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*{;i?})2De+1>pq C3pj4ZjL&y n36#NkStY TUB5(b}Bi'Bhn>9ZZ^ gZv5v7Z4M*ď$h")`]Ao/>?ö9[[kW_ 5=[X$ 5čL/soƥ_GNK _cZDo hW4PǧhvhB +gOȕ |I_^s<1b+Ѩy=_aPqYʞ"p=tiC!uG ,J)0p] (TR|cƷ4»B/׾*ьůI-?诫8?ۯwW |#xwúϊMCB.񵥾[kY]G%u-c_XZ Q>stream 0 J q 538.5 0 0 61.5 28.35 14.2 cm /img0 Do Q 0.98431 0.78824 0.08627 RG 135.75 w 24.07 742.4 m 558.15 742.4 l S 0.001 w [] 0 d 2.25 w 20.74 812.53 m 561.48 812.53 l S 0.001 w [] 0 d [] 0 d 2.25 w 20.74 674.53 m 561.48 674.53 l S 0.001 w [] 0 d [] 0 d 2.25 w 21.82 813.61 m 21.82 673.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 560.4 813.61 m 560.4 673.45 l S 0.001 w [] 0 d q 191.25 0 0 117.75 28.35 685.65 cm /img1 Do Q /F1 12 Tf 0.6 0.6 0.6 rg BT 1 0 0 1 136.35 656.27 Tm (,QVSHFWLQJIRUEHWWHUOLYHV)Tj ET /F1 28 Tf 0 0 0 rg BT 1 0 0 1 147.05 596.27 Tm (.H\\LQVSHFWLRQUHSRUW)Tj ET 20.58 w 27.33 552.19 m 557.15 552.19 l S 0.001 w /F2 24 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 504.5 Tm (Care homes for older people)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 6 Tf BT 1 0 0 1 28.35 493.46 Tm ()Tj ET /F1 6 Tf BT 1 0 0 1 28.35 486.22 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 472.44 m 160.38 472.44 l S 0.001 w 1 1 1 RG 20.58 w 162.63 472.44 m 563.65 472.44 l S 0.001 w 0.99608 0.9451 0.76078 RG 73.32 w 31.2 423.24 m 160.38 423.24 l S 0.001 w 1 1 1 RG 73.32 w 162.63 423.24 m 563.65 423.24 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 461.02 m 565.85 461.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 483.85 m 565.85 483.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 461.02 m 565.85 461.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 385.45 m 565.85 385.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 484.93 m 30.07 384.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 161.5 484.93 m 161.5 384.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 484.93 m 564.78 384.38 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 467.67 Tm (Name:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 165.48 467.67 Tm (Summerfield)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 444.84 Tm (Address:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 165.48 444.84 Tm (42-43 Wellington Road )Tj ET /F2 12 Tf BT 1 0 0 1 165.48 427.26 Tm (Dudley)Tj ET /F2 12 Tf BT 1 0 0 1 165.48 409.68 Tm (West Midlands)Tj ET /F2 12 Tf BT 1 0 0 1 165.48 392.1 Tm (DY1 1RD)Tj ET /F3 10 Tf BT 1 0 0 1 28.35 373.2 Tm ()Tj ET /F3 10 Tf BT 1 0 0 1 28.35 356.2 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 336.66 m 358.95 336.66 l S 0.001 w 1 1 1 RG 20.58 w 361.2 336.66 m 565.9 336.66 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 348.08 m 568.1 348.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 325.25 m 568.1 325.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 349.15 m 30.07 324.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 360.07 349.15 m 360.07 324.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 349.15 m 567.02 324.17 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 331.89 Tm (The quality rating for this )Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 191.92 331.89 Tm (care home)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 255.59 331.89 Tm ( is:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 386.8 331.89 Tm (one star adequate service)Tj ET /F3 10 Tf BT 1 0 0 1 28.35 312.99 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 293.94 Tm (A quality rating is our assessment of how well a care home, agency or scheme is )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 276.94 Tm (meeting the needs of the people who use it.)Tj ET /F2 12 Tf BT 1 0 0 1 295.2 276.94 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 303.65 276.94 Tm (We give a quality rating following a full )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 259.94 Tm (assessment of the service.)Tj ET /F2 12 Tf BT 1 0 0 1 189.22 259.94 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 197.67 259.94 Tm (We call this a key inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 242.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 225.46 m 315.25 225.46 l S 0.001 w 20.58 w 317.5 225.46 m 565.9 225.46 l S 0.001 w 1 1 1 RG 20.58 w 317.5 202.63 m 346.55 202.63 l S 0.001 w 20.58 w 348.8 202.63 m 377.9 202.63 l S 0.001 w 20.58 w 380.15 202.63 m 409.2 202.63 l S 0.001 w 20.58 w 411.45 202.63 m 440.55 202.63 l S 0.001 w 20.58 w 442.8 202.63 m 471.9 202.63 l S 0.001 w 20.58 w 474.15 202.63 m 503.2 202.63 l S 0.001 w 20.58 w 505.45 202.63 m 534.55 202.63 l S 0.001 w 20.58 w 536.8 202.63 m 565.9 202.63 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 214.04 m 568.1 214.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 236.87 m 568.1 236.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 214.04 m 568.1 214.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 191.21 m 568.1 191.21 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 237.95 m 30.07 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 237.95 m 316.37 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 215.12 m 347.67 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 215.12 m 379.02 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 215.12 m 410.32 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 215.12 m 441.67 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 215.12 m 473.02 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 215.12 m 504.32 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 215.12 m 535.67 190.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 237.95 m 567.02 190.13 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 220.69 Tm (Lead inspector:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 320.35 220.69 Tm (Date:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 197.86 Tm (Jean Edwards)Tj ET /F2 12 Tf BT 1 0 0 1 329.63 197.86 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 360.95 197.86 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 392.28 197.86 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 423.61 197.86 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 454.95 197.86 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 486.28 197.86 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 517.6 197.86 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 548.96 197.86 Tm (9)Tj ET /F3 10 Tf BT 1 0 0 1 28.35 178.96 Tm ()Tj ET /F3 10 Tf BT 1 0 0 1 28.35 161.96 Tm ()Tj ET /F1 10 Tf BT 1 0 0 1 297.64 144.96 Tm ()Tj ET /F1 10 Tf BT 1 0 0 1 297.64 132.89 Tm ()Tj ET /F1 10 Tf BT 1 0 0 1 297.64 120.82 Tm ()Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 10 0 obj<>>> endobj 11 0 obj <>stream 0 J 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (2)Tj ET 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 297.64 803.65 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 787.03 Tm (This is a report of an inspection where we looked at how well this )Tj ET /F2 12 Tf BT 1 0 0 1 428.32 787.03 Tm (care home is meeting )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 769.53 Tm (the needs of people who use it.)Tj ET /F2 12 Tf BT 1 0 0 1 226.66 769.53 Tm (There is a summary of what we think this service does )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 752.03 Tm (well, what they have improved on and, where it applies, what they need to do better.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 734.54 Tm (We use the national minimum standards to describe the outcomes that people should )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 717.04 Tm (experience.)Tj ET /F2 12 Tf BT 1 0 0 1 106.61 717.04 Tm (National minimum standards are written by the Department of Health for )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 699.54 Tm (each type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 679.55 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 28.35 662.05 Tm (what you will see under each outcome area.)Tj ET [] 0 d 0.5 w 0 0 0 RG 22.69 653.87 m 572.15 653.87 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.69 320.23 m 572.15 320.23 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.7 653.87 m 22.7 320.23 l S 0.001 w [] 0 d [] 0 d 0.5 w 572.15 653.87 m 572.15 320.23 l S 0.001 w [] 0 d /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 640.57 Tm (Outcome area \(for example )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 173.59 640.57 Tm (Choice of home\))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 31.2 610.27 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 1 216.34 610.27 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 1 435.79 610.27 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 31.2 598.12 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 30.6 533.38 m 562.45 533.38 l S 0.001 w 1 1 1 RG 39.99 w 29.47 513.38 m 563.57 513.38 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 27.27 534.5 m 565.77 534.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 576.74 m 565.77 576.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 534.5 m 565.77 534.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 492.26 m 565.77 492.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 577.82 m 28.35 491.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 577.82 m 564.7 491.18 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 561.06 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 34.87 543.56 Tm (inspection)Tj ET /F2 10 Tf BT 1 0 0 1 95.78 543.56 Tm (.)Tj ET /F2 12 Tf BT 1 0 0 1 34.87 518.82 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 34.87 501.32 Tm (key inspection.)Tj ET /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 461.81 Tm (This is what people )Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 131.32 461.81 Tm (staying in this care home experience:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 424.65 Tm (Judgement:)Tj ET 1 0.9451 0.76078 RG 39.99 w 30.6 393.35 m 562.45 393.35 l S 0.001 w 1 1 1 RG 39.99 w 29.47 394.47 m 563.57 394.47 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 27.27 415.59 m 565.77 415.59 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 373.35 m 565.77 373.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 416.67 m 28.35 372.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 416.67 m 564.7 372.27 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 399.91 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 1 517.79 399.91 Tm (We )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 382.41 Tm (will say whether it is excellent, good, adequate or poor.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 356.54 Tm (Evidence:)Tj ET 1 0.9451 0.76078 RG 22.5 w 30.6 333.98 m 562.45 333.98 l S 0.001 w 1 1 1 RG 22.5 w 29.47 335.11 m 563.57 335.11 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 27.27 347.48 m 565.77 347.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 322.73 m 565.77 322.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 348.55 m 28.35 321.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 348.55 m 564.7 321.65 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 331.79 Tm (This box describes the information we used to come to our judgement.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 285.18 Tm (Copies of the)Tj ET /F2 12 Tf BT 1 0 0 1 111.71 285.18 Tm (National Minimum Standards )Tj ET /F2 12 Tf BT 1 0 0 1 290.49 285.18 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 302.34 285.18 Tm (Care Homes for Older People)Tj ET /F2 12 Tf BT 1 0 0 1 477.18 285.18 Tm ( can be found )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 267.68 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 28.35 250.18 Tm (Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 232.69 Tm (Stationery Office is also available: )Tj ET /F2 12 Tf 0 0 1 rg BT 1 0 0 1 238.73 232.69 Tm (www.tso.co.uk/bookshop)Tj ET /F2 12 Tf 0 0 0 rg BT 1 0 0 1 28.35 192.7 Tm (The Commission for Social Care Inspection aims to:)Tj ET /F4 12 Tf BT 1 0 0 1 46.35 172.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 64.35 172.7 Tm (Put the people who use social care first)Tj ET /F4 12 Tf BT 1 0 0 1 46.35 155.06 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 64.35 155.06 Tm (Improve services and stamp out bad practice)Tj ET /F4 12 Tf BT 1 0 0 1 46.35 137.42 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 64.35 137.42 Tm (Be an expert voice on social care)Tj ET /F4 12 Tf BT 1 0 0 1 46.35 119.78 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 64.35 119.78 Tm (Practise what we preach in our own organisation)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 79.64 Tm (Our duty to regulate social care services is set out in the Care Standards Act 2000.)Tj ET endstream endobj 12 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 13 0 obj <>stream 0 J 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (3)Tj ET 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm (5HDGHU,QIRUPDWLRQ)Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 28.35 774.22 m 224.05 774.22 l S 0.001 w 1 1 1 RG 20.58 w 226.3 774.22 m 567 774.22 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 28.35 751.39 m 224.05 751.39 l S 0.001 w 1 1 1 RG 20.58 w 226.3 751.39 m 567 751.39 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 28.35 728.56 m 224.05 728.56 l S 0.001 w 1 1 1 RG 20.58 w 226.3 728.56 m 567 728.56 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 28.35 705.73 m 224.05 705.73 l S 0.001 w 1 1 1 RG 20.58 w 226.3 705.73 m 567 705.73 l S 0.001 w 0.99608 0.9451 0.76078 RG 151.8 w 28.35 617.29 m 224.05 617.29 l S 0.001 w 1 1 1 RG 151.8 w 226.3 617.29 m 567 617.29 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 28.35 528.85 m 224.05 528.85 l S 0.001 w 1 1 1 RG 20.58 w 226.3 528.85 m 567 528.85 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 26.14 762.8 m 569.2 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 739.97 m 569.2 739.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 717.14 m 569.2 717.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 694.31 m 569.2 694.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 540.26 m 569.2 540.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 785.63 m 569.2 785.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 762.8 m 569.2 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 739.97 m 569.2 739.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 717.14 m 569.2 717.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 694.31 m 569.2 694.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 540.26 m 569.2 540.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 517.43 m 569.2 517.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 786.71 m 27.22 516.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 225.17 786.71 m 225.17 516.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 568.12 786.71 m 568.12 516.35 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 31.2 769.45 Tm (Document Purpose)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 769.45 Tm (Inspection report)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 746.62 Tm (Author)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 746.62 Tm (CSCI)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 723.79 Tm (Audience)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 723.79 Tm (General public)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 700.96 Tm (Further copies from)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 700.96 Tm (0870 240 7535 \(telephone order line\))Tj ET /F2 12 Tf BT 1 0 0 1 31.2 678.13 Tm (Copyright)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 678.13 Tm (Copyright \()Tj ET /F2 12 Tf BT 1 0 0 1 313.49 678.13 Tm (2009)Tj ET /F2 12 Tf BT 1 0 0 1 344.02 678.13 Tm (\) Commission for Social Care )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 663.55 Tm (Inspection \(CSCI\). This publication may be reproduced )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 648.97 Tm (in whole or in part, free of charge, in any format or )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 634.39 Tm (medium provided that it is not used for commercial )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 619.81 Tm (gain. This consent is subject to the material being )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 605.23 Tm (reproduced accurately and on proviso that it is not )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 590.65 Tm (used in a derogatory manner or misleading context. )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 576.07 Tm (The material should be acknowledged as CSCI )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 561.49 Tm (copyright, with the title and date of publication of the )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 546.91 Tm (document specified.)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 524.08 Tm (Internet address)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 524.08 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (4)Tj ET 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm (,QIRUPDWLRQDERXWWKHFDUHKRPH)Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 774.22 m 267.95 774.22 l S 0.001 w 1 1 1 RG 20.58 w 270.2 774.22 m 565.65 774.22 l S 0.001 w 0.99608 0.9451 0.76078 RG 73.32 w 31.2 725.02 m 267.95 725.02 l S 0.001 w 1 1 1 RG 73.32 w 270.2 725.02 m 565.65 725.02 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 675.82 m 267.95 675.82 l S 0.001 w 1 1 1 RG 20.58 w 270.2 675.82 m 565.65 675.82 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 652.99 m 267.95 652.99 l S 0.001 w 1 1 1 RG 20.58 w 270.2 652.99 m 565.65 652.99 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 630.16 m 267.95 630.16 l S 0.001 w 1 1 1 RG 20.58 w 270.2 630.16 m 565.65 630.16 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 607.33 m 267.95 607.33 l S 0.001 w 1 1 1 RG 20.58 w 270.2 607.33 m 565.65 607.33 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 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 28.99 785.63 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 (Summerfield)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 (42-43 Wellington Road )Tj ET /F2 12 Tf BT 1 0 0 1 273.05 729.04 Tm (Dudley)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 711.46 Tm (West Midlands)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 693.88 Tm (DY1 1RD)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 (01384239331)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 34.05 625.39 Tm (Email address:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 602.56 Tm (Provider web address:)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 583.61 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 28.35 566.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 547.12 m 353.25 547.12 l S 0.001 w 1 1 1 RG 20.58 w 355.5 547.12 m 565.9 547.12 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 558.54 m 568.1 558.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 535.71 m 568.1 535.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 559.61 m 30.07 534.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 559.61 m 354.37 534.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 559.61 m 567.02 534.63 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 542.35 Tm (Name of registered provider\(s\):)Tj ET /F2 12 Tf BT 1 0 0 1 355.5 542.35 Tm (Merron Care Ltd)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 523.41 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 503.92 m 353.25 503.92 l S 0.001 w 1 1 1 RG 20.58 w 355.5 503.92 m 565.9 503.92 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 481.09 m 353.25 481.09 l S 0.001 w 1 1 1 RG 20.58 w 355.5 481.09 m 565.9 481.09 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 492.5 m 568.1 492.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 515.33 m 568.1 515.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 492.5 m 568.1 492.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 469.67 m 568.1 469.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 516.41 m 30.07 468.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 516.41 m 354.37 468.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 516.41 m 567.02 468.6 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 499.15 Tm (Type of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 499.15 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 476.32 Tm (Number of places registered:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 476.32 Tm (38)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 457.37 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 28.35 440.37 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 420.88 m 565.6 420.88 l S 0.001 w 41.16 w 31.2 387.76 m 297.2 387.76 l S 0.001 w 20.58 w 299.45 398.05 m 565.6 398.05 l S 0.001 w 20.58 w 299.45 377.47 m 432.52 377.47 l S 0.001 w 20.58 w 432.52 377.47 m 565.6 377.47 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 409.47 m 567.8 409.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 432.3 m 567.8 432.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 409.47 m 567.8 409.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 366.06 m 567.8 366.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 433.37 m 30.07 364.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 410.54 m 298.32 364.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 433.37 m 566.72 364.98 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 416.11 Tm (Conditions of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 393.28 Tm (Category\(ies\) :)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 393.28 Tm (Number of places \(if applicable\):)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 372.7 Tm (Under 65)Tj ET /F2 12 Tf BT 1 0 0 1 435.37 372.7 Tm (Over 65)Tj ET 1 1 1 RG 20.58 w 31.2 351.27 m 297.3 351.27 l S 0.001 w 20.58 w 299.55 351.27 m 431.45 351.27 l S 0.001 w 20.58 w 433.7 351.27 m 565.6 351.27 l S 0.001 w 35.16 w 31.2 321.15 m 297.3 321.15 l S 0.001 w 35.16 w 299.55 321.15 m 431.45 321.15 l S 0.001 w 35.16 w 433.7 321.15 m 565.6 321.15 l S 0.001 w 20.58 w 31.2 291.03 m 297.3 291.03 l S 0.001 w 20.58 w 299.55 291.03 m 431.45 291.03 l S 0.001 w 20.58 w 433.7 291.03 m 565.6 291.03 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 268.2 m 565.6 268.2 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 339.85 m 567.8 339.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 302.44 m 567.8 302.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 279.61 m 567.8 279.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 256.78 m 567.8 256.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 362.68 m 567.8 362.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 339.85 m 567.8 339.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 302.44 m 567.8 302.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 279.61 m 567.8 279.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 256.78 m 568.1 256.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 233.95 m 568.1 233.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 363.76 m 30.07 232.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.42 363.76 m 298.42 278.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.57 363.76 m 432.57 278.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 363.76 m 566.72 232.88 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 346.5 Tm (dementia)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 346.5 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 346.5 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 323.67 Tm (old age, not falling within any other )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 309.09 Tm (category)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 323.67 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 323.67 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 286.26 Tm (physical disability)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 286.26 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 286.26 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 263.43 Tm (Additional conditions: )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 240.6 Tm (The Manager should source and undertake further training in dementia care.)Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 219.16 m 315.25 219.16 l S 0.001 w 1 1 1 RG 20.58 w 317.5 219.16 m 346.55 219.16 l S 0.001 w 20.58 w 348.8 219.16 m 377.9 219.16 l S 0.001 w 20.58 w 380.15 219.16 m 409.2 219.16 l S 0.001 w 20.58 w 411.45 219.16 m 440.55 219.16 l S 0.001 w 20.58 w 442.8 219.16 m 471.9 219.16 l S 0.001 w 20.58 w 474.15 219.16 m 503.2 219.16 l S 0.001 w 20.58 w 505.45 219.16 m 534.55 219.16 l S 0.001 w 20.58 w 536.8 219.16 m 565.9 219.16 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 230.58 m 568.1 230.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 207.75 m 568.1 207.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 231.65 m 30.07 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 231.65 m 316.37 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 231.65 m 347.67 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 231.65 m 379.02 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 231.65 m 410.32 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 231.65 m 441.67 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 231.65 m 473.02 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 231.65 m 504.32 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 231.65 m 535.67 206.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 231.65 m 567.02 206.67 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 214.39 Tm (Date of last inspection)Tj ET /F2 12 Tf BT 1 0 0 1 328.2 214.39 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 359.53 214.39 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 390.86 214.39 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 422.18 214.39 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 453.53 214.39 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 484.86 214.39 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 516.18 214.39 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 547.53 214.39 Tm (8)Tj ET 0.99608 0.9451 0.76078 RG 17 w 31.2 195.87 m 565.9 195.87 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 186.25 m 568.1 186.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 187.32 m 30.07 55.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 187.32 m 567.02 55.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 205.5 m 568.1 205.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 186.25 m 568.1 186.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 56.15 m 568.1 56.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 206.57 m 30.07 185.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 206.57 m 567.02 185.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 192.31 Tm (Brief description of the )Tj ET /F2 12 Tf BT 1 0 0 1 177.31 192.31 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 173.06 Tm (Summerfield was originally two large traditional semi detached residential properties )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 156.06 Tm (that have been linked and extended to its present form. The home is registered to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 139.06 Tm (provide personal care for up to 38 people with up to 18 places accommodating older )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 122.06 Tm (people who have dementia, up to 12 places for older people who do not fall within any )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 105.06 Tm (other category and up to 8 places for people who are over 65 years and have a )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 88.06 Tm (physical disability. The home comprises of three floors. The basement is used to house )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 71.06 Tm (the boilers and is also a storage area. The ground floor has a number of bedrooms, )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (5)Tj ET 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 0.99608 0.9451 0.76078 RG 17 w 31.2 804.03 m 565.9 804.03 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 30.07 689.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 795.48 m 567.02 689.08 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 28.99 690.15 m 568.1 690.15 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 (two offices, the kitchen, communal areas and hygiene facilities. The first floor )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 766.47 Tm (accommodates further bedrooms, bathrooms, sluice and toilets. Summerfield Care )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 749.47 Tm (Home is located near to central Dudley and is situated on a main road, which is also a )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 732.47 Tm (main bus route. Opposite is the Dudley Leisure Centre, there is a Carvery next door )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 715.47 Tm (and a number of shops are in the local vicinity, a small car park is available to the front )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 698.47 Tm (of the home.)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 530/Matrix [1 0 0 1 0 0]>>stream xMo0>eGJ%NrCnRVgJX*";kי~&l#jWFC +e2!c2 Xft=|愒%4j2R)n!UպE+I<Z׃s{efBkvkjO/l|%Y4 i(9ʴ"5qrXs1T1%,;UA6A$Iޅ&A;rp()*$@S 0nRn"ٴR򌰷6ۻV]0UeFؐl&&!e{>V>H-3j0Մ"e,LUvԚu^|U:u"s]rnw=}oGf[b0tw7~=XÍ`t6qXمR..p\-F[4z"L8@~~9M {gػą/w`_ZKNߜʻ։gZЬN> endobj 21 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 40.96 m 566.93 40.96 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 37.19 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 489.47 37.19 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 520 37.19 Tm (6)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 526.99 37.19 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 545.29 37.19 Tm (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 778.65 Tm (6XPPDU\\)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 757.7 Tm (This is an overview of what we found during the inspection.)Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 737.22 m 381.05 737.22 l S 0.001 w 1 1 1 RG 20.58 w 383.3 737.22 m 566.2 737.22 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 748.64 m 568.4 748.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 725.81 m 568.4 725.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 749.71 m 30.07 724.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 382.17 749.71 m 382.17 724.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 749.71 m 567.32 724.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 732.45 Tm (The quality rating for this )Tj ET /F2 12 Tf BT 1 0 0 1 191.92 732.45 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 255.59 732.45 Tm ( is:)Tj ET /F2 12 Tf BT 1 0 0 1 398 732.45 Tm (one star adequate service)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 700.31 Tm (2XUMXGJHPHQWIRUHDFKRXWFRPH)Tj ET /F2 10 Tf BT 1 0 0 1 212.29 624.27 Tm (Choice of home)Tj ET /F2 10 Tf BT 1 0 0 1 164.41 584.02 Tm (Health and personal care)Tj ET /F2 10 Tf BT 1 0 0 1 145.18 543.77 Tm (Daily life and social activities)Tj ET /F2 10 Tf BT 1 0 0 1 157.95 503.52 Tm (Complaints and protection)Tj ET /F2 10 Tf BT 1 0 0 1 226.36 463.27 Tm (Environment)Tj ET /F2 10 Tf BT 1 0 0 1 251.17 423.02 Tm (Staffing)Tj ET /F2 10 Tf BT 1 0 0 1 127.47 382.77 Tm (Management and administration)Tj ET q 0.75227 0 0 0.75161 305.05 317.32 cm /Xf1 Do Q 1 1 1 RG 20.58 w 31.2 266.08 m 567.85 266.08 l S 0.001 w 201.16 w 32.32 152.96 m 566.72 152.96 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.2 254.66 m 567.85 254.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 254.66 m 568.92 254.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 51.25 m 568.92 51.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 255.74 m 31.2 50.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 255.74 m 567.85 50.17 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 261.3 Tm (How we did our inspection:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 35.17 238.48 Tm (The last key inspection took place on 10 April 2008, and the CSCI undertook a Random )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 223.9 Tm (Inspection on 2 December 2008 and further urgent Random Inspection on 6 February )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 209.32 Tm (2009.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 194.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 180.15 Tm (We, the Care Quality Commission \(CQC\), undertook an unannounced key inspection )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 165.57 Tm (visit. This meant that the home had not been given prior notice of the inspection visit. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 150.99 Tm (The inspector and the local area manager visited the home between 07:30 and 17:15 )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 136.41 Tm (hours. The CQC pharmacy inspector visited the home on a separate day to assess the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 121.83 Tm (home's medication systems. We monitored the compliance with all Key National )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 107.25 Tm (Minimum Standards at these visits. The range of inspection methods to obtain evidence )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 92.68 Tm (and make judgements included, discussions with the temporary acting manager, a )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 78.1 Tm (company director and staff on duty during the visit. We also talked to people living at )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 63.51 Tm (the home, and made observations of people without verbal communication skills. Other )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 1 1 1 RG 484.14 w 32.32 570.46 m 566.72 570.46 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 30.12 813.65 m 568.92 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 327.26 m 568.92 327.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 814.73 m 31.2 326.19 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 814.73 m 567.85 326.19 l S 0.001 w [] 0 d /F2 12 Tf 0 0 0 rg BT 1 0 0 1 32.92 802.72 Tm (information was gathered before this inspection visit including notification of incidents, )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 788.14 Tm (accidents and events submitted to the previous Commission for Social Care Inspection. )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 773.56 Tm (A number of records and documents were examined. The registered persons submitted )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 758.98 Tm (the homes Annual Quality Assurance Assessment \(AQAA\) as requested prior to the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 744.4 Tm (inspection visit.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 729.82 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 715.24 Tm (We toured the premises, looking at communal areas of the home, the bathrooms, )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 700.66 Tm (toilets, laundry, kitchen areas, and people's bedrooms, with their permission, where )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 686.08 Tm (possible.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 671.5 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 656.92 Tm (We circulated surveys prior to this inspection visit and received there were no )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 642.34 Tm (responses from people living at the home, 2 responses from relatives, 2 responses )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 627.76 Tm (from health professionals and 4 responses from staff. The collated results form part of )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 613.18 Tm (this report.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 598.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 584.02 Tm (This service had a 0 Star, poor, quality rating in 2008, briefly improved to One star, )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 569.44 Tm (adequate, but further visits made told us that they were not improving the service.)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 (This visit has told us that some improvements have been made since February 2009, )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 525.7 Tm (when we last visited. There is still no permanent manager, one has been employed and )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 511.12 Tm (should be in her position in June 2009.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 496.54 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 481.96 Tm (The process of the inspection is to show where the service is doing well and where )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 467.38 Tm (improvements are needed, and to consider the management ability to meet these )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 452.8 Tm (changes.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 438.22 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 423.64 Tm (From all of the information we make a judgment on the outcomes for people using the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 409.06 Tm (service for all the different sections as shown in this report and a final quality rating )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 394.48 Tm (which will determine further regulation activity.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 379.9 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 365.32 Tm (A statement of purpose and service user guide is available. The home has not )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 350.74 Tm (published the range of fees in the service user guide and people are advised to contact )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 336.16 Tm (the home for up to date information about fee levels. )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 355.92 w 32.32 595.86 m 566.72 595.86 l S 0.001 w 20.58 w 32.7 405.36 m 569.35 405.36 l S 0.001 w 328.8 w 33.82 228.43 m 568.22 228.43 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 30.12 416.78 m 568.92 416.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 776.03 m 31.2 415.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 416.78 m 569.35 416.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 393.95 m 569.35 393.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 393.95 m 570.42 393.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 62.9 m 570.42 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 395.03 m 32.7 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 776.03 m 567.85 415.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 569.35 395.03 m 569.35 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 0.99216 0.89804 0.5451 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 0.99216 0.89804 0.5451 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 0.99216 0.89804 0.5451 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 (The temporary acting manager transferred from another home in the company at short )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.18 Tm (notice on the evening of 6 February 2009, had responded to the previous inspection )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.6 Tm (reports with considerable improvements. All requirements and many of the good )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.02 Tm (practice recommendations required at the last inspections visit had been actioned.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.44 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 685.86 Tm (The people living at the home were encouraged to treat the as their own home and to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.28 Tm (be as independent as possible. We saw some examples of people being able to make )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.7 Tm (choices about their daily routines and meals. It was positive that the temporary acting )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.12 Tm (manager had an "open door" policy to encourage relatives and people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.54 Tm (home to talk to her on an individual basis.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 612.96 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.38 Tm (There was a warm and friendly rapport between staff and people living at the home. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 583.8 Tm (Staff were aware of individual people's likes and dislikes and generally how to meet )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 569.22 Tm (their needs. A response from a healthcare professional made the following comments, " )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 554.64 Tm (Summerfield Care Home has been up and down. Improved greatly since YH came as )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 540.06 Tm (acting manager. Atmosphere more relaxed. Happy with care of diabetic residents now. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 525.48 Tm (Staff are helpful and know about the residents with information readily available.")Tj ET /F2 12 Tf BT 1 0 0 1 35.17 510.9 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 496.32 Tm (All staff are checked to ensure that they are suitable to work with vulnerable people.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 481.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 467.16 Tm (Staff had a good relationship with the people they are caring for, spending time talking )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 452.58 Tm (with them and enjoying some activities.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 438 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 423.42 Tm (There are enough staff on duty to ensure that the needs of each person can be met.)Tj ET /F2 10 Tf BT 1 0 0 1 568.97 594.31 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 403.25 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 32.7 400.59 Tm (What has improved since the last inspection?)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 569.35 403.81 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 226.88 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 377.76 Tm (The temporary acting manager team had introduced improvements to all areas of the )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 363.18 Tm (home in a short period of time. This notably included the standards of cleanliness in )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 348.6 Tm (the home. There were no noticeable malodours in the communal areas, though there )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 334.02 Tm (were some in a few individual bedrooms. Following a poor environmental health )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 319.44 Tm (inspection the standards in the kitchen had markedly improved at a second visit from )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 304.86 Tm (the Environmental Health Officer, though the 'Scores on the Doors' 2 star rating will )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 290.28 Tm (not change until the next full inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 275.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 261.12 Tm (There was improved assessment and management of risks, care planning and care )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 246.54 Tm (records. These provided better information and clearer guidance so that all staff knew )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 231.96 Tm (about each person's needs, preferences and wishes. The records we looked at were )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 217.38 Tm (better completed and kept up to date, though additional areas for improvement were )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 202.8 Tm (identified at this visit.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 188.22 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 173.64 Tm (The majority of answers to CQC survey questions from 2 relative surveys returned, )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 159.06 Tm (were 'usually' or 'sometimes' and comments included, " initially when my relative was )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 144.48 Tm (admitted the care home was run very well and the standards were met. However the )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 129.9 Tm (manager left, and the home became very disorganised and standards fell dramatically )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 115.32 Tm (and many good care staff also left. However over the past few months the relief )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 100.74 Tm (manager was appointed, many changes have been made, new very good care staff )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 86.16 Tm (employed and at present the total standards have improved. With the recent )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 71.58 Tm (employment of a permanent manager hopefully the home will continue to improve.")Tj ET /F2 10 Tf BT 1 0 0 1 570.47 226.88 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 1 1 1 RG 469.56 w 33.82 577.75 m 568.22 577.75 l S 0.001 w 20.58 w 33.45 330.43 m 570.1 330.43 l S 0.001 w 253.86 w 34.57 190.96 m 568.97 190.96 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.62 813.65 m 570.42 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 341.84 m 570.42 341.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 569.35 814.73 m 569.35 340.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 319.01 m 570.1 319.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 341.84 m 570.1 341.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 319.01 m 571.17 319.01 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 32.7 814.73 m 32.7 340.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 320.09 m 33.45 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 320.09 m 570.1 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.42 802.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.42 788.14 Tm (Improvements had also been put in place to make the home's medication system )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 773.56 Tm (safer, so that each person would receive their medicines as prescribed at the right time )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 758.98 Tm (and al previous requirements and good practice recommendations relating to )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 744.4 Tm (medication were met. However the CQC pharmacist inspector identified additional )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 729.82 Tm (areas, which needed to be improved at this inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 34.42 715.24 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.42 700.66 Tm (The 2 responses to professional healthcare surveys answered 'usually' to most )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 686.08 Tm (questions and comments included, "There has been an overall improvement noticed on )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 671.5 Tm (my last visit. I cover Dr X, therefore not in the home very frequently, but the care )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 656.92 Tm (\(overall\) appeared to be slipping, caring better in last 2 months.")Tj ET /F2 12 Tf BT 1 0 0 1 34.42 642.34 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.42 627.76 Tm (Improvements had been made to the way concerns, complaints and matters requiring )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 613.18 Tm (notification to outside agencies were reported and the Local Authority and the CQC had )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 598.6 Tm (received notifications of any events affecting people living at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.42 584.02 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.42 569.44 Tm (The temporary acting manager had reorganized staffing by dealing with disciplinary )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 554.86 Tm (matters, recruiting additional suitable staff and had sourced training to make progress )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 540.28 Tm (to ensure all staff were up to date with mandatory and good practice training. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 525.7 Tm (meant staff were more knowledgeable and skilled to meet the needs of people living at )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 511.12 Tm (the home. A relative commented, "Vast improvement seen recently, mother in law )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 496.54 Tm (loves it here now. "Care staff work very hard, very pleasant. Staff here now are )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 481.96 Tm (brilliant." "Home very pleasant now". She says, "they do look after you here.")Tj ET /F2 12 Tf BT 1 0 0 1 34.42 467.38 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.42 452.8 Tm (Staffing recruitment has improved and the management ensure that no one starts )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 438.22 Tm (work without being checked.)Tj ET /F2 12 Tf BT 1 0 0 1 34.42 423.64 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.42 409.06 Tm (Various maintenance work has been carried out to ensure that the bathrooms are safe )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 394.48 Tm (and clean to use.)Tj ET /F2 12 Tf BT 1 0 0 1 34.42 379.9 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.42 365.32 Tm (Improvements had been made to health and safety, with systems and records better )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 350.74 Tm (organised and information readily available.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 328.88 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 33.45 325.66 Tm (What they could do better:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 31.2 189.41 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 302.83 Tm (There were a number of areas still requiring improvement at this inspection. The )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 288.25 Tm (registered persons must continue to monitor the way peoples medication is )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 273.67 Tm (administered at the home, taking action to provide additional medication training and )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 259.09 Tm (assess the competency of staff to make sure issues are recognised and referred to )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 244.51 Tm (healthcare professionals and any mistakes are avoided and do not pose risks to )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 229.93 Tm (peoples health and well being.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 215.35 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 200.77 Tm (There are also care records, which should be expanded to provide enhanced )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 186.19 Tm (information for staff so that each person's needs are fully met. These include moving )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 171.61 Tm (and handling risk assessments, which must provide staff with specific guidance as to )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 157.03 Tm (what equipment and techniques are to be used to transfer people safely. Appropriate )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 142.45 Tm (referrals to GP's and dieticians must also be made for anyone with poor appetite and )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 127.87 Tm (weight loss, with weights monitored and recorded regularly.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 113.29 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 98.71 Tm (As highlighted at previous inspections there must be improvements to provide more )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 84.13 Tm (individual activities and more opportunities for outings into the community. The )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 69.55 Tm (registered persons must make provision for more individual activities for people with )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 1 1 1 RG 396.66 w 34.57 614.2 m 568.97 614.2 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 32.37 813.65 m 571.17 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 414.74 m 571.17 414.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 814.73 m 33.45 413.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 814.73 m 570.1 413.67 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.17 802.72 Tm (dementia or sensory loss with each person's participation or refusal accurately noted. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 788.14 Tm (Previous good practice recommendations in this area have not been acted on. We )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 773.56 Tm (received comments from relatives, which included, "Could do more activities." The )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.98 Tm (registered persons must put in place a maintenance and refurbishment plan for the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.4 Tm (tired and generally shabby environment with speedier action, to improve the home to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.82 Tm (make it a pleasant place for people living there. Also ensure that there is daily )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.24 Tm (domestic cover for the home, this will assist to keep the home clean, fresh and free )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.66 Tm (from unpleasant smells. The bedrooms need to be cleaned promptly to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 686.08 Tm (smells are dealt with quickly.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.5 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.92 Tm (Attention to the personalisation of bedrooms and other areas of the home needs to be )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.34 Tm (assessed and actions put into place to ensure that these areas are comfortable and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.76 Tm (reflect the personality of those using the room.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 613.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.6 Tm (The registered persons or a nominated person must consistently undertake monthly, )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 584.02 Tm (unannounced quality monitoring visits as to the conduct of the home with reports )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 569.44 Tm (available to the home and CQC. This is particularly important for the manager and staff )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 554.86 Tm (to sustain and build on improvements to meet the national minimum standards and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 540.28 Tm (provide good quality outcomes for people living at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 525.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 511.12 Tm (This home has not had a registered manager for 10 months and has not had real )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 496.54 Tm (stability since August 2006. The current temporary management arrangements cannot )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 481.96 Tm (offer people living in the home assurances that all their needs will be consistently met. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 467.38 Tm (The registered provider must put in place strategies and systems to support effective )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 452.8 Tm (and consistent management and an application to register the new manager due to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 438.22 Tm (commence employment on 8 June 2008 must be submitted to the CQC Regional )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 423.64 Tm (Registration Team within 3 months.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 400.18 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 380.19 Tm (If you want to know what action the person responsible for this )Tj ET /F2 12 Tf BT 1 0 0 1 416.37 380.19 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 480.04 380.19 Tm ( is taking )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 362.69 Tm (following this report, you can contact them using the details set out on page 4.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 342.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 322.7 Tm (The report of this inspection is available from our website )Tj ET /F2 12 Tf BT 1 0 0 1 380.85 322.7 Tm (www.cqc.org.uk.)Tj ET /F2 12 Tf BT 1 0 0 1 490.78 322.7 Tm (You can get )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 305.2 Tm (printed copies from )Tj ET /F2 12 Tf BT 1 0 0 1 149.87 305.2 Tm (enquiries@cqc.org.uk or by telephoning our order line )Tj ET /F2 12 Tf BT 1 0 0 1 488.4 305.2 Tm (0870 240 )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 287.71 Tm (7535.)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 31 0 obj <>stream 0 J 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (11)Tj ET 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 26 w 32.32 740.77 m 562.53 740.77 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 756.02 m 565.85 756.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 727.77 m 565.85 727.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 757.1 m 30.07 726.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 757.1 m 564.78 726.7 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 738.89 Tm (&RQWHQWV)Tj ET 1 1 1 RG 16 w 28.35 694.52 m 566.93 694.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 690.46 Tm (Choice of home \(standards 1 - 6\))Tj ET 16 w 28.35 672.52 m 566.93 672.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 668.46 Tm (Health and personal care \(standards 7 - 11\))Tj ET 16 w 28.35 650.52 m 566.93 650.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 646.46 Tm (Daily life and social activities \(standards 12 - 15\))Tj ET 16 w 28.35 628.52 m 566.93 628.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 624.46 Tm (Complaints and protection \(standards 16 - 18\))Tj ET 16 w 28.35 606.52 m 566.93 606.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 602.46 Tm (Environment \(standards 19 - 26\))Tj ET 16 w 28.35 584.52 m 566.93 584.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 580.46 Tm (Staffing \(standards 27 - 30\))Tj ET 16 w 28.35 562.52 m 566.93 562.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 558.46 Tm (Management and administration \(standards 31 - 38\))Tj ET /F2 12 Tf BT 1 0 0 1 28.35 538.46 Tm (Outstanding statutory requirements)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 516.59 Tm (Requirements and recommendations from this inspection)Tj ET endstream endobj 33 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 36 0 obj <>stream 0 J 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 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 0.99216 0.89804 0.5451 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 281.81 w 34.6 299.27 m 562.54 299.27 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 259.32 w 33.47 288.02 m 563.66 288.02 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 156.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 419.88 m 564.79 156.16 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 31.27 157.23 m 565.87 157.23 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 (adequate)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 403.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 385.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.75 Tm (The home's purpose and service user guide are not accurate or up to date and people )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 341.25 Tm (living at the home do not have contracts terms and conditions of occupancy. This has )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 323.76 Tm (the effect that people and their advocates do not have good information about their )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 306.26 Tm (rights and entitlements, or how care will be provided.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 288.77 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 271.27 Tm (The home has comprehensive assessment tools, which means that each persons )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 253.77 Tm (needs can be thoroughly assessed to ensure that their needs and preferences will be )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 236.28 Tm (met. The home actively encourages introductory visits and there was some evidence )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 218.78 Tm (to demonstrate that people had been given the opportunity and time to make )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 201.29 Tm (decisions, which were right for them.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 183.79 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 166.29 Tm (This home does not provide intermediate care, therefore Standard 6 is not applicable.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 141.55 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 49.34 w 34.6 106.69 m 562.54 106.69 l S 0.001 w 1 1 1 RG 22.5 w 32.35 122.36 m 564.79 122.36 l S 0.001 w 27.97 w 33.47 94.88 m 563.66 94.88 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 109.99 m 565.87 109.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 111.07 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 111.07 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 109.99 m 564.79 109.99 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 35.5 119.05 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 94.31 Tm (We looked at copy of the home's statement of purpose dated April 2008 and the )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99216 0.89804 0.5451 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 (service user guide, which showed it was updated 29/08/07 by previous registered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (manager. There was no evidence that these documents could also be provided in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (alternative formats. The documents were clearly out of date and did not include all )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (essential information such as the home's admission criteria or range of fees.)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 (We discussed the omissions and out of date inaccurate information with the temporary )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (acting manager and a director from the organisation. We strongly recommended the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (documents should be kept up to date and comprehensive information should be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (included in the service user guide to give people accurate information about the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (service to help them make decisions about the choice of home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (There were no new admissions to the home since the random inspection on 6 )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (February 2009, when serious concerns were identified. We looked at a sample of three )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (care files of people admitted to the home during the last two years. We saw that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (though two people had a contract and statement of terms and conditions on their files )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (these had not been completed signed or dated. This document had not been revised )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (and updated to be easy to read and understand, there was little detail about what was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (included in the fee, the role and responsibility of the provider, and the rights and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (obligations of the person living at the home. The temporary acting manager and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (director of the organisation acknowledged the omissions but we were not given a plan )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (and timescale to achieve this.)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 (The temporary acting manager, in post since the Random Inspection 6 February 2009, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (told us that she had found the home's records to be disorganised and had difficulty )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (locating some records, confirming our findings at the Random Inspections in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (December 2008 and February 2009. She told us she had not been able to complete )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (the home's AQAA \(Annual Quality Assurance Assessment\) with the required data. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (From the information provided at the home we noted that the majority of people were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (funding through the Local Authorities and had received recent reviews of their care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (needs.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (We noted that the temporary acting manager had acted promptly to seek support and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (advice from health professionals for a person, whose mental health needs had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (changed, and an early admission to hospital had been arranged to prevent a further )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (escalation in symptoms. This demonstrated a good awareness of the person's health )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (care needs.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (We held discussions with a director of the company and the acting manager about the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (admission some time previously, of a person with a diagnosed mental disorder. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (indicated that the person was not admitted according to clear admission criteria and )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 196.33 w 34.6 713.24 m 562.54 713.24 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 174.96 w 33.47 701.43 m 563.66 701.43 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 611.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 611.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 612.82 m 565.87 612.82 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (was outside the home's registration categories. At the time of this admission there )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (was no assurance the home could meet this person's needs, with staff who were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (trained, experienced, competent and knowledgeable about the diagnosed condition.)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 (The temporary acting manager had introduced considerable improvements to build on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (the good practices seen in April 2008, before the departure of the previous registered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (manager. The majority of assessment documentation was well completed and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (individual preferences were recorded such as rising, retiring, preferred activities, likes )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (and dislikes. This meant that new staff had good and accurate information about each )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (person's needs and preferences about how they wished their care to be provided.)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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 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 0.99216 0.89804 0.5451 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 176.84 w 34.6 385.75 m 562.54 385.75 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 154.34 w 33.47 374.51 m 563.66 374.51 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 295.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 453.88 m 564.79 295.13 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 31.27 296.21 m 565.87 296.21 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 (adequate)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 437.12 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 (There are care plans, risk assessments and monitoring arrangements, which generally )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.25 Tm (provide staff with the information they need to meet residents each person's needs. )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 357.76 Tm (There is multi disciplinary working taking place on a regular basis, which means that )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 340.26 Tm (the health needs of people living at the home will be met most of the time. The homes )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 322.77 Tm (arrangements for administration of medication are not satisfactory to safeguard each )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 305.27 Tm (persons health and well being.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 280.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 188.31 w 34.6 176.18 m 562.54 176.18 l S 0.001 w 1 1 1 RG 22.5 w 32.35 261.34 m 564.79 261.34 l S 0.001 w 166.94 w 33.47 164.37 m 563.66 164.37 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 248.97 m 565.87 248.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 250.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 250.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 248.97 m 564.79 248.97 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 35.5 258.03 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.28 Tm (The standards relating to Health and Personal Care, including medication management )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 215.79 Tm (had varied considerably from 2007 to this key inspection. The standards were judged )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.29 Tm (to be poor in 2007 and a warning letter was issued to the registered proprietor on 11 )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 180.79 Tm (October 2007. A new registered manager had made strenuous efforts to make sure )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.3 Tm (that improvements were made by April 2008. This manager subsequently left the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 145.8 Tm (home's employ in July 2008 and at random inspections in December 2008 and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.31 Tm (February 2009 standards had significantly deteriorated again. A registered manager )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 110.81 Tm (was transferred to Summerfield from another home in the company as a matter of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.31 Tm (urgency on 6 February 2009 and standards had once again significantly improved.)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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99216 0.89804 0.5451 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 (We looked in depth at a sample of care records for three of the eighteen people living )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (the home. We saw that each person had a comprehensive care plan, using improved )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (formats. There was insufficient evidence demonstrating the good practice of involving )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (the person and their relatives or representatives in the development and review of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (their planned care. This was particularly important for people assessed as lacking )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (capacity to make informed decisions or give informed consent.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (We noted that the revised care plans were generally based on comprehensive )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (assessment information and included all essential basic information and identification )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (of any associated risks. The addition of personal preference information and the plan )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (to introduce life histories to record each persons preferred daily routines for staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (guidance making sure that care was delivered with a person centred approach was a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (good initiative, which is in the process of being implemented. There were still some )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (improvements to be made, where care plans did not reflect all needs or some )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (expansion was required. Examples were plans to manage diabetic conditions to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (maintain people at optimum health and must be more specific in relation to health )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (checks, and a healthy diet.)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 was evidence from records and discussions that each persons health was being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (more carefully monitored with appropriate action taken. We saw evidence of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (documented health care assessments, screening, treatment and intervention. However )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (we saw an example where there were significant changes in one person's condition, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (with weight loss, some loss of mobility, recently diagnosed Reynard's disease, general )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (deterioration and refusals to take medication on occasions. This was not reflected in a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (review of care plans or a referral to the GP, chiropodist and community dietician's for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (advice and support. We also noted that the moving and handling risk assessments did )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (not contain sufficient information for staff guidance for all transfers, the equipment to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (be used or the number of staff required for assistance. This meant that people may be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (exposed to unacceptable risks. We discussed the need to expand the moving and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (handling risk assessments with the acting manager, who agreed to take remedial )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (action.)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 (At the previous key inspection in April 2008, we strongly recommended that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (registered persons should consider using Antecedent, Behaviour, Consequence \(ABC\) )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (records to evaluate the effectiveness of strategies and use of PRN medication for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (people with challenging or distressed behaviours. The three records we looked at all )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (identified that each person could display aggressive behaviour and though there were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (detailed written risk assessments, there were not sufficiently detailed strategies to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (guide staff to manage incidents and there were no records to monitor and evaluate )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99216 0.89804 0.5451 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 (situations, as we had recommended. This meant that opportunities to identify triggers )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (or trends, which could be minimised or diffused were missed and people may be put )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (at risk or be given medication unnecessarily.)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 (We saw that persons living at the home had generally good access to health care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (services to meet their assessed needs both within the home and in the local )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (community. Some people were able to choose their own GP within the limits of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (geographical borders, that the majority of people were registered with a GP practice )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (contacted to the home. There was documentary evidence to demonstrate that people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (had generally good access to dentists, opticians, and other community services. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (However the records of two people did not demonstrate regular appointments after )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (July 2008. We discussed the omissions with the temporary acting manager, who )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (acknowledged that more improvements and closer vigilance was needed.)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 (We spoke to a district nurse who had been involved with the home for approximately )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (18 months. She told us she was involved with people at the home who required daily )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (insulin injections. We discussed with her the concern that staff at the home undertook )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (the regular BM \(blood sugar monitoring\). At the previous key inspection we had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (told staff had not received training to carry out this invasive body procedure and we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (were assured that training would be undertaken and a written protocol, ratified by )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (health professionals would be put in place. We asked whether staff were trained to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (undertake this procedure, she stated that she was not aware of whether the staff have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (done training to carry out the procedure, she personally had not provided any )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (training. We repeated our discussions with the temporary acting manager as to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (whether the staff who have carried out the BM procedure had received training and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (whether there was a blood glucose monitoring protocol in place for the staff to follow. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (She confirmed that there was no written protocol in place and was unaware of training )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (provided from healthcare professionals. She agreed to contact the relevant nurses to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (obtain training and work with them to devise and implement an agreed protocol for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (this invasive body procedure, as a matter of priority. The District Nurse told us that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (until recently staff were handing her the person's BM results on a piece of paper but )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (this had improved with staff now recording the BM results in appropriate records. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (saw that the 'normal parameters' for each person were also documented, which )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (demonstrated good practice.)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 (The district nurse and a number of relatives told us that there was a significant )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (improvement in the home since the temporary acting manager arrived in February )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (2009. They gave examples of a cleaner, pleasant environment, no noticeable )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (malodour now, and residents calmer and happier. We were told that that residents )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (were treated respectfully and privacy and dignity were maintained. The nurse told us )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99216 0.89804 0.5451 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 (that the temporary acting manager and staff were always welcoming and helpful and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (they were knowledgeable about people living at the home, with information readily )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (available.)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 (The pharmacist inspection lasted three hours. We looked at medicines, Medicine )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (Administration Record \(MAR\) charts and care plans of five people, who lived in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (home. One senior care was spoken with and all feedback was given to the acting )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (manager, Yvonne Hughes.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (The acting manager had worked hard to ensure that the medication is administered as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (prescribed and had met all the requirements surrounding medication left at the last )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (random inspection in February 2009. Good systems had been installed. All the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (prescriptions were seen prior to dispensing but a copy was not taken to check the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (medicines or MAR chart received into the home. Ms Hughes was keen to implement )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (this system at the next 28 day cycle.)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 quantities of all medicines received and any balances carried over had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (recorded enabling audits to take place. These indicted that staff were now )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (administering and accurately recording what they have done. All creams were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (recorded on a separate cream chart and the carer signed when they had administered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (them. The senior care assistant also signed the MAR chart even though they had not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (applied them. The acting manager was keen to change this practice to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (staff only sign to record exactly what they have done.)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 (All medicines were stored in two medication trolleys that were taken to the people in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (the home. The senior carer was observed looking at the MAR chart before the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (preparation of the medication, which was good practice. She signed the MAR chart )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (directly after the transaction. It was clear from the records when a medicine had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (refused and destroyed. All surplus medication was kept in a large locked medication )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (cupboard. The medicines were well laid out so it was easy to find a medicine in both )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (the trolley and cupboard. All Controlled drug balances were accurate and correctly )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (stored.)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 (Staff had received training to ensure that they safely handled medication and medical )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (information about the different prescribed medicines were available for staff to read. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (Further training was required as the knowledge of the senior care assistant spoken )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (with, regarding what the prescribed medication was for was limited. She would not be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (able to fully support the clinical needs of the people she looks after. Many medicines )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (had been prescribed to be administered on a "when required" basis. These were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (administered on a routine basis and there were no supporting protocols detailing why )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99216 0.89804 0.5451 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 (they should be used for staff to follow. This is of concern as the senior care assistant )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (had a poor understanding of what the medicines were for so therefore would not be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (able to make the correct judgment as to why or when a medicine should be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (administered. This was evidenced as most medicines prescribed to be administered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (when required only were administered routinely.)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 (Ms Hughes had installed a simplified care plan system so all the information was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (recorded in a set place. These were in their infancy with respect to the clinical )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (information for the individual residents. The care plans surrounding medication were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (poor. It was difficult to see why some medication had been prescribed or what the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (clinical conditions of some of the people who lived in the home were.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (Some doctors' visits had been recorded together with the outcome, so it was easy to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (identify why these had been prescribed but some information was missing. Many )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (medicines had been prescribed to control behaviour that had sedating side effects with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (no rationale behind the prescribing. This was of concern that the acting manager had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (not identified this and sought additional medication reviews. One letter was seen )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (where the consultant clearly instructed in January 2009 for one medicine to stop and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (another medicine to be reduced in strength over a number of weeks. Both medicines )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (were still prescribed and administered. Another resident was to have his sedating )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (medication prescribed to control behaviour reviewed in one to two months time. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (record was dated March 2007. No further information had been recorded, as to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (whether a review had taken place and he was still prescribed and administered this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (medication Nutritional supplements had been prescribed for one person but these had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (not been recorded on the MAR chart or the care plans. She had not been weighed for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (the last two months as she had refused, but alternative weight assessments had not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (been used.)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 (There was no record of one medicine that was to be administered by the district )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (nurse. The acting manager knew why it had been prescribed and for how long but )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (there was no information about this in her care plans for the care staff to read.)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 (One resident had her peak flow to assess her asthma measured on a daily basis for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (the last five months. No action had been taken despite the reading being very low and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (she was very breathless. The senior care had no understanding why she did this so did )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (not recognise the levels were low. In addition the residents medication had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (administered incorrectly which may have contributed to her poor asthma control. At )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (no time had the doctor been called in to reassess her inhalers.)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 (We observed that all staff on duty during this inspection visit were respectful and )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 196.33 w 34.6 713.24 m 562.54 713.24 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 174.96 w 33.47 701.43 m 563.66 701.43 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 611.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 611.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 612.82 m 565.87 612.82 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (sensitive in their approach with people living at the home. Examples were that staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (did not rush people when communicating, they made efforts to ensure people were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (included in conversations by the way they positioned themselves so eye contact could )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (be made. They gave people time and opportunity to answer questions and used )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (gestures to help people understand better.)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 (People looked generally well presented and dressed appropriately for the weather, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (with efforts made to co ordinate clothing, where possible, helping people maintain )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (their dignity. It was positive to see that people were wearing suitable footwear, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (promoting their dignity and safety. )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 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 0.99216 0.89804 0.5451 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 194.33 w 34.6 411.01 m 562.54 411.01 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 171.84 w 33.47 399.76 m 563.66 399.76 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 311.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 487.88 m 564.79 311.64 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 31.27 312.71 m 565.87 312.71 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 495.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 471.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 471.12 Tm (adequate)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 471.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 453.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 426.75 Tm (There are only limited planned and spontaneous activities available on a regular basis, )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 409.25 Tm (which mean that people may not have opportunities to develop socially stimulating )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 391.76 Tm (activities. Peoples cultural and spiritual needs are not met. The majority of people are )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 374.26 Tm (able to maintain good contact with family and friends.)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 (People cannot be assured they will always receive a balanced, nutritious and varied )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 321.77 Tm (selection of food that meets their tastes and choices.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 297.03 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 204.82 w 34.6 184.43 m 562.54 184.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 277.84 m 564.79 277.84 l S 0.001 w 183.45 w 33.47 172.62 m 563.66 172.62 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 265.47 m 565.87 265.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 266.55 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 266.55 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 265.47 m 564.79 265.47 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 35.5 274.53 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 249.79 Tm (There was evidence during the inspection, which indicated that staff listened to people )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 232.29 Tm (living at the home and made efforts to provide flexible daily living routines, which )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 214.79 Tm (enabled people to enjoy a reasonable quality of life according to their personal )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 197.3 Tm (preferences. We saw that people were assisted to get up early, as indicated in their )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 179.8 Tm (care plans and others got up later and were able to have breakfast over an extended )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 162.31 Tm (period.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 144.81 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 127.31 Tm (We were told that though none of the people living at the home were able to go out )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 109.82 Tm (unescorted, though we were told some people went out with relatives. We spoke to a )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 92.32 Tm (relative who told us that they usually took their spouse out to lunch on a weekly )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99216 0.89804 0.5451 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 (event, which was very much enjoyed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (We noted that activities were ad hoc, undertaken by staff. The temporary acting )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (manager informed us that the activities co coordinator had left and not been replaced. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (There were a limited range of activities, but no activities timetable, though there were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (pictures of what might be available, such as reading, puzzles, sing a longs, knitting, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (board games, gardening, and remembering. There were no trips or outings organised )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (by the home and the previous recommendation to explore the option of people being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (registered to use the Ring and Ride Service had not been actioned.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (We observed some spontaneous activities sessions initiated by staff, holding )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (conversations with people, or singing. It was also positive that classical music was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (played in a quieter area of the dementia unit. We saw some pictorial evidence of craft )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (activities and a knitted display on the dementia unit. We noted that there was a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (supply of large print books, games and musical instruments, which we were told the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (people at the home enjoyed. Comments from relatives were that there could be more )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (activities.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (We discussed the lack of stimulation and poor contact with the outside community )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (with the acting manager and one of the directors, who agreed to look at either )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (employing another activities co coordinator or to allocate additional care hours to be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (designated for activities. We strongly recommended this should be for a minimum of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (15 hours per week, with training to ensure appropriate social stimulation was offered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (to everyone and especially to people with dementia and sensory disabilities.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (The temporary acting manager told us she was seeking to involve local priests, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (ministers, and church groups to visit the home or for people go out to attend services, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (as they wished. She acknowledged that there was no spiritual involvement for people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (at the home at present.)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 (We saw evidence that family and friends were welcomed and people we spoke to told )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (us they knew they could visit the home at any time. We were told that the temporary )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (acting manager and current staff team made time to talk to visitors and share )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (information, where possible.)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 (During the tour of the home we saw only limited evidence that people were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (encouraged to bring in their personal possessions to personalise their room. Though )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (the temporary acting manager and one of the directors present at the end of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (inspection told us they would be taking action to proactively encourage people to have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (their personal possessions around them in their bedroom. We saw inventories of )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 616.23 w 34.6 503.29 m 562.54 503.29 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 594.86 w 33.47 491.48 m 563.66 491.48 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 191.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 191.84 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 31.27 192.92 m 565.87 192.92 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 (personal possessions on the sample of files examined. However, these were not all )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (fully completed and were not signed and dated by the person or their representative )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (and witnessed by the member of staff.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (There were records of decision whether or not people wished to have keys to their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (bedrooms, however we noted that some people had been assessed as lacking capacity )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (to make decisions. We strongly recommended that the registered persons involve )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (appropriate representation or advocates where decisions need to be agreed in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (person's best interests. We urged the temporary acting manager to ensure all staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (were provided with an understanding of the Mental Capacity Act 2005 and its )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (implications for their work with people who may lack capacity.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (We discretely observed mealtimes and saw that staff were aware of the needs of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (people who found it difficult to eat and we noted that they offered sensitive assistance )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (with feeding. They were aware of the importance of offering food at the person's pace, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (so that they were not hurried. We also noted that hot and cold drinks were frequently )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (offered throughout the day. Efforts had been made so that the dining rooms looked )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (more inviting with tablecloths, placemats, crockery and condiments.)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 (The meals looked appetising, and staff tried to make meal times a sociable, enjoyable )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (experience. We asked a sample of people about the food at meal times, and received )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (generally favourable comments, "food very nice", and "we have a choice". We noted )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (that the menus had been revised and a two weekly written menu was displayed, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (offering alternative choices at the main midday meal. For example during the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (inspection people were offered liver and onions, with mash, or chips and vegetables, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (or egg chips and beans, with sponge and custard or ice cream for pudding.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (We discussed nutrition with care staff and catering staff, who were generally )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (knowledgeable about each person's nutritional needs. We were told that a choice was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (always offered. We discussed the need for additional nutritional training, especially )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (relating to an approach to healthy eating, rather than just a sugar free diet for people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (with diabetes. We gave the temporary acting manager contact numbers for the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (Diabetic Specialist nursing service and address for the community dieticians, who were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (available to give support, advice and training in relation to health, balanced nutrition.)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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 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 0.99216 0.89804 0.5451 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 124.35 w 34.6 497 m 562.54 497 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 101.85 w 33.47 485.75 m 563.66 485.75 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 432.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 538.88 m 564.79 432.62 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 31.27 433.7 m 565.87 433.7 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 (adequate)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 522.12 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 (People can not be confident that the they ae protected from abuse at all times. People )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.25 Tm (can be assurred that their concerns will be listened to but can not be confident that )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 442.76 Tm (these will be recorded and acted upon.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 418.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 325.8 w 34.6 244.93 m 562.54 244.93 l S 0.001 w 1 1 1 RG 22.5 w 32.35 398.83 m 564.79 398.83 l S 0.001 w 304.43 w 33.47 233.12 m 563.66 233.12 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 386.45 m 565.87 386.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 387.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 387.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 386.45 m 564.79 386.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 395.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 370.77 Tm (There is a complaints procedure available and this can be found in the policy file, the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.27 Tm (Service User's Guide and in the reception area. Some of the information is out of date, )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 335.78 Tm (it is recommended that this and other policies are reviewed and up dated.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.28 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 300.79 Tm (This process is not available in any other format for those who may have problems )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.29 Tm (reading the information.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 265.79 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.3 Tm (The acting manager told us that there was a form available for staff to record )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 230.8 Tm (information from others in relation to concerns and complaints. Two staff spoken to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.31 Tm (told us that they would try to deal with any concerns or complaints at the time, or )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 195.81 Tm (report them to the senior carer or manager if more serious. They did not know about )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.31 Tm (the forms that are available to complete, this means that the system for recording )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 160.82 Tm (concerns and complaints and is not robust. The manager told us that there had been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.32 Tm (no concerns or complaints since the last inspection, but as the process is not followed )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 125.83 Tm (we can not be confident that this is the case.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.33 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 90.83 Tm (There are policies and procedures which tell staff what abuse is and their responsibility )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 371.29 w 34.6 625.76 m 562.54 625.76 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 349.92 w 33.47 613.95 m 563.66 613.95 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 436.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 436.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 437.86 m 565.87 437.86 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 (in reporting this. The manager assured us that staff have recently had training in this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (areas and certificates for 8 staff were seen. The training matrix told us that all staff, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (except for four had now completed this training. Two recently employed staff told us )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (what they would do and who they would report to.)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 policy does clearly state that all safeguarding should be reported to the social )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (service department, telephone number should be made available to staff, relatives and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (people at the home so they can directly report any suspicion or witnessed abuse.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (There is no Whistle Blowing policy and this is required so that staff understand their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (role in protection of vulnerable people and their responsibility in reporting suspicions, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (allegations and witness actions of abuse.)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 (Since the last inspection two staff were accused of abuse, this was reported and was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (to be investigated by the 'Safeguarding Team' which is lead by social services. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (provider was told to suspend both staff until the investigation was complete. In )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (February 2009, a visit was made to the home and it was found that these two staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (were working in the home. This does not protect the people who live there form abuse )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (and also puts these two staff at risk of further allegations. A requirement was made, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (since this time both staff have left.)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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 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 0.99216 0.89804 0.5451 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 106.85 w 34.6 488.74 m 562.54 488.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 84.36 w 33.47 477.5 m 563.66 477.5 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 433.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 433.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 434.19 m 565.87 434.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (poor)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 505.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.75 Tm (Each person can not be confident that the place they live in is clean, pleasent and in )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm (good repair. This reduces the positive outcomes for those who are living there.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 418.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 326.3 w 34.6 245.17 m 562.54 245.17 l S 0.001 w 1 1 1 RG 22.5 w 32.35 399.32 m 564.79 399.32 l S 0.001 w 304.93 w 33.47 233.36 m 563.66 233.36 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 386.95 m 565.87 386.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 388.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 388.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 386.95 m 564.79 386.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 396.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 371.27 Tm (The home has two units; both have a lounge with dining room together. The first unit, )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.77 Tm (which is used by people with dementia, looked onto the front car park.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.27 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.78 Tm (The dining chairs were not all in good repair and two were unsteady. It is )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm (recommended that these are repaired or replaced to ensure that they are safe to use. )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (All the tables had lace table clothes, on two tables these stuck to the table and when )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm (lifted the tables were dirty. It is important that these are clean.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (The unit used by people who are frail was lighter and the furniture was acceptable. In )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (both these areas the carpets were clean and there were no unpleasant smells.)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 (Three bedrooms were seen. All had unpleasant smells, the acting manager told us that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm (the domestic person had not yet cleaned these areas. These were visited again later in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (the day and two still had unpleasant smells. It is important that rooms are kept clean )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm (and fresh at all times.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (One shared room had recently been decorated, the walls had been emulsioned, but )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 703.72 w 34.6 459.55 m 562.54 459.55 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 682.34 w 33.47 447.74 m 563.66 447.74 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 104.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 104.36 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 31.27 105.44 m 565.87 105.44 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 paint work and radiator cover had not. The dividing curtain to ensure privacy for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (both people using this room was not available. The acting manager told us that this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (had been taken down while the room was decorated; she admitted that there was no )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (other form of screening available. This would mean that the people using this room )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (had been assisted with personal care without privacy. The dividing curtain was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (replaced during this visit; this is not acceptable as it should have been available at all )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (times.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (There were items, in the bedrooms, of furniture that had handles missing, or were in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (poor repair, flooring that was damaged and the rooms lacked personalisation and in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (one case look very institutional. This is not pleasant for people to live in and where )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (there are repairs required these could result in injury to the person using the furniture )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (or the room.)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 (Two communal bathrooms were looked at. We were told that these had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (decorated and repaired. One bathroom had some tiles replaces, there was no evidence )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (that any of the woodwork had been painted. It one bathroom a number of toiletries )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (were found under the sink, this would indicate that people are washed with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm ('communal' toiletres; this does not ensure their individualism and dignity. The flooring )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (in the toliet areas on the ground floor has been replaced.)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 (We recommended that the freezer in the kitchen area was replaced, this has not been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (done. Also the micro-wave handle has broken making it difficult to open. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (management must ensure that they assess equipment in the service and repair or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (replace this when it is required.)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 (The home had a visit from Environmental Health in March 2009 and was required to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (address some areas to meet their standards. A further visit showed they had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (completed these, they have been rated as 2 Star which means that they are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm ('satisfactory' at meeting the Food Safety and Hygiene legislation.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (A very basic plan of maintenance had been developed by the acting manager, this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (reflected the recommendations made by use and the Environmental Health )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (Department and did not assure us that a full assessment of the home had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (carried out and a decision made about what actions need be taken and when.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (Some of the windows are UPV double glazing. The wooden framed windows require )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (painting and this was a recommendation at the last inspection. The management must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (ensure that the state of decor of this service is of an acceptable standard.)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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 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 0.99216 0.89804 0.5451 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 124.35 w 34.6 480 m 562.54 480 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 101.85 w 33.47 468.75 m 563.66 468.75 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 415.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 415.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 416.7 m 565.87 416.7 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (adequate)Tj ET 0.99216 0.89804 0.5451 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 (Each person can be assurred that the people who care for them have been check and )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm (found suitable. They can not be sure that all staff have received enough training to )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 425.76 Tm (meet all their needs in the best way.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 401.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 308.8 w 34.6 236.43 m 562.54 236.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 381.83 m 564.79 381.83 l S 0.001 w 287.43 w 33.47 224.62 m 563.66 224.62 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 369.45 m 565.87 369.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 370.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 370.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 369.45 m 564.79 369.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 378.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.77 Tm (On this visit we were told that there were 19 people living at the home. Only 18 )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.27 Tm (people were there during the visit, as one was in hospital.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.78 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm (There were four care staff with a senior carer on duty supported by the manager. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (cook, domestic and laundry persons were also working. This means that there was )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm (enough staff in the home to ensure that the needs of each person could be met.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (The acting manager told us that there are usually three to four care staff on duty in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (the afternoon, and two care staff at night. One member of staff is delegated to finish )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm (the tea time meal and another is delegated to do the laundry during the afternoon )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm (shift. This reduces the number of staff available to ensure that the people living at the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm (home are well and their needs are met. At this time with only 18 people to care for )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (there was no evidence that this had an impact, it is recommended that staffing levels )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm (are continually assessed and altered when needed.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (We required that the management indicated who would be responsible at night, this )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 668.72 w 34.6 477.04 m 562.54 477.04 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 647.35 w 33.47 465.23 m 563.66 465.23 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 139.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 139.35 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 31.27 140.43 m 565.87 140.43 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 (had not been done consistently, after discussion the manager stated that she would )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (do this. It is important for one person to be responsible for making decisions to ensure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (that care and issues arising can be discussed and acted upon.)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 (We looked at the rota for two months and saw that the staffing levels have remained )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (stable. There are at times gaps in domestic assistance and it is not clear who is then )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (responsible for cleaning the home. The acting manager is not on the rota, this should )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (be added.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (Four staff files were examined to ensure that employment processes are robust and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (that staff are suitable to work with vulnerable people. All the files seen told us that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (checks are made to ensure that each member of staff is suitable.)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 (Improvements should be made to the employment process to ensure that there are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (clear interview notes, identification of the person and that all staff complete a medical )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (form. There was no indication in the staff records that the management had discussed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (reasons fro leaving their last post or gaps in employment. This is important to be sure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (that the person is suitable and capable of working in this environment.)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 (Each new employee has a basic induction and also completes basic training in line with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (the Common Induction Standards. In one case this was completed at their last job, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (the management must ensure that these are completed in the service, so that any )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (gaps in knowledge or skills can be addressed to ensure that the best care possible is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (available for each person.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (Training in 'Deprivation of Liberty Safeguarding' [this ensures that peoples rights are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (met] must be made available for all staff so that they know what this is and their role. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (The manager told us that she and the registered provider were attending training in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (June and would then consider training for the staff.)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 (The acting manager has up dated the training records and has organised training so )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (that the staff are up to date with health and safety, fire, food hygiene and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (safeguarding. The staff have also done some training in dementia care.)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 (Supervision records did not indicate that a training assessment had been undertaken )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (to show where there are gaps in knowledge and skills of the staff, to ensure that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (needs of each person are properly met.)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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 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 0.99216 0.89804 0.5451 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 89.36 w 34.6 412.49 m 562.54 412.49 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 66.86 w 33.47 401.24 m 563.66 401.24 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 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 32.35 365.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 436.88 m 564.79 365.61 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 31.27 366.69 m 565.87 366.69 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 (adequate)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 420.12 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 (Each person can not be assurred that the home is always run in their best interest.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 351 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 258.79 w 34.6 211.42 m 562.54 211.42 l S 0.001 w 1 1 1 RG 22.5 w 32.35 331.82 m 564.79 331.82 l S 0.001 w 237.42 w 33.47 199.61 m 563.66 199.61 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 319.45 m 565.87 319.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 320.52 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 320.52 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 319.45 m 564.79 319.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 328.51 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 303.76 Tm (The home is being managed by the registered manager from another home in this )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 286.27 Tm (group. She was brought in to manage the home after the random Inspection in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.77 Tm (February, which confirmed that actions to improve the service had not been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 251.27 Tm (undertaken. We have been told that a manager was employed in March but only )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.78 Tm (remained in post for three weeks, as they were unsuitable. A new manager has been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.28 Tm (employed and will take up her role in June 2009. We were told that she has previous )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.79 Tm (management experience and is a qualified nurse.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.29 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.79 Tm (The acting manager told us that she will support the new manager for the first month, )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.3 Tm (while she settles into her new role.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.8 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.31 Tm (The deputy manager has recently resigned after a long period of sickness, the acting )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.81 Tm (manager told us that there are plans to employ a new deputy after the manager has )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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99216 0.89804 0.5451 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 (commenced her post.)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 (The acting manager has instigated some improvements as discussed in this report. In )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (most cases these will require further work to ensure that they are robust and can be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (sustained. It was noted that the employment and management of the staff is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (improved and staff told us that there is more organisation and they feel supported.)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 (We saw the Quality Assurance folder, only one month, which was completed for April )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (2009. The quality assurance for the service should be completed regularly and the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (information analysed so that plans can be developed to continue to improve the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (service. Surveys have not been sent to others or the people using the service. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (acting manager told us that she is intending to do this in June and will then develop a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (report of the findings. Surveys from last year nor a report could be found.)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 (A visit was made by the acting manager during this time and a report produced. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (told us that some areas for improvement had been recognised, there were no plans of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (action to show how improvements can be made.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (Record keeping in the home needs to improve, during this visit it was found that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (records were not kept in order and information was not always easily found. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (means that staff would also have difficulty finding certain information.)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 (There is no maintenance plan, this does not assure us that the management assess )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (the environment and plan for the future in relation to repairs and replacement of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (items, or the decoration of the home. And discussed earlier, some bedrooms have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (been decorated, all walls had been emulsioned, but paint work and radiators had not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (been re-decorated.)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 (There is one record of a recent staff meeting, these need to be carried out regularly as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (should meetings with the people who live there and their friends and relatives, so that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (the management can organise and run the home in the best interest of all.)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 (Supervision records told us that staff have been receiving regular supervision since )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (February 2009. Records were looked at and these need to be more robust. There is no )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (evidence that staff are actively involved in the process and a learning needs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (assessment had not be carried out, therefore we can not be sure that staff have the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (skills necessary to meet all the needs of each person they care for.)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 (Personal money for some people is managed by the service. Individual records are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (kept witch show money deposited and used from the account and a running record of )Tj ET endstream endobj 77 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 78 0 obj <>stream 0 J 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (32)Tj ET 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99216 0.89804 0.5451 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 (money left. Three were checked and found to be correct. The manager told us that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (each person has access to their money Monday to Friday during office hours, when the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (manager is available. The management need to assess this and consider a process so )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (that if a person want money at other times this can be arranged.)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 liability certificate for this service was out of date, the acting manager told us that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (the new one was available but was not at the home. We asked for this to be sent so )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (we can be confident they have one. This has not been done, the up to date certificate )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (must be displayed.)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 (Maintenance of equipment is up to date and a sample of certificates were seen. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (home has a maintenance person, who works between the three services in the Dudley )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (area. He told us that he carries out basic repairs and decor in the home. He also told )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (us that this home had improved since February and that moral amongst staff is better.)Tj ET endstream endobj 79 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 81 0 obj <>stream 0 J 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.99608 0.9451 0.76078 RG 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 0.99608 0.9451 0.76078 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 0.99216 0.89804 0.5451 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 ()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 1 548.37 783.16 Tm (5)Tj ET 0.99608 0.9451 0.76078 RG 69.18 w 31.2 683.94 m 566.2 683.94 l S 0.001 w 30.3 w 31.2 631.95 m 91 631.95 l S 0.001 w 30.3 w 93.25 631.95 m 197.4 631.95 l S 0.001 w 30.3 w 199.65 631.95 m 289.5 631.95 l S 0.001 w 30.3 w 291.75 631.95 m 473.9 631.95 l S 0.001 w 30.3 w 476.15 631.95 m 566.2 631.95 l S 0.001 w 1 1 1 RG 20.58 w 31.2 604.26 m 91.05 604.26 l S 0.001 w 20.58 w 93.3 604.26 m 197.4 604.26 l S 0.001 w 20.58 w 199.65 604.26 m 289.45 604.26 l S 0.001 w 20.58 w 291.7 604.26 m 473.8 604.26 l S 0.001 w 20.58 w 476.05 604.26 m 566.1 604.26 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 30.07 616.75 m 30.07 591.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 616.75 m 567.22 591.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 648.22 m 568.4 648.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 615.67 m 568.3 615.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 616.75 m 92.17 591.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 616.75 m 198.52 591.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 616.75 m 290.57 591.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 616.75 m 474.92 591.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 719.65 m 568.4 719.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 648.22 m 568.4 648.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 615.67 m 568.4 615.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 592.84 m 568.3 592.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 720.73 m 30.07 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 649.3 m 92.12 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 649.3 m 198.52 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 649.3 m 290.62 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 649.3 m 475.02 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 720.73 m 567.32 614.6 l S 0.001 w [] 0 d /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 702.45 Tm (Outstanding statutory requirements)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 684.03 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 669.45 Tm (been met.)Tj ET /F2 12 Tf BT 1 0 0 1 95.57 669.45 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 104.02 669.45 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 654.87 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 637.05 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 634.05 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 634.05 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 634.05 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 634.05 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 621.9 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 602.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 96.15 599.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 202.5 599.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 599.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 478.9 599.49 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 0.99608 0.9451 0.76078 RG 52.74 w 31.2 748.59 m 566.2 748.59 l S 0.001 w 30.3 w 31.2 704.82 m 91 704.82 l S 0.001 w 30.3 w 93.25 704.82 m 197.4 704.82 l S 0.001 w 30.3 w 199.65 704.82 m 289.5 704.82 l S 0.001 w 30.3 w 291.75 704.82 m 473.9 704.82 l S 0.001 w 30.3 w 476.15 704.82 m 566.2 704.82 l S 0.001 w 1 1 1 RG 20.58 w 31.2 677.13 m 91.05 677.13 l S 0.001 w 20.58 w 93.3 677.13 m 197.4 677.13 l S 0.001 w 20.58 w 199.65 677.13 m 289.45 677.13 l S 0.001 w 20.58 w 291.7 677.13 m 473.8 677.13 l S 0.001 w 20.58 w 476.05 677.13 m 566.1 677.13 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 30.07 689.63 m 30.07 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 689.63 m 567.22 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.3 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 689.63 m 92.17 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 689.63 m 198.52 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 689.63 m 290.57 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 689.63 m 474.92 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 776.09 m 568.4 776.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.4 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 665.72 m 568.3 665.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 777.17 m 30.07 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 722.18 m 92.12 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 722.18 m 198.52 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 722.18 m 290.62 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 722.18 m 475.02 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 777.17 m 567.32 687.47 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 759.9 Tm (Immediate requirements:)Tj ET 0.99216 0.89804 0.5451 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 ()Tj ET /F2 12 Tf BT 1 0 0 1 96.15 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 202.5 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 478.9 672.36 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 66.74 w 31.2 594.97 m 566.2 594.97 l S 0.001 w 30.3 w 31.2 544.2 m 91 544.2 l S 0.001 w 30.3 w 93.25 544.2 m 197.4 544.2 l S 0.001 w 30.3 w 199.65 544.2 m 289.5 544.2 l S 0.001 w 30.3 w 291.75 544.2 m 473.9 544.2 l S 0.001 w 30.3 w 476.15 544.2 m 566.2 544.2 l S 0.001 w 1 1 1 RG 255 w 31.2 399.3 m 91.05 399.3 l S 0.001 w 255 w 93.3 399.3 m 197.4 399.3 l S 0.001 w 255 w 199.65 399.3 m 289.45 399.3 l S 0.001 w 255 w 291.7 399.3 m 473.8 399.3 l S 0.001 w 255 w 476.05 399.3 m 566.1 399.3 l S 0.001 w 206.65 w 31.2 166.23 m 91.05 166.23 l S 0.001 w 206.65 w 93.3 166.23 m 197.4 166.23 l S 0.001 w 206.65 w 199.65 166.23 m 289.45 166.23 l S 0.001 w 206.65 w 291.7 166.23 m 473.8 166.23 l S 0.001 w 206.65 w 476.05 166.23 m 566.1 166.23 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 270.68 m 568.3 270.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 529.01 m 30.07 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 529.01 m 567.22 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.48 m 568.4 560.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 527.93 m 568.3 527.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 529.01 m 92.17 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 529.01 m 198.52 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 529.01 m 290.57 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 529.01 m 474.92 60.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 629.47 m 568.4 629.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.48 m 568.4 560.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 527.93 m 568.4 527.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 270.68 m 568.3 270.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 61.78 m 568.3 61.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 630.55 m 30.07 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 561.56 m 92.12 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 561.56 m 198.52 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 561.56 m 290.62 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 561.56 m 475.02 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 630.55 m 567.32 526.85 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 616.28 Tm (Statutory requirements)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 596.28 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 581.7 Tm (Standards Act 2000, Care Homes)Tj ET /F2 12 Tf BT 1 0 0 1 239.77 581.7 Tm (Regulations 2001 and the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 567.12 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 549.3 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 546.3 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 546.3 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 546.3 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 546.3 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 534.15 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 514.74 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 514.74 Tm (4)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 514.74 Tm (14)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 514.74 Tm (The registered persons must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 497.74 Tm (ensure all persons admitted )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 480.74 Tm (to the home can be )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 463.74 Tm (accommodated in )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 446.74 Tm (compliance with the home's )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 429.74 Tm (registration categories, with )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 412.74 Tm (a 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ET /F2 12 Tf BT 1 0 0 1 34.05 575.48 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 575.48 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 575.48 Tm (The registered persons should ensure that large print, easy )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 560.9 Tm (read information be put in place as a matter of course to )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 546.32 Tm (aid communication, especially for people with dementia.)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 531.74 Tm (This is a repeated good practice recommendation, which )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 517.16 Tm (was not met.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 494.33 Tm (9)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 494.33 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 494.33 Tm (It is recommended that the registered manager consider )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 479.75 Tm (consulting residents about transport options for outings and )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 465.17 Tm (registering people who express interest on the Ring and )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 450.59 Tm (Ride service. This would facilitate residents to access local )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 436.01 Tm (community amenities.)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 421.43 Tm (This is a repeated good practice recommendation, which )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 406.85 Tm (was not met.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 384.02 Tm (10)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 384.02 Tm (14)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 384.02 Tm (It is recommended that all residents have up to date )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 369.44 Tm (inventories of their personal possessions, which are signed )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 354.86 Tm (dated and witnessed by staff, the resident and / or their )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 340.28 Tm (representative.)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 325.7 Tm (This is a repeated good practice recommendation, which )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 311.12 Tm (was not met.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 288.29 Tm (11)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 288.29 Tm (15)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 288.29 Tm (It is recommended that further work be undertaken to )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 273.71 Tm (provide this information in large print, picture format, as )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 259.13 Tm (residents with dementia may not be able to read the menu )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 244.55 Tm (in its present format.)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 229.97 Tm (This is a repeated good practice recommendation, which )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 215.39 Tm (was not met.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 192.56 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 192.56 Tm (16)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 192.56 Tm (The process for making complaints should be reviewed and )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 177.98 Tm (up dated to ensure that staff, relatives and people using )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 163.4 Tm (the service are clear about who they cna complain to and )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 148.82 Tm (what they should expect.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 125.99 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 125.99 Tm (16)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 125.99 Tm (An audit of how concerns and complaints are recorded by )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 111.41 Tm (staff should be undertaken and actions put into place to )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 96.83 Tm (ensure that there is accurate recording and evidence that )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 82.25 Tm (actions were taken to address these concerns and imporve )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 67.67 Tm (the service.)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 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 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w 28.99 188.46 m 568.3 188.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 151.05 m 568.3 151.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 84.48 m 568.3 84.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 723.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 745.16 m 92.17 724.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.47 745.16 m 198.47 724.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 814.73 m 567.32 723.73 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 797.47 Tm (Recommendations)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 779.89 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 765.31 Tm (Minimum Standards and the registered person\(s\) should consider them as a way of )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 750.73 Tm (improving their service.)Tj ET /F2 10 Tf BT 1 0 0 1 34.05 729.91 Tm (No)Tj ET /F2 10 Tf BT 1 0 0 1 96.15 729.91 Tm (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 34.05 706.75 Tm (14)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 706.75 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 706.75 Tm (The telephone numbers of social service departments who )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 692.17 Tm (support the people living at the home should be available )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 677.59 Tm (to staff, relatives and each person so that they can report )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 663.01 Tm (any suspected or witnessed abuse directly if needed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 640.18 Tm (15)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 640.18 Tm (19)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 640.18 Tm (A full assessment of all shared facilities and the building )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 625.6 Tm (should be undertaken and a )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 602.77 Tm (16)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 602.77 Tm (19)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 602.77 Tm (The chairs in the dining room on the Dementia Unit should )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 588.19 Tm (be examined and any that are unstable should be repaired )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 573.61 Tm (or replaced.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 550.78 Tm (17)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 550.78 Tm (21)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 550.78 Tm (Each person should have their own tolietries and the use of )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 536.2 Tm ('communal toiletries' should cease. This will ensure )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 521.62 Tm (individualism and dignity of each person in the home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 498.79 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 498.79 Tm (24)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 498.79 Tm (A full assessment of all bedrooms should be carried out and )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 484.21 Tm (actions taken to make repairs to flooring, furniture and )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 469.63 Tm (decor as needed. An action plan with suitabel time scales )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 455.05 Tm (should be made available.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 432.22 Tm (19)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 432.22 Tm (26)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 432.22 Tm (All table clothes and tables should be kept clean to )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 417.64 Tm (minimise smells and ensure that the standard is acceptable )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 403.06 Tm (to increase the positive experience of dining.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 380.23 Tm (20)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 380.23 Tm (27)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 380.23 Tm (A named person should be indicated on the rotas for the )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 365.65 Tm (night duty to ensure that it is clear who is responsible for )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 351.07 Tm (making decisions.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 328.24 Tm (21)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 328.24 Tm (27)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 328.24 Tm (An assessment of care hours should be kept under review )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 313.66 Tm (to ensure that there are always enough staff to meet the )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 299.08 Tm (needs of the people living at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 276.25 Tm (22)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 276.25 Tm (27)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 276.25 Tm (It should be made clear how the cleaning of the home is )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 261.67 Tm (carried out when there is no domestic person on duty. This )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 247.09 Tm (will ensure that the standard of cleanliness is acceptable )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 232.51 Tm (and maintained.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 209.68 Tm (23)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 209.68 Tm (28)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 209.68 Tm (The acting manager / manager should be added to the rota )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 195.1 Tm (indicating when they are at work.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 172.27 Tm (24)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 172.27 Tm (30)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 172.27 Tm (Training in Deprivation of Liberty Safeguards should be )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 157.69 Tm (made available to all staff.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 134.86 Tm (25)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 134.86 Tm (35)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 134.86 Tm (An assessment of how people can access their money )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 120.28 Tm (outside normal office hours should be carried out, and a )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 105.7 Tm (process considered so that if required money can be )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 91.12 Tm (available at all times.)Tj ET endstream endobj 94 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 95 0 obj <>stream 0 J 0.98431 0.78824 0.08627 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 0.98431 0.78824 0.08627 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 (40)Tj ET 0.98431 0.78824 0.08627 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 (41)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 0.99608 0.9451 0.76078 RG 67.32 w 31.2 778.87 m 566.2 778.87 l S 0.001 w 18.15 w 31.2 733.88 m 91.05 733.88 l S 0.001 w 18.15 w 93.3 733.88 m 197.35 733.88 l S 0.001 w 18.15 w 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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 102 0 obj<> endobj 103 0 obj<>/Subtype/CIDFontType2/Type/Font/W [3[312]]/CIDToGIDMap/Identity/DW 1000>> endobj 104 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 105 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 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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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Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Fri Oct 10 11:48:26 2008 % Converted from TrueType font 'TIMES.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Times New Roman) readonly def /FamilyName (Times New Roman) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -109 def /UnderlineThickness 49 def end readonly def /FontName /TimesNewRomanPSMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-77 -216 1009 877} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put 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 TcJ6*]h[zeKq)ƷW0jlBIf14%B[tnqNOדe{fC;1I^7^r5=[ySwF 5ZUͧ@;J7{Phx ғ*⿅΅V1lCd3Dk9+ ~Iic*x 2YC.eKgt_"t!Ztb$~iS[xdw +P7)%g9/-awT=JK/{ Q'y!kA,7 Α$?H}Om"s*5aks*HRUufn6i?kɝ=-0X%lϧQ4ݡ`rџ~D&#&:t]=.ok &DZђԺŠRq [j@3a*42K]sjϖjG_n 4Ϛ5. *Ly^w`ܮ64r/:!?u:};ߜ`dӤJY2R'wbTCI2CRNY2uD-.Y9y:2Cʸ`ͻq5dBpQŰ: TimM;f ]+ozY0,(Fh^ GirY E W| -R̵vVP ce޾'zH+1= PU~}fIa 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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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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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