trolley at 12:10. However the meal was not served until 12:35. As the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (tables had been set at 12:00 a number of people had been sat at the tables for over )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (half an hour and so had lost interest and had left. At the inspection in 2008 it was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (reported that "Also noted was that the process of offering the choices, getting the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (meal served, and then cutting up the food left a number of residents sitting with no )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (food whilst some people had already finished and were leaving the tables. It was felt )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (that this may have been due to some of the staff being busy elsewhere at lunchtime.")Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (These comments appeared to remain on this inspection. Staff did not appear to be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (available to serve the meals. We were told that staff were still supporting people with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (personal care. One staff member started to serve the meals at 12:35. At 12:45 there )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (was no supervision in the dining area. Six people had been served leaving nine people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (with no meal. When staff were again availer the people who had been served first had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (nearly finished with people who were sat at the same table yet to be served. By )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (13:00hrs some people had still not being served. It was observed that due to lack of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (staff supervision at least two people were struggling to eat their meals. For one )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (person this resulted in little of the meal being eaten. For another the meal went cold )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (prior to the individual receiving a prompt to eat her meal. Due to the timescales )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (involved in the serving of the meal one person had eaten and left the room when staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (were not in attendance. When the individual re entered the room staff offered another )Tj ET endstream endobj 56 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 57 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (22)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (meal. This was evidence that staff were unaware who had eaten and who had not. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (One person required support to eat his food. This person remained in the lounge area )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (to eat. A staff member was observed sitting on a coffee table to support this person. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (Interactions from this staff member was limited. The staff member did not tell the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (person what was on the plate and did not get involved in any conversation. Drink was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (not offered to this individual until the end of the meal. By 13:20 the puddings had yet )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (to be served. As previously stated by this time a number of people living at the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (had become impatient and left the table. It is advised that food is not plated up until )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (staff are available to support all people even if this means that some people do not get )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (their meal until a later time. This allows staff time to ensure that they have the time )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (to spend with people during meals and ensures that meal times are a pleasant )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (experience for all. This time also allows staff to monitor dietary intake more effectively )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (which will promote the general health of people living at the home. Menus were on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (display in the lyde unit on one table only.This menu did not relate to the day of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (inspection but several days earlier. The menu was not readily accessible to the people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (living at the home. The area caters for people who have dementia and as such they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (may difficulty in making choices or remembering what choice of food they have made. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (Additionally some people living at the home cannot verbally express their choices. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (Staff could develop a system were they plate up the choices \(one staff member only )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (was observed to do this\) and show these to people who can then make a choice. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (Alternatively staff could develop pictures and photographs of the food again enabling )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (people to have a greater understanding on what is being offered.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (Drinks were available in the dining areas and communal rooms. Not all people in their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (rooms had access to a drink at all times during the day.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (One bedroom was observed in the afternoon. Three untouched drinks were observed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (to be on the window sill out of reach of the individual who was in bed. A tray with the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (lunch time meal was on the over bed table. The majority of this was untouched. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (may have been in part due to the fact that the individual was not sitting in an upright )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (position. A staff member was observed to enter the room and remove the plates. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (staff member made no reference to the uneaten meal nor did they offer an )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (alternative.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (In this report under the section heading 'Health and Person Care' is reference to our )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (concerns regarding some people who have sustained weight loss and low body weight. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (It is recommended that the provision of snacks between meals be provided in line with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (assessed nutritional care management needs.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (It should be noted that the food served was of a good standard and well prepared. On )Tj ET endstream endobj 58 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 59 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (23)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 56.36 w 34.6 783.22 m 562.54 783.22 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 34.99 w 33.47 771.41 m 563.66 771.41 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 751.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 751.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 752.79 m 565.87 752.79 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (one day of the inspection however only one vegetable "carrots" were served. It could )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (not be ascertained what alternative would be offered if you did not like carrots.)Tj ET endstream endobj 60 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 61 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (24)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Complaints and protection )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 87.25 w 32.32 669.88 m 562.53 669.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 68 w 31.2 680.63 m 563.65 680.63 l S 0.001 w 1 1 1 RG 17 w 31.2 635.88 m 563.65 635.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 626.25 m 565.85 626.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 625.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 625.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (If people have concerns with their care, they or people close to them know how to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (complain. Any concern is looked into and action taken to put things right. The care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (home safeguards people from abuse and neglect and takes action to follow up any )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (allegations.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (Peoples legal rights are protected, including being able to vote in elections.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 608 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 586 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 586 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 563.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 141.85 w 34.6 488.25 m 562.54 488.25 l S 0.001 w 1 1 1 RG 22.5 w 32.35 550.17 m 564.79 550.17 l S 0.001 w 119.35 w 33.47 477 m 563.66 477 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 537.8 m 565.87 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 538.88 m 32.35 415.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 538.88 m 564.79 415.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 537.8 m 564.79 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 416.2 m 565.87 416.2 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 546.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 522.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 522.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 522.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 504.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 477.75 Tm (Systems and procedures in the home may not protect people from abuse.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 442.76 Tm (People living in the home may not be confident that their concerns and complaints will )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 425.26 Tm (be listened to. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 400.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 308.3 w 34.6 236.18 m 562.54 236.18 l S 0.001 w 1 1 1 RG 22.5 w 32.35 381.33 m 564.79 381.33 l S 0.001 w 286.93 w 33.47 224.37 m 563.66 224.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 368.96 m 565.87 368.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 370.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 370.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 368.96 m 564.79 368.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 378.02 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.27 Tm (During induction staff receive information about safeguarding adults and must sign to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 335.78 Tm (say that they understand this and the Whistle blowing policy. The home has copies of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.28 Tm (the local authority guidance "Safeguarding Adults in Somerset" and key staff are )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 300.79 Tm (familiar with actions to be taken.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.29 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 265.79 Tm (The home has received five complaints since the last inspection. These have been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.3 Tm (investigated in line with the homes complaints procedure. In addition during the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 230.8 Tm (inspection other concerns were identified that had been raised by the manager that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.31 Tm (were not documented in the complaints log. We have also received some concerns )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 195.81 Tm (with regard to the care and support afforded to a number of individuals living at the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.31 Tm (home. These concerns will be investigated under the Somerset Safeguarding policy )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 160.82 Tm (and procedures. This may include restricted visiting for two people living at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.32 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 125.83 Tm (A number of concerns were identified during the inspection that may impact on )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.33 Tm (individuals rights. It was identified in the nursing area that for one person a table was )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 90.83 Tm (being used to restrict the movements of this individual. A staff member explained that )Tj ET endstream endobj 62 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 63 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (25)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 161.34 w 34.6 730.73 m 562.54 730.73 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 139.97 w 33.47 718.92 m 563.66 718.92 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 646.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 646.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 647.82 m 565.87 647.82 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (the table was in place as the "lady gets up and tries to walk". this is not in line with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (best practice guidelines. Staff should consider the use of such tools as pressure mats )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (in this situation.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (Consideration should also be given to the comments made in the outcome group )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm ("health and personal care" with regard to the use of medication that is classed as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm ("sedation")Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET endstream endobj 64 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 65 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (26)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Environment )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 34 w 31.2 697.63 m 563.65 697.63 l S 0.001 w 1 1 1 RG 68 w 31.2 644.38 m 563.65 644.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People stay in a safe and well-maintained home that is homely, clean, pleasant and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (hygienic. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 666.32 Tm (People stay in a home that has enough space and facilities for them to lead the life )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 649.32 Tm (they choose and to meet their needs. The home makes sure they have the right )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (specialist equipment that encourages and promotes their independence. Their room )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (feels like their own, it is comfortable and they feel safe when they use it.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 264.32 w 34.6 410.01 m 562.54 410.01 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 241.82 w 33.47 398.77 m 563.66 398.77 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 275.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 275.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 276.73 m 565.87 276.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 505.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.75 Tm (People are able to personalise their bedrooms.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 425.76 Tm (The home is fitted with a range of aids and adaptations. Orientation signage in the )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 408.26 Tm (Lyde unit needs to be developed. Screening to protect the privacy and dignity of )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 390.77 Tm (people is not available in all areas.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 373.27 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 355.77 Tm (The standard of cleanliness is overall good however some areas required attention on )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 338.28 Tm (the day of the inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 320.78 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 303.29 Tm (The home does not have systems in place to reduce the risk of the spread of infection )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 285.79 Tm (in all areas.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 261.04 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 168.83 w 34.6 166.44 m 562.54 166.44 l S 0.001 w 1 1 1 RG 22.5 w 32.35 241.86 m 564.79 241.86 l S 0.001 w 147.46 w 33.47 154.63 m 563.66 154.63 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 229.49 m 565.87 229.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 230.56 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 230.56 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 229.49 m 564.79 229.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 238.55 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (The tour of the premises found the home in good condition. The premises were )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm (purpose built and have wide corridors and a 13 person passenger lift giving good )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm (wheelchair access around the building.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (The communal rooms are comfortable and have good natural light. The individual )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm (accommodation older and newly built is well appointed comfortably furnished and can )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm (be personalised.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm ()Tj ET endstream endobj 66 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 67 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (27)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 563.75 w 34.6 529.53 m 562.54 529.53 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 542.38 w 33.47 517.72 m 563.66 517.72 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 244.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 244.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 245.41 m 565.87 245.41 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (There is a good level of equipment with adjustable beds and specialist equipment for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (pressure relief and nursing care. As previously stated in this report it was identified )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (that a number of people were nursed in bed for various reasons nurse call bell leads )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (were not in place in a number of these rooms.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (The dementia care unit is appropriately decorated in communal areas to aid people's )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (independence and interest around the unit. There is use of colour coordination for the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (toilets and there are objects of reminiscence around the corridors for people to view )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (and handle. This however is not the case in individuals bedrooms. All of tr bedrooms )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (have en-suite facilities and a built in cupboard. The doors to each of these are the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (same. This may add to the disorientation of people living in these rooms. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (Consideration should be given to signage on these doors to aid the accessibility of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (these area.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (As previously stated a number of the double rooms did not have adequate screening )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (in place to protect the dignity of people occupying these rooms. In addition orientation )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (signage was not available in on all the bedroom doors in the Lyde unit. Signage of this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (type would help people locate their personal space.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (There are infection control measures in place. All staff have access to personal )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (protective clothing and there are sufficient hand washing facilities for them around the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (It was noted that some significant malodorous were noted on the first day of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (inspection in the Lyde unit. The management need to consider these comments and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (ensure that the malodours are kept to a minimum at all times. This may include the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (replacement of some floor coverings if necessary.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (The home has sluice facilities and sufficient toilets and bathrooms.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (One bathroom was seen that was being used as a storage space for equipment and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (was very cluttered. This may reduce the use of this bathroom. )Tj ET endstream endobj 68 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 69 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (28)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Staffing )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 17 w 31.2 618.88 m 563.65 618.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have safe and appropriate support as there are enough competent staff on duty )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (at all times. They have confidence in the staff at the home because checks have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (done to make sure that they are suitable to care for them. Their needs are met and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (they are cared for by staff who get the relevant training and support from their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (managers.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 176.84 w 34.6 453.75 m 562.54 453.75 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 154.34 w 33.47 442.51 m 563.66 442.51 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 363.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 363.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 364.21 m 565.87 364.21 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 505.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.75 Tm (Staff recruitment is not robust in all areas.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 425.76 Tm (Staff have recieved all necessary training)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 408.26 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 390.77 Tm (Staffing numbers appaer to be sufficant although these need to be reviewed in line )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 373.27 Tm (with the dependancy levels of the people living at th home )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 348.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 256.31 w 34.6 210.18 m 562.54 210.18 l S 0.001 w 1 1 1 RG 22.5 w 32.35 329.34 m 564.79 329.34 l S 0.001 w 234.94 w 33.47 198.37 m 563.66 198.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 316.97 m 565.87 316.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 318.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 318.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 316.97 m 564.79 316.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 326.03 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm (The staff duty rota's were obtained during the inspection. These were viewed following )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (the visit to the home. These showed that the home appears to have sufficient )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm (numbers of staff on duty at all times. These however were not compared to the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm (dependency of people living at the home. Some areas identified in this report such as )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (staff still supporting people with personal care and hygiene when the lunch had )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (arrived suggest that the staffing levels need to be reviewed.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm (A range of other staff including cleaners, cooks and maintenance staff are available.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (The duty rota's showed that some staff are working a relatively high numbers of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm (hours. Some in around 58 hours per week. Staff have however opted out of the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm (working time directive and it was evident that the manager ensures that all staff have )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (two full days off a week. Comments received by staff were very positive about working )Tj ET endstream endobj 70 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 71 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (29)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 441.27 w 34.6 590.77 m 562.54 590.77 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 419.9 w 33.47 578.96 m 563.66 578.96 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 366.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 366.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 367.88 m 565.87 367.88 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (Staff training records were viewed. The home was unable to produce a training matrix. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (Training is recorded for each staff member separately. It could not be confirmed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (therefore how the training needs of each individual staff are identified easily and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (subsequent training arranged. It was noted however on reviewing a random sample of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (individual staff training records that all staff appear to the received all necessary )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (training. This included updates for the registered nurses in line with NMC guidelines. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (number of staff have completed or are completing an NVQ.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (Five staff recruitment files were viewed during the inspection visit. These showed that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (recruitment procedure may not be robust in all cases. In three of the files it was noted )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (that two written references were not obtained before the individual staff member )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (commenced work at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (For one person it was evident that there had been gaps in the employment history )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (which had not been discussed with the staff member.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (For additional person it was evident that there had been issues with the persons last )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (employer. There was no written evidence that the manager had discussed this with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (the staff member or previous employer. We raised this issue with the manager who )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (stated that she had discussed and reviewed this issue prior to offering employment )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (and was satisfied enough to employ the individual. It is advised that the manager )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (documents issues such as these at the interview stage.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (It was confirmed in the recruitment files seen that staff had completed an induction in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (line with good practice guidelines.)Tj ET endstream endobj 72 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 73 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (30)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Management and administration )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.25 w 32.32 618.88 m 562.53 618.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 102 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 524.25 m 565.85 524.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 523.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 523.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have confidence in the care home because it is led and managed appropriately. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (People control their own money and choose how they spend it. If they or someone )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (close to them cannot manage their money, it is managed by the care home in their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (best interests. The environment is safe for people and staff because appropriate health )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (and safety practices are carried out.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People get the right support from the care home because the manager runs it )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (appropriately with an open approach that makes them feel valued and respected. The )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (people staying at the home are safeguarded because it follows clear financial and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (accounting procedures, keeps records appropriately and ensures their staff understand )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (the way things should be done. They get the right care because the staff are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (supervised and supported by their managers.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 506 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 484 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 484 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 461.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 229.33 w 34.6 342.51 m 562.54 342.51 l S 0.001 w 1 1 1 RG 22.5 w 32.35 448.17 m 564.79 448.17 l S 0.001 w 206.83 w 33.47 331.26 m 563.66 331.26 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 435.8 m 565.87 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 436.88 m 32.35 225.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 436.88 m 564.79 225.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 435.8 m 564.79 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 226.72 m 565.87 226.72 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 444.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 420.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 420.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 420.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 402.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.75 Tm (The home manager has the experiance to run the home.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 340.76 Tm (Staff do not recieve adequate supervision.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 323.26 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 305.77 Tm (The Care quailty Commission may not recieve all notifications about events at the )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 288.27 Tm (home)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 270.77 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 253.28 Tm (People living at the home cannot be assured of a safe environment and that systems )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 235.78 Tm (are in place to rectify problems.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 211.04 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 118.82 w 34.6 141.44 m 562.54 141.44 l S 0.001 w 1 1 1 RG 22.5 w 32.35 191.85 m 564.79 191.85 l S 0.001 w 97.45 w 33.47 129.63 m 563.66 129.63 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 179.48 m 565.87 179.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 180.56 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 180.56 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 179.48 m 564.79 179.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 188.54 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.79 Tm (The Registered Manager, Mrs Bev Davies, has managed the home for a significant )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.3 Tm (period of time . The Statement of Purpose confirms that she is a Registered Nurse )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.8 Tm (with qualifications and experience in management. The manager and the company as )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.31 Tm (a whole need to consider the comments,requirements and recommendations made in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.81 Tm (this report as a number of the requirements made at this inspection remain )Tj ET endstream endobj 74 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 75 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (31)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 721.21 w 34.6 450.8 m 562.54 450.8 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 699.84 w 33.47 438.99 m 563.66 438.99 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 86.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 86.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 87.94 m 565.87 87.94 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (outstanding from previuos inspection visits.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (Staff spoken with felt able to approach the manager and felt well supported.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (Various staff meetings are held regularly. Records seen confirmed that these are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (usually well attended by most staff.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (Staff are issued with a copy of the General and Social Care Council code of conduct, as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (seen on staff files.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (It could not be confirmed if staff receive formal supervision. The nurses supervise a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (group of care staff each and the manager supervises nurses and senior staff. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (requested copies of recent supervision for staff. These could not be found. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (manager could not confirm when staff had received supervision nor if this was up to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (date. The manager appeared unclear what was meant by supervision as described in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (Standard 36 of the National minimum standards.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (All records seen were stored securely. A current Employer's Liability Insurance )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (certificate is displayed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (During this inspection some concerns were raised with regard to the health and safety )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (arrangements at the home. The care planning process could not confirm what )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (arrangements were in place for all individuals living at the home with regard to the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (equipment used for moving and handling. In addition during the inspection it was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (observed that staff were pushing people in wheelchairs with no foot plates. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (increases the risk of injury to the person in the chair as their feet and legs may be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (dragged and caught under the wheelchair.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (During the inspection the care planning process did not identify if any person living at )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (the home was at risk of ingestion. Toiletries were insecure and freely available to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (people living at the home. This may pose a risk particularly to people who have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (dementia.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (Under Regulation 37 of the Care Home Regulations homes are required to inform us of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (any adverse incident at the home. We have received numerous of these notifications )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (with regard to deaths at the home. As previously stated we have received some )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (concerns with regard to the care and support afforded to people living at the home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (Some of these concerns relate to incidents of pressure ulcers at the home and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (subsequent admissions to hospital and to concerns raised by member of the public )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (and relatives. We have not received information with regard to these issues. )Tj ET endstream endobj 77 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 79 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (32)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.99216 0.9451 0.76078 RG 36.25 w 29.47 793.28 m 564.97 793.28 l S 0.001 w 0.95294 0.95294 0.95294 RG 17 w 28.35 804.03 m 566.1 804.03 l S 0.001 w 17 w 28.35 784.78 m 422.1 784.78 l S 0.001 w 17 w 424.35 784.78 m 467.1 784.78 l S 0.001 w 1 1 1 RG 17 w 469.35 784.78 m 494.1 784.78 l S 0.001 w 0.95294 0.95294 0.95294 RG 17 w 496.35 784.78 m 539.1 784.78 l S 0.001 w 1 1 1 RG 17 w 541.35 784.78 m 566.1 784.78 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 794.4 m 568.3 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 813.65 m 568.3 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 794.4 m 568.3 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 775.15 m 568.3 775.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 814.73 m 27.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 423.22 795.48 m 423.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 468.22 795.48 m 468.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 495.22 795.48 m 495.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 540.22 795.48 m 540.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 814.73 m 567.22 774.08 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 33.75 800.47 Tm (Are there any outstanding requirements from the last inspection?)Tj ET /F2 12 Tf BT 1 0 0 1 429.75 781.22 Tm (Yes)Tj ET /F7 12 Tf BT 1 0 0 1 476.37 783.16 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 501.75 781.22 Tm (No)Tj ET /F7 12 Tf BT 1 0 0 1 546.75 783.16 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 654.5 w 32.32 391.28 m 564.97 391.28 l S 0.001 w 1 1 1 RG 286.02 w 31.2 472.66 m 91.05 472.66 l S 0.001 w 286.02 w 93.3 472.66 m 197.4 472.66 l S 0.001 w 286.02 w 199.65 472.66 m 289.45 472.66 l S 0.001 w 286.02 w 291.7 472.66 m 473.8 472.66 l S 0.001 w 286.02 w 476.05 472.66 m 566.1 472.66 l S 0.001 w 81.9 w 31.2 286.45 m 91.05 286.45 l S 0.001 w 81.9 w 93.3 286.45 m 197.4 286.45 l S 0.001 w 81.9 w 199.65 286.45 m 289.45 286.45 l S 0.001 w 81.9 w 291.7 286.45 m 473.8 286.45 l S 0.001 w 81.9 w 476.05 286.45 m 566.1 286.45 l S 0.001 w 140.22 w 31.2 173.14 m 91.05 173.14 l S 0.001 w 140.22 w 93.3 173.14 m 197.4 173.14 l S 0.001 w 140.22 w 199.65 173.14 m 289.45 173.14 l S 0.001 w 140.22 w 291.7 173.14 m 473.8 173.14 l S 0.001 w 140.22 w 476.05 173.14 m 566.1 173.14 l S 0.001 w 37.88 w 31.2 81.84 m 91.05 81.84 l S 0.001 w 37.88 w 93.3 81.84 m 197.4 81.84 l S 0.001 w 37.88 w 199.65 81.84 m 289.45 81.84 l S 0.001 w 37.88 w 291.7 81.84 m 473.8 81.84 l S 0.001 w 37.88 w 476.05 81.84 m 566.1 81.84 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 328.53 m 568.3 328.53 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 244.38 m 568.3 244.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 101.91 m 568.3 101.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 617.88 m 30.07 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 617.88 m 567.22 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 649.35 m 568.4 649.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 616.8 m 568.3 616.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 617.88 m 92.17 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 617.88 m 198.52 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 617.88 m 290.57 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 617.88 m 474.92 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 720.78 m 568.4 720.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 649.35 m 568.4 649.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 616.8 m 568.4 616.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 328.53 m 568.3 328.53 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 244.38 m 568.3 244.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 101.91 m 568.3 101.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 61.78 m 568.3 61.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 721.86 m 30.07 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 650.43 m 92.12 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 650.43 m 198.52 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 650.43 m 290.62 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 650.43 m 475.02 615.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 721.86 m 567.32 615.72 l S 0.001 w [] 0 d /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 703.57 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 685.15 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 670.57 Tm (been met.)Tj ET /F2 12 Tf BT 1 0 0 1 95.57 670.57 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 104.02 670.57 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 655.99 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 638.17 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 635.17 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 635.17 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 635.17 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 635.17 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 623.02 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 603.61 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 600.61 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 600.61 Tm (16\(2\)\(i\)\(4\)12)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 586.03 Tm (\(4\)\(a\)\(b\)17\(1)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 571.45 Tm (\)\(a\)Sch.3)Tj ET /F2 12 Tf BT 1 0 0 1 260.11 571.45 Tm ( \(l\))Tj ET /F2 12 Tf BT 1 0 0 1 294.55 600.61 Tm (Fluids must be available to )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 586.03 Tm (those who can manage )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 571.45 Tm (independently at all times )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 556.87 Tm (when sitting in their rooms )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 542.29 Tm (or when in bed.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 527.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 513.13 Tm (Call bells must be accessible )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 498.55 Tm (at all times and must be )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 483.97 Tm (placed within reach after )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 469.39 Tm (care interventions / changes )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 454.81 Tm (of position.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 440.23 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 425.65 Tm (A recorded system of )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 411.07 Tm (appropriate supervision is )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 396.49 Tm (required to be implemented )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 381.91 Tm (to support people to summon )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 367.33 Tm (assistance when needed.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 352.75 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 335.17 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 478.9 600.61 Tm (21/04/2008)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 315.34 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 312.34 Tm (22)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 312.34 Tm (23\(2\)\(l\))Tj ET /F2 12 Tf BT 1 0 0 1 294.55 312.34 Tm (Designated storage must be )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 297.76 Tm (used rather than communal )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 283.18 Tm (bathrooms for equipment )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 268.6 Tm (that is not in use.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 251.02 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 478.9 312.34 Tm (21/04/2008)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 231.19 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 228.19 Tm (27)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 228.19 Tm (18 \(1\))Tj ET /F2 12 Tf BT 1 0 0 1 294.55 228.19 Tm (It is required that the )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 213.61 Tm (manager reviews the )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 199.03 Tm (numbers of staff available to )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 184.45 Tm (ensure that the needs of the )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 169.87 Tm (people living at the home are )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 155.29 Tm (met.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 140.71 Tm (Previously required by )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 126.13 Tm (19/9/07)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 108.55 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 478.9 228.19 Tm (21/04/2008)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 88.72 Tm (4)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 85.72 Tm (29)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 85.72 Tm (18\(1\)\(a\))Tj ET /F2 12 Tf BT 1 0 0 1 294.55 85.72 Tm (Recruitment procedure must )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 71.14 Tm (include that at interview any )Tj ET /F2 12 Tf BT 1 0 0 1 478.9 85.72 Tm (21/04/2008)Tj ET endstream endobj 80 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 81 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (33)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 198.21 w 32.32 712.3 m 564.97 712.3 l S 0.001 w 1 1 1 RG 96.48 w 31.2 660.31 m 91.05 660.31 l S 0.001 w 96.48 w 93.3 660.31 m 197.4 660.31 l S 0.001 w 96.48 w 199.65 660.31 m 289.45 660.31 l S 0.001 w 96.48 w 291.7 660.31 m 473.8 660.31 l S 0.001 w 96.48 w 476.05 660.31 m 566.1 660.31 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 710.75 m 30.07 609.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 710.75 m 567.22 609.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.22 m 568.4 742.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 709.67 m 568.3 709.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 710.75 m 92.17 609.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 710.75 m 198.52 609.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 710.75 m 290.57 609.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 710.75 m 474.92 609.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.4 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.22 m 568.4 742.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 709.67 m 568.4 709.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 610.94 m 568.3 610.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 743.3 m 92.12 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 743.3 m 198.52 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 743.3 m 290.62 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 743.3 m 475.02 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 814.73 m 567.32 708.6 l S 0.001 w [] 0 d /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 796.45 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 778.03 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 763.45 Tm (been met.)Tj ET /F2 12 Tf BT 1 0 0 1 95.57 763.45 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 104.02 763.45 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 748.87 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 731.05 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 728.05 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 728.05 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 728.05 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 728.05 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 715.9 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 292.3 698.74 Tm (gaps in employment history )Tj ET /F2 12 Tf BT 1 0 0 1 292.3 684.16 Tm (be explored and the reasons )Tj ET /F2 12 Tf BT 1 0 0 1 292.3 669.58 Tm (for them be documented, to )Tj ET /F2 12 Tf BT 1 0 0 1 292.3 655 Tm (ensure the safety of people )Tj ET /F2 12 Tf BT 1 0 0 1 292.3 640.42 Tm (using the service.)Tj ET /F2 12 Tf BT 1 0 0 1 292.3 619.84 Tm ()Tj ET endstream endobj 82 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 83 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (34)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 797.57 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 782.15 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 355.65 w 32.32 596.01 m 564.97 596.01 l S 0.001 w 1 1 1 RG 125.64 w 31.2 624.6 m 91.05 624.6 l S 0.001 w 125.64 w 93.3 624.6 m 197.4 624.6 l S 0.001 w 125.64 w 199.65 624.6 m 289.45 624.6 l S 0.001 w 125.64 w 291.7 624.6 m 473.8 624.6 l S 0.001 w 125.64 w 476.05 624.6 m 566.1 624.6 l S 0.001 w 140.22 w 31.2 489.42 m 91.05 489.42 l S 0.001 w 140.22 w 93.3 489.42 m 197.4 489.42 l S 0.001 w 140.22 w 199.65 489.42 m 289.45 489.42 l S 0.001 w 140.22 w 291.7 489.42 m 473.8 489.42 l S 0.001 w 140.22 w 476.05 489.42 m 566.1 489.42 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 560.66 m 568.3 560.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 689.63 m 30.07 417.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 689.63 m 567.22 417.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.3 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 689.63 m 92.17 417.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 689.63 m 198.52 417.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 689.63 m 290.57 417.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 689.63 m 474.92 417.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 776.09 m 568.4 776.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.4 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.66 m 568.3 560.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 418.19 m 568.3 418.19 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 777.17 m 30.07 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 722.18 m 92.12 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 722.18 m 198.52 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 722.18 m 290.62 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 722.18 m 475.02 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 777.17 m 567.32 687.47 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 759.9 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 742.32 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 727.74 Tm (The registered person had to meet these within 48 hours.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 709.92 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 706.92 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 706.92 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 706.92 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 706.92 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 694.77 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 675.36 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 672.36 Tm (22)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 672.36 Tm (16)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 672.36 Tm (The management must )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 657.78 Tm (ensure that appropriate )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 643.2 Tm (orientation signage and )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 628.62 Tm (screening is available )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 614.04 Tm (throughout the home.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 596.46 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 581.88 Tm (To ensure that the home is )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 567.3 Tm (accessible to all.)Tj ET /F2 12 Tf BT 1 0 0 1 478.9 672.36 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.47 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 544.47 Tm (26)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 544.47 Tm (16)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 544.47 Tm (The home must ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 529.89 Tm (malodours are kept to a )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 515.31 Tm (minimum. This may include )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 500.73 Tm (the replacement of some )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 486.15 Tm (carpets if required )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 468.57 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 453.99 Tm (This will ensure that people )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 439.41 Tm (live in a clean and pleasant )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 424.83 Tm (environment)Tj ET /F2 12 Tf BT 1 0 0 1 478.9 544.47 Tm (16/09/2009)Tj ET 0.95294 0.95294 0.95294 RG 286.29 w 32.32 236.54 m 564.97 236.54 l S 0.001 w 1 1 1 RG 187 w 31.2 185.77 m 91.05 185.77 l S 0.001 w 187 w 93.3 185.77 m 197.4 185.77 l S 0.001 w 187 w 199.65 185.77 m 289.45 185.77 l S 0.001 w 187 w 291.7 185.77 m 473.8 185.77 l S 0.001 w 187 w 476.05 185.77 m 566.1 185.77 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 281.48 m 30.07 90.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 281.48 m 567.22 90.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 312.95 m 568.4 312.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 280.4 m 568.3 280.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 281.48 m 92.17 90.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 281.48 m 198.52 90.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 281.48 m 290.57 90.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 281.48 m 474.92 90.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 381.94 m 568.4 381.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 312.95 m 568.4 312.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 280.4 m 568.4 280.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 91.15 m 568.3 91.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 383.02 m 30.07 279.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 314.03 m 92.12 279.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 314.03 m 198.52 279.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 314.03 m 290.62 279.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 314.03 m 475.02 279.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 383.02 m 567.32 279.32 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 368.75 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 348.75 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 334.17 Tm (Standards Act 2000, Care Homes)Tj ET /F2 12 Tf BT 1 0 0 1 239.77 334.17 Tm (Regulations 2001 and the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 319.59 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 301.77 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 298.77 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 298.77 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 298.77 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 298.77 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 286.62 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 267.21 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 267.21 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 267.21 Tm (15)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 267.21 Tm (The assessments and )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 250.21 Tm (associated care plans should )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 233.21 Tm (be up to date in order that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 216.21 Tm (they reflect the current )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 199.21 Tm (needs of the people living at )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 182.21 Tm (the home and give clear )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 165.21 Tm (guidance to staff. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 148.21 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 131.21 Tm (This will ensure that staff )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 114.21 Tm (meet the needs of the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 97.21 Tm (people living at the home. )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 267.21 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 267.21 Tm ()Tj ET endstream endobj 84 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 85 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (35)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm 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The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 733.49 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 730.49 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 730.49 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 730.49 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 730.49 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 718.34 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 698.93 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 698.93 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 698.93 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 698.93 Tm (The health and personal )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 681.93 Tm (care needs of people living )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 664.93 Tm (at the home should be met )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 647.93 Tm (at all times. This should )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 630.93 Tm (include access to fluids, oral )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 613.93 Tm (hygiene and a regular )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 596.93 Tm (change of position. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 579.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 562.93 Tm (To ensure that the health )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 545.93 Tm (needs of people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 528.93 Tm (home are met.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 698.93 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 698.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 509.68 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 509.68 Tm (9)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 509.68 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 509.68 Tm (Staff should ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 492.68 Tm (they record when )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 475.68 Tm (medication is given or )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 458.68 Tm (applied this should included )Tj ET 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The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 733.49 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 730.49 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 730.49 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 730.49 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 730.49 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 718.34 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 295.8 701.18 Tm (conducted in a manner )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 684.18 Tm (which respects the privacy )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 667.18 Tm (and dignity of people living )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 650.18 Tm (at the home. This should )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 633.18 Tm (include improvements to )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 616.18 Tm (screening in the double )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 599.18 Tm (rooms and to the glass )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 582.18 Tm (panels in the doors on the )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 565.18 Tm (Lyde unit )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 548.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 295.8 531.18 Tm (This will ensure the dignity )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 514.18 Tm (and self esteem of people is )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 497.18 Tm (maintained )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 475.68 Tm (6)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 475.68 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 475.68 Tm (16)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 475.68 Tm (The home shall develop a )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 458.68 Tm (range of social and )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 441.68 Tm (recreational oppertunites for )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 424.68 Tm (all people living at the home )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 407.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 390.68 Tm (To ensure that people life )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 373.68 Tm (full and active lives )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 475.68 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 475.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 354.43 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 354.43 Tm (14)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 354.43 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 354.43 Tm (The management must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 337.43 Tm (ensure that people living at )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 320.43 Tm (the home are offered )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 303.43 Tm (choices in all areas including )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 286.43 Tm (meals, times of bathing and )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 269.43 Tm (how to spend thier day. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 252.43 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 235.43 Tm (To ensure that people have )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 218.43 Tm (an influence on thier lives )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 354.43 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 354.43 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 199.18 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 199.18 Tm (15)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 199.18 Tm (16)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 199.18 Tm (Staff must be available to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 182.18 Tm (support people with meals )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 165.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 148.18 Tm (To ensure that meals are a )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 131.18 Tm (pleasant experience and to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 114.18 Tm (ensure staff can robustly )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 97.18 Tm (monitor the dietary needs of )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 199.18 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 199.18 Tm ()Tj ET endstream endobj 88 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 89 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (37)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 720.29 w 32.32 451.26 m 564.97 451.26 l S 0.001 w 1 1 1 RG 34 w 31.2 693.99 m 91.05 693.99 l S 0.001 w 34 w 93.3 693.99 m 197.4 693.99 l S 0.001 w 34 w 199.65 693.99 m 289.45 693.99 l S 0.001 w 34 w 291.7 693.99 m 473.8 693.99 l S 0.001 w 34 w 476.05 693.99 m 566.1 693.99 l S 0.001 w 136 w 31.2 606.74 m 91.05 606.74 l S 0.001 w 136 w 93.3 606.74 m 197.4 606.74 l S 0.001 w 136 w 199.65 606.74 m 289.45 606.74 l S 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28.99 88.86 m 568.3 88.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 745.74 m 92.12 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 745.74 m 198.52 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 745.74 m 290.62 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 745.74 m 475.02 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 814.73 m 567.32 711.04 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 800.47 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 780.47 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 765.89 Tm (Standards Act 2000, Care Homes)Tj ET /F2 12 Tf BT 1 0 0 1 239.77 765.89 Tm (Regulations 2001 and the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 751.31 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 733.49 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 730.49 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 730.49 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 730.49 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 730.49 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 718.34 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 295.8 701.18 Tm (the people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 684.18 Tm (home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 662.68 Tm (9)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 662.68 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 662.68 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 662.68 Tm (The home must review any )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 645.68 Tm (restrictive practises in place )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 628.68 Tm (for people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 611.68 Tm (home. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 594.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 577.68 Tm (To ensure that people at the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 560.68 Tm (home are protected from )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 543.68 Tm (abusive practises)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 662.68 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 662.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 524.43 Tm (10)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 524.43 Tm (29)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 524.43 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 524.43 Tm (Two written references need )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 507.43 Tm (to be obtained for all new )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 490.43 Tm (staff prior to them )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 473.43 Tm (commencing work at the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 456.43 Tm (home.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 439.43 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 422.43 Tm (To ensure that people living )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 405.43 Tm (at the home are protected )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 388.43 Tm (by robust recruitment )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 371.43 Tm (procedures )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 524.43 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 524.43 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 352.18 Tm (11)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 352.18 Tm (37)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 352.18 Tm (37)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 352.18 Tm (The management must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 335.18 Tm (ensure that CQC are )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 318.18 Tm (informed of all events in the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 301.18 Tm (care home which adversely )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 284.18 Tm (affects the well being or )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 267.18 Tm (safety of any service user. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 250.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 233.18 Tm (This will ensure that CQC )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 216.18 Tm (can adequatly monitor the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 199.18 Tm (home. )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 352.18 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 352.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 179.93 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 179.93 Tm (38)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 179.93 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 179.93 Tm (Staff must not push people )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 162.93 Tm (in wheelchairs with out )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 145.93 Tm (footplates )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 128.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 111.93 Tm (This will reduce the risk of )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 94.93 Tm (injury. )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 179.93 Tm (16/09/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 179.93 Tm ()Tj ET endstream endobj 90 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 91 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj 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(Refer to Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.45 729.91 Tm (Good Practice Recommendations)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 708.62 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 708.62 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 708.62 Tm (The care plans should demonstrate that due consideration )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 694.04 Tm (to the mental capacity act has been given. The plans )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 679.46 Tm (should detail if the individual has capacity to make )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 664.88 Tm (decisions which may effect their lives. If people have been )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 650.3 Tm (assessed as lacking capacity then the plan should clearly )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 635.72 Tm (state who will make decisions on their behalf. )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 612.89 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 612.89 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 612.89 Tm (The home must consider the use of advocates for any )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 598.31 Tm (person who lacks capacity to make decisions and choices )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 583.73 Tm (about their lives )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 560.9 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 560.9 Tm (27)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 560.9 Tm (It is recommended that staffing levels are reviewed in line )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 546.32 Tm (with the dependency levels of people living at the home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 523.49 Tm (4)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 523.49 Tm (36)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 523.49 Tm (It is recommended that all staff receive regular supervision )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 508.91 Tm (in line with Standard 36 of the National minimum )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 494.33 Tm (standards. )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 471.5 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 471.5 Tm (38)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 471.5 Tm (The staff must consider the risk of ingestion particularly in )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 456.92 Tm (the lyde unit. Toiletries should be held securely for those )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 442.34 Tm (people deemed at risk. )Tj ET endstream endobj 92 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 93 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (39)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 22.5 w 22.95 802.41 m 560.45 802.41 l S 0.001 w /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 799.09 Tm (Helpline:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 28.35 781.11 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 759.6 Tm (Telephone:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 95.88 759.6 Tm ( 03000 616161)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 739.6 Tm (Email:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 66.84 739.6 Tm ( enquiries@cqc.org.uk)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 719.61 Tm (Web:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 64.35 719.61 Tm (www.cqc.org.uk)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 699.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 679.61 Tm (We want people to be able to access this information. If you would like a summary in a )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 662.12 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 622.62 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 605.13 Tm (reproduced in whole or in part, free of charge, in any format or medium provided that it )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 587.63 Tm (is not used for commercial gain. This consent is subject to the material being )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 570.13 Tm (reproduced accurately and on proviso that it is not used in a derogatory manner or )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 552.64 Tm (misleading context. 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 ,E#F` &`&#HH-,E#F#a &a&#HH-,E#F` a F`&#HH-,E#F#a ` &a a&#HH-,E#F`@a f`&#HH-,E#F#a@` &a@a&#HH-, <<-, E# D# ZQX# D#Y QX# MD#Y &QX# D#Y!!-, EhD ` EFvhE`D-, C#Ce -, C#C -,F#pF>F#pFE: -,EJ#DEI#D-, E%EadPQXED!!Y-,Cc#b#B+-, EC`D-,CCe -, i@a ,b`+ d#da\XaY-,E+G#DGz-,TX CTXJIDDYY-,CXE+#DzEi #D QX+#Dz!zYY-,-,KRX!ED#E %ERXD!!YY-,/-, %EI#DEJ#DEe#E %`j #B#hj`a Ry!J@JE TX#!?#YaDRyI@ IE TX#!?#YaD-,C#C -,C#C -, C#C -, C#Ce -,C#Ce -,C#Ce -,KRXED!!Y-, %#I@` c RX#%8#%e8c8!!!!!Y-,Ei C`:-,%# `#-,%# a#-,%-, ` <<-, a <<-,++**-,CC -,>**-,5-,vK#p KE PXaY:/-,!! d#d@b-,!QX d#d b@/+Y`-,!QX d#dUb/+Y`-, d#d@b`#!-,&&&&Eh:-,&&&&Ehe:-,E# E %PX&a&`YD-,F#F`F# F`ab# #KKpE` PXa@Yh:-,3+**-,CXY-,CXY-#@/?103!%!!8 P@+  { /999?999/10&''&&'632!!!!67`,9) KgJ*JJ&J (""" """ zJzJee") """"!!""+ ]+PV =`9PPPP""""""""""""""""""""""kk4!!!!!!!!!!!!o!!!!!!!o!!!!!!!!!po==!!!!!!!!!!!!!!!!!!b!Q!?!.!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!}!&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&`9_@ FF@H H2 %H2 #H2 "H2 !H2  H2 H2 H2 H2 @[H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 yH2 nH2 dH2 _H2 ]H2 ZH2 XH2 H2 H2 H2 H2 H2 H2 H2 @LH2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 \H2& & 7E@CzweaWU$"   KKSBKcKb S# QZ#BKKTB8+TXCXYY++++++++++++++++++++++++++++++++KPyAP*&+++++KSyAP*&+++++P2Ka`+++++++++++++++++++++++++++++++++++++++++++++++++++++++++EiSBKPXBYC\XBY CX`!YBp>CX;!~ +Y #B #BCX-A-A +Y#B#BCX~;! +Y#B#B endstream endobj 99 0 obj<> endobj 100 0 obj<>/Subtype/CIDFontType2/Type/Font/W [53[891]133[891]]/CIDToGIDMap/Identity/DW 1000>> endobj 101 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0035><0085> endcodespacerange 2 beginbfrange <0035><0035><0052> <0085><0085><00a3> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 78 0 obj<> endobj 102 0 obj <>stream %!PS-AdobeFont-1.0: ArialMT Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Thu Oct 09 15:49:19 2008 % Converted from TrueType font 'ARIAL.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Arial) readonly def /FamilyName (Arial) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -106 def /UnderlineThickness 73 def end readonly def /FontName /ArialMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-46 -210 1000 896} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B T13҂uGFsnA S1_ z.H@sV-umQ/ rgrVFcSctóinuk̾uA M[\b y9_ )(ib]o7PaZk=JI4wr QeR-ӐhX}Qt 1ݫja@K^ }= j"D3XU:*u?| 6&f]'(VY k?YODn7Or>TɩZfZvZ7N-N}.^1>dL,͝0n8^|0~ZPFP^̵x} Tj9th ?H2wr=\aK&cE"*X8)nXZI- Rҿ mRdokh_`V#wp; նגdRyf,jL%>lzr{,V\d6koXp a~( q;(I9zF<2(u4Z+(9%%W# )3Z+B gmMJۿ;5t2&M}wP-B*' lC7AEÐ-XaTu:RD/ ~Xmv@JO"Ⲕ!d #\8_A#~#aMzNNZ2>ieec5+#TMg]Ⴤ]p9jqe^alǣ̏:Ϯ6~O(SW™^tpTeͦVzĻ[ 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All Rights Reserved %%CreationDate: Thu Oct 09 15:25:10 2008 % Converted from TrueType font 'VERDANA.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.35) readonly def /Notice (Typeface and data 1996 Microsoft Corporation. All Rights Reserved) readonly def /FullName (Verdana) readonly def /FamilyName (Verdana) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -88 def /UnderlineThickness 59 def end readonly def /FontName /Verdana def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-30 -207 1447 1000} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /middot put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B Tc gPUcOx {OqqQF4-UټXODU8o\kswKami%ޗﶥB$S/1LW~'T^<T4PX+ԯ({A34.KUĖn%*R_g!g(F4%ٸD K~ɕy8e!lcx# |< -}^^i(XlŨ3K a[y3E7Oz,߉1N6+Pj)cpS-mR\7߃Ra0bRTl,SQYKO׏C8y'߭sU5d}DҰMۭT[I[(㏭AK9%+,E B`6P( :8|NoYo>XImF;:Bŀÿ Kt,!fa"X0*Im Srߋ{8w;Ҵ+DIZy41Żp m`Z# 2;7aޗ8~$6<+p Uk!i͢m~~ I[z)*a0wmNQ ^\تw?@ċ=0}Ơ6YWUfo&|*aGѤrvʧ:q9h@) 6u%sBo$N?J6(Ah:m~\ZXݐ^NR(>^;:i~f6{'Y &'W|-}犁$$S Cp`Ӎ+Wǧ`q4{W_E&9YXs1sZQ<*`(SaD~e 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Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Fri Oct 10 11:50:06 2008 % Converted from TrueType font 'SYMBOL.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 1.60) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Symbol) readonly def /FamilyName (Symbol) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -109 def /UnderlineThickness 49 def end readonly def /FontName /SymbolMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {0 -220 1113 1005} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /universal put dup 35 /numbersign put dup 36 /existential put dup 37 /percent put dup 38 /ampersand put dup 39 /suchthat put dup 40 /parenleft put dup 41 /parenright put dup 42 /asteriskmath put dup 43 /plus put dup 44 /comma put dup 45 /minus put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /congruent put dup 65 /Alpha put dup 66 /Beta put dup 67 /Chi put dup 68 /Delta put dup 69 /Epsilon put dup 70 /Phi put dup 71 /Gamma put dup 72 /Eta put dup 73 /Iota put dup 74 /theta1 put dup 75 /Kappa put dup 76 /Lambda put dup 77 /Mu put dup 78 /Nu put dup 79 /Omicron put dup 80 /Pi put dup 81 /Theta put dup 82 /Rho put dup 83 /Sigma put dup 84 /Tau put dup 85 /Upsilon put dup 86 /sigma1 put dup 87 /Omega put dup 88 /Xi put dup 89 /Psi put dup 90 /Zeta put dup 91 /bracketleft put dup 92 /therefore put dup 93 /bracketright put dup 94 /perpendicular put dup 95 /underscore put dup 96 /radicalex put dup 97 /alpha put dup 98 /beta put dup 99 /chi put dup 100 /delta put dup 101 /epsilon put dup 102 /phi put dup 103 /gamma put dup 104 /eta put dup 105 /iota put dup 106 /phi1 put dup 107 /kappa put dup 108 /lambda put dup 109 /mu put dup 110 /nu put dup 111 /omicron put dup 112 /pi put dup 113 /theta put dup 114 /rho put dup 115 /sigma put dup 116 /tau put dup 117 /upsilon put dup 118 /omega1 put dup 119 /omega put dup 120 /xi put dup 121 /psi put dup 122 /zeta put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /similar put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /.notdef put dup 131 /.notdef put dup 132 /.notdef put dup 133 /.notdef put dup 134 /.notdef put dup 135 /.notdef put dup 136 /.notdef put dup 137 /.notdef put dup 138 /.notdef put dup 139 /.notdef put dup 140 /.notdef put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /.notdef put dup 146 /.notdef put dup 147 /.notdef put dup 148 /.notdef put dup 149 /.notdef put dup 150 /.notdef put dup 151 /.notdef put dup 152 /.notdef put dup 153 /.notdef put dup 154 /.notdef put dup 155 /.notdef put dup 156 /.notdef put dup 157 /.notdef put dup 158 /.notdef put dup 159 /.notdef put dup 160 /.notdef put dup 161 /Upsilon1 put dup 162 /minute put dup 163 /lessequal put dup 164 /fraction put dup 165 /infinity put dup 166 /florin put dup 167 /club put dup 168 /diamond put dup 169 /heart put dup 170 /spade put dup 171 /arrowboth put dup 172 /arrowleft put dup 173 /arrowup put dup 174 /arrowright put dup 175 /arrowdown put dup 176 /degree put dup 177 /plusminus put dup 178 /second put dup 179 /greaterequal put dup 180 /multiply put dup 181 /proportional put dup 182 /partialdiff put dup 183 /bullet put dup 184 /divide put dup 185 /notequal put dup 186 /equivalence put dup 187 /approxequal put dup 188 /ellipsis put dup 189 /arrowvertex put dup 190 /arrowhorizex put dup 191 /carriagereturn put dup 192 /aleph put dup 193 /Ifraktur put dup 194 /Rfraktur put dup 195 /weierstrass put dup 196 /circlemultiply put dup 197 /circleplus put dup 198 /emptyset put dup 199 /intersection put dup 200 /union put dup 201 /propersuperset put dup 202 /reflexsuperset put dup 203 /notsubset put dup 204 /propersubset put dup 205 /reflexsubset put dup 206 /element put dup 207 /notelement put dup 208 /angle put dup 209 /gradient put dup 210 /registerserif put dup 211 /copyrightserif put dup 212 /trademarkserif put dup 213 /product put dup 214 /radical put dup 215 /dotmath put dup 216 /logicalnot put dup 217 /logicaland put dup 218 /logicalor put dup 219 /arrowdblboth put dup 220 /arrowdblleft put dup 221 /arrowdblup put dup 222 /arrowdblright put dup 223 /arrowdbldown put dup 224 /lozenge put dup 225 /angleleft put dup 226 /registersans put dup 227 /copyrightsans put dup 228 /trademarksans put dup 229 /summation put dup 230 /parenlefttp put dup 231 /parenleftex put dup 232 /parenleftbt put dup 233 /bracketlefttp put dup 234 /bracketleftex put dup 235 /bracketleftbt put dup 236 /bracelefttp put dup 237 /braceleftmid put dup 238 /braceleftbt put dup 239 /braceex put dup 240 /.notdef put dup 241 /angleright put dup 242 /integral put dup 243 /integraltp put dup 244 /integralex put dup 245 /integralbt put dup 246 /parenrighttp put dup 247 /parenrightex put dup 248 /parenrightbt put dup 249 /bracketrighttp put dup 250 /bracketrightex put dup 251 /bracketrightbt put dup 252 /bracerighttp put dup 253 /bracerightmid put dup 254 /bracerightbt put dup 255 /.notdef put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B T=:[RXz:F.V0zjQ 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C <RG<29Ap@AC6/?o /?o 7 9999PKKTBKKSB 2+KdRBKRXYKTXYKSXY++++st+ststEEha#DsEEha#DEEha#DEh#D+s+++++++++++++st++++++ssssssss+ss+s+++++st++++u++++++++++++++++++++t+st+sst+st+t+ss++st+s+++ss+++s++++s+++++++++++sttu++++++++++++++++++++++++++s+++++qEhq#Dstu++++ endstream endobj 113 0 obj<> endobj 114 0 obj<>/Subtype/CIDFontType2/Type/Font/W [3[312]]/CIDToGIDMap/Identity/DW 1000>> endobj 115 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0003><0003> endcodespacerange 1 beginbfrange <0003><0003><00a0> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 5 0 obj<> endobj 8 0 obj<> endobj 34 0 obj<> endobj 55 0 obj<> endobj 76 0 obj<> endobj 116 0 obj<> endobj 117 0 obj<> endobj 118 0 obj<> endobj 119 0 obj<> endobj 120 0 obj<> endobj xref 0 121 0000000000 65535 f 0000000015 00000 n 0000002248 00000 n 0000420568 00000 n 0000357658 00000 n 0000441912 00000 n 0000023960 00000 n 0000018182 00000 n 0000442041 00000 n 0000391848 00000 n 0000024168 00000 n 0000030840 00000 n 0000031016 00000 n 0000031153 00000 n 0000037538 00000 n 0000037729 00000 n 0000048748 00000 n 0000048915 00000 n 0000051233 00000 n 0000051391 00000 n 0000052142 00000 n 0000052230 00000 n 0000056327 00000 n 0000056517 00000 n 0000059696 00000 n 0000059854 00000 n 0000067314 00000 n 0000067472 00000 n 0000070436 00000 n 0000070594 00000 n 0000072525 00000 n 0000281151 00000 n 0000322530 00000 n 0000072692 00000 n 0000442170 00000 n 0000079407 00000 n 0000079595 00000 n 0000082283 00000 n 0000082452 00000 n 0000089134 00000 n 0000089322 00000 n 0000095365 00000 n 0000095534 00000 n 0000101258 00000 n 0000101427 00000 n 0000107274 00000 n 0000107443 00000 n 0000113173 00000 n 0000113342 00000 n 0000117437 00000 n 0000117606 00000 n 0000124177 00000 n 0000124365 00000 n 0000130066 00000 n 0000130235 00000 n 0000442301 00000 n 0000136134 00000 n 0000136303 00000 n 0000142213 00000 n 0000142382 00000 n 0000143876 00000 n 0000144045 00000 n 0000150717 00000 n 0000150905 00000 n 0000152871 00000 n 0000153040 00000 n 0000159330 00000 n 0000159518 00000 n 0000164042 00000 n 0000164211 00000 n 0000170740 00000 n 0000170928 00000 n 0000174831 00000 n 0000175000 00000 n 0000181562 00000 n 0000181750 00000 n 0000442432 00000 n 0000187057 00000 n 0000287270 00000 n 0000187226 00000 n 0000195908 00000 n 0000196077 00000 n 0000199423 00000 n 0000199582 00000 n 0000207740 00000 n 0000207899 00000 n 0000215303 00000 n 0000215462 00000 n 0000222590 00000 n 0000222749 00000 n 0000230348 00000 n 0000230507 00000 n 0000235881 00000 n 0000236040 00000 n 0000238375 00000 n 0000238534 00000 n 0000238572 00000 n 0000280971 00000 n 0000281283 00000 n 0000286462 00000 n 0000286641 00000 n 0000286857 00000 n 0000287404 00000 n 0000322358 00000 n 0000322653 00000 n 0000357484 00000 n 0000358209 00000 n 0000391675 00000 n 0000391971 00000 n 0000419053 00000 n 0000419244 00000 n 0000419603 00000 n 0000420702 00000 n 0000441132 00000 n 0000441314 00000 n 0000441518 00000 n 0000442555 00000 n 0000442629 00000 n 0000442677 00000 n 0000442712 00000 n 0000442774 00000 n trailer <<8399a4de99cb78e6fc3101396d8b03b9>]/Root 119 0 R/Size 121>> startxref 443005 %%EOF