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156.67 Tm ()Tj ET /F1 10 Tf BT 1 0 0 1 297.64 144.6 Tm ()Tj ET /F1 10 Tf BT 1 0 0 1 297.64 132.54 Tm ()Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 10 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (2)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (46)Tj ET 0.8 0.8 0.8 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 review of quality of outcomes that people experience in this )Tj ET /F2 12 Tf BT 1 0 0 1 448.39 787.03 Tm (care home. We )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 769.53 Tm (believe high quality care should)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 749.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 749.53 Tm (Be safe)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 733.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 733.53 Tm (Have the right outcomes, including clinical outcomes)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 717.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 717.53 Tm (Be a good experience for the people that use it)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 701.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 701.53 Tm (Help prevent illness, and promote healthy, independent living)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 685.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 685.53 Tm (Be available to those who need it when they need it.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 651.03 Tm (The first part of the review gives the overall quality rating for the )Tj ET /F2 12 Tf BT 1 0 0 1 427.6 651.03 Tm (care home:)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 631.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 631.04 Tm (3 stars - excellent)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 615.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 615.04 Tm (2 stars - good)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 599.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 599.04 Tm (1 star - adequate)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 583.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 583.04 Tm (0 star - poor)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 551.04 Tm (There is also a bar chart that gives a quick way of seeing the quality of care that the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 534.04 Tm (home provides under key areas that matter to people.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 500.04 Tm (There is a summary of what we think this service does well, what they have improved )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 483.04 Tm (on and, where it applies, what they need to do better.)Tj ET /F2 12 Tf BT 1 0 0 1 364.74 483.04 Tm (We use the national minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 466.04 Tm (standards to describe the outcomes that people should experience.)Tj ET /F2 12 Tf BT 1 0 0 1 443.2 466.04 Tm (National minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 449.04 Tm (standards are written by the Department of Health for each type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 409.54 Tm (After the summary there is more detail about our findings. The following table explains )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 392.05 Tm (what you will see under each outcome area.)Tj ET [] 0 d 0.5 w 0 0 0 RG 22.69 383.86 m 572.15 383.86 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.69 50.22 m 572.15 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.7 383.86 m 22.7 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 572.15 383.86 m 572.15 50.22 l S 0.001 w [] 0 d /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 370.56 Tm (Outcome area \(for example )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 173.59 370.56 Tm (Choice of home\))Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 340.26 Tm (These are the outcomes that people )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 216.34 340.26 Tm (staying in care homes should experience.)Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 435.79 340.26 Tm (They reflect the things )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 328.11 Tm (that people have said are important to them:)Tj ET 0 0 0 RG 0.001 w 0 Tr 1 0.9451 0.76078 RG 82.23 w 30.6 263.37 m 562.45 263.37 l S 0.001 w 0.95294 0.95294 0.95294 RG 39.99 w 29.47 285.61 m 563.57 285.61 l S 0.001 w 1 1 1 RG 39.99 w 29.47 243.37 m 563.57 243.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 306.73 m 565.77 306.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 222.25 m 565.77 222.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 307.81 m 28.35 221.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 307.81 m 564.7 221.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 291.05 Tm (This box tells you the outcomes that we will always inspect against when we do a key )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 273.55 Tm (inspection)Tj ET /F2 10 Tf BT 1 0 0 1 95.78 273.55 Tm (.)Tj ET /F2 12 Tf BT 1 0 0 1 34.87 248.81 Tm (This box tells you any additional outcomes that we may inspect against when we do a )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 231.31 Tm (key inspection.)Tj ET /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 191.8 Tm (This is what people )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 131.32 191.8 Tm (staying in this care home experience:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 154.64 Tm (Judgement:)Tj ET 1 0.9451 0.76078 RG 39.99 w 30.6 123.34 m 562.45 123.34 l S 0.001 w 1 1 1 RG 39.99 w 29.47 124.46 m 563.57 124.46 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 145.58 m 565.77 145.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 103.34 m 565.77 103.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 146.66 m 28.35 102.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 146.66 m 564.7 102.26 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 129.9 Tm (This box tells you our opinion of what we have looked at in this outcome area.)Tj ET /F2 12 Tf BT 1 0 0 1 517.79 129.9 Tm (We )Tj ET /F2 12 Tf BT 1 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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 (3)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (46)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 779.1 Tm (We review the quality of the service against outcomes from the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 762.1 Tm (Standards \(NMS\).)Tj ET /F2 12 Tf BT 1 0 0 1 144.87 762.1 Tm (Those standards are written by the Department of Health for each )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 745.1 Tm (type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 705.6 Tm (Copies of the)Tj ET /F2 12 Tf BT 1 0 0 1 111.71 705.6 Tm (National Minimum Standards )Tj ET /F2 12 Tf BT 1 0 0 1 290.49 705.6 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 302.34 705.6 Tm (Care Homes for Adults \(18-65 years\))Tj ET /F2 12 Tf BT 1 0 0 1 526.6 705.6 Tm ( can )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 688.11 Tm (be found at www.dh.gov.uk or bought from The Stationery Office \(TSO\) PO Box 29, St )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 670.61 Tm (Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 653.11 Tm (Stationery Office is also available: )Tj ET /F2 12 Tf 0 0 1 rg BT 1 0 0 1 238.73 653.11 Tm (www.tso.co.uk/bookshop)Tj ET /F2 12 Tf 0 0 0 rg BT 1 0 0 1 28.35 613.12 Tm (The mission of the Care Quality Commission is to make care better for people by:)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 596.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 596.12 Tm (Regulating health and adult social care services to ensure quality and safety )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 580.12 Tm (standards, drive improvement and stamp out bad practice)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 564.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 564.12 Tm (Protecting the rights of people who use services, particularly the most )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 548.12 Tm (vulnerable and those detained under the Mental Health Act 1983)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 532.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 532.12 Tm (Providing accessible, trustworthy information on the quality of care and )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 516.12 Tm (services so people can make better decisions about their care and so that )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 500.12 Tm (commissioners and providers of services can improve services.)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 484.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 484.12 Tm (Providing independent public accountability on how commissioners and )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 468.12 Tm (providers of services are improving the quality of care and providing value )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 452.12 Tm (for money.)Tj ET /F1 14 Tf BT 1 0 0 1 28.35 390.28 Tm (5HDGHU,QIRUPDWLRQ)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 28.35 368.85 m 224.05 368.85 l S 0.001 w 1 1 1 RG 20.58 w 226.3 368.85 m 567 368.85 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 346.02 m 224.05 346.02 l S 0.001 w 1 1 1 RG 20.58 w 226.3 346.02 m 567 346.02 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 323.19 m 224.05 323.19 l S 0.001 w 1 1 1 RG 20.58 w 226.3 323.19 m 567 323.19 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 300.36 m 224.05 300.36 l S 0.001 w 1 1 1 RG 20.58 w 226.3 300.36 m 567 300.36 l S 0.001 w 0.95294 0.95294 0.95294 RG 137.22 w 28.35 219.21 m 224.05 219.21 l S 0.001 w 1 1 1 RG 137.22 w 226.3 219.21 m 567 219.21 l S 0.001 w 0.95294 0.95294 0.95294 RG 38.16 w 28.35 129.27 m 224.05 129.27 l S 0.001 w 1 1 1 RG 38.16 w 226.3 129.27 m 567 129.27 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 149.47 m 569.2 149.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 380.26 m 569.2 380.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 149.47 m 569.2 149.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 109.06 m 569.2 109.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 381.34 m 27.22 107.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 225.17 381.34 m 225.17 107.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 568.12 381.34 m 568.12 107.99 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 31.2 364.08 Tm (Document Purpose)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 364.08 Tm (Inspection report)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 341.25 Tm (Author)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 341.25 Tm (Care Quality Commission)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 318.42 Tm (Audience)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 318.42 Tm (General public)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 295.59 Tm (Further copies from)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 295.59 Tm (0870 240 7535 \(telephone order line\))Tj ET /F2 12 Tf BT 1 0 0 1 31.2 272.76 Tm (Copyright)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 272.76 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 258.18 Tm (This publication may be reproduced in whole or in part, )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 243.6 Tm (free of charge, in any format or medium provided that )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 229.02 Tm (it is not used for commercial gain. This consent is )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 214.44 Tm (subject to the material being reproduced accurately )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 199.86 Tm (and on proviso that it is not used in a derogatory )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 185.28 Tm (manner or misleading context. The material should be )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 170.7 Tm (acknowledged as CQC copyright, with the title and date )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 156.12 Tm (of publication of the document specified.)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 133.29 Tm (Internet address)Tj ET /F2 12 Tf 1 0 0 rg BT 1 0 0 1 229.15 133.29 Tm (www.cqc.org.uk)Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 15 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (4)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (46)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm 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567.85 629.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 606.41 m 567.85 606.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 583.58 m 567.85 583.58 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 28.99 652.07 m 567.85 652.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 629.24 m 567.85 629.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 606.41 m 567.85 606.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 583.58 m 567.85 583.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.75 m 567.85 560.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 786.71 m 30.07 559.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 269.07 786.71 m 269.07 559.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.77 786.71 m 566.77 559.67 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 (Penn House)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 746.62 Tm (Address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 746.62 Tm (The National Society For Epilepsy)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 729.04 Tm (Chesham Lane )Tj ET /F2 12 Tf BT 1 0 0 1 273.05 711.46 Tm (Chalfont St Peter)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 693.88 Tm (Gerrards Cross)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 676.3 Tm (Bucks)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 658.72 Tm (SL9 0RJ)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 635.89 Tm (Telephone number:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 635.89 Tm (01494601435)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 613.06 Tm (Fax number:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 590.23 Tm (Email address:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 567.4 Tm (Provider web address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 567.4 Tm (www.epilepsysociety.org.uk)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 548.45 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 505.01 m 564.77 505.01 l S 0.001 w 1 1 1 RG 20.58 w 355.5 528.96 m 565.9 528.96 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 506.13 m 353.25 506.13 l S 0.001 w 1 1 1 RG 20.58 w 355.5 506.13 m 565.9 506.13 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 483.3 m 353.25 483.3 l S 0.001 w 1 1 1 RG 20.58 w 355.5 483.3 m 565.9 483.3 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 517.55 m 568.1 517.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 494.72 m 568.1 494.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 540.38 m 568.1 540.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 517.55 m 568.1 517.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 494.72 m 568.1 494.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 471.89 m 568.1 471.89 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 541.45 m 30.07 470.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 541.45 m 354.37 470.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 541.45 m 567.02 470.81 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 524.19 Tm (Name of registered provider\(s\):)Tj ET /F2 12 Tf BT 1 0 0 1 355.5 524.19 Tm (The National Society for Epilepsy)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 501.36 Tm (Type of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 501.36 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 478.53 Tm (Number of places registered:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 478.53 Tm (22)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 459.59 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 28.35 442.59 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 63.99 w 32.32 400.27 m 564.47 400.27 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 411.68 m 567.8 411.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 434.51 m 567.8 434.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 411.68 m 567.8 411.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 368.27 m 567.8 368.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 435.59 m 30.07 367.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 412.76 m 298.32 367.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 435.59 m 566.72 367.2 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 418.33 Tm (Conditions of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 395.5 Tm (Category\(ies\) :)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 395.5 Tm (Number of places \(if applicable\):)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 374.92 Tm (Under 65)Tj ET /F2 12 Tf BT 1 0 0 1 435.37 374.92 Tm (Over 65)Tj ET 1 1 1 RG 20.58 w 31.2 353.48 m 297.3 353.48 l S 0.001 w 20.58 w 299.55 353.48 m 431.45 353.48 l S 0.001 w 20.58 w 433.7 353.48 m 565.6 353.48 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 330.65 m 565.6 330.65 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 342.07 m 567.8 342.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 319.24 m 567.8 319.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 296.41 m 568.1 296.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 364.9 m 567.8 364.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 342.07 m 567.8 342.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 319.24 m 568.1 319.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 296.41 m 568.1 296.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 244.42 m 568.1 244.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 365.97 m 30.07 243.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.42 365.97 m 298.42 340.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.57 365.97 m 432.57 340.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 365.97 m 566.72 243.34 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 348.71 Tm (physical disability)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 348.71 Tm (22)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 348.71 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 325.88 Tm (Additional conditions: )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 303.05 Tm (The maximum number of service users to be accommodated is 22)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 280.22 Tm (The registered person may provide the following category of service only: Care home )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 265.64 Tm (only \(PC\) to service users of the following gender: Either whose primary care needs on )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 251.06 Tm (admission to the home are within the following category : Physical disability \(PD\))Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 229.63 m 315.25 229.63 l S 0.001 w 1 1 1 RG 20.58 w 317.5 229.63 m 346.55 229.63 l S 0.001 w 20.58 w 348.8 229.63 m 377.9 229.63 l S 0.001 w 20.58 w 380.15 229.63 m 409.2 229.63 l S 0.001 w 20.58 w 411.45 229.63 m 440.55 229.63 l S 0.001 w 20.58 w 442.8 229.63 m 471.9 229.63 l S 0.001 w 20.58 w 474.15 229.63 m 503.2 229.63 l S 0.001 w 20.58 w 505.45 229.63 m 534.55 229.63 l S 0.001 w 20.58 w 536.8 229.63 m 565.9 229.63 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 241.04 m 568.1 241.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 218.21 m 568.1 218.21 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 242.12 m 30.07 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 242.12 m 316.37 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 242.12 m 347.67 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 242.12 m 379.02 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 242.12 m 410.32 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 242.12 m 441.67 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 242.12 m 473.02 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 242.12 m 504.32 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 242.12 m 535.67 217.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 242.12 m 567.02 217.13 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 224.86 Tm (Date of last inspection)Tj ET /F2 12 Tf BT 1 0 0 1 328.2 224.86 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 359.53 224.86 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 390.86 224.86 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 422.18 224.86 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 453.53 224.86 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 484.86 224.86 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 516.18 224.86 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 547.53 224.86 Tm (8)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 206.34 m 565.9 206.34 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 196.71 m 568.1 196.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 197.79 m 30.07 39.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 197.79 m 567.02 39.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 215.96 m 568.1 215.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 196.71 m 568.1 196.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 40.22 m 568.1 40.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 217.04 m 30.07 195.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 217.04 m 567.02 195.63 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 202.78 Tm (Brief description of the )Tj ET /F2 12 Tf BT 1 0 0 1 177.31 202.78 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 183.53 Tm (Penn House is one of a number of homes situated on the Chalfont Centre for Epilepsy. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 166.53 Tm (The home is registered to provide residential care to for up to twenty two adults with a )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 149.53 Tm (physical disability, including one relief bed.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 132.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 115.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 98.53 Tm (The home provides care and support to individuals with a range of personal care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 81.53 Tm (needs. The home is made up of five flats each with their own kitchen, sitting area and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 64.53 Tm (shower. Downstairs is wheelchair accessible.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 47.53 Tm ()Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 17 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (5)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (46)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 804.03 m 565.9 804.03 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 794.4 m 568.1 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 795.48 m 30.07 604.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 795.48 m 567.02 604.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.1 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 794.4 m 568.1 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 605.15 m 568.1 605.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 793.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 814.73 m 567.02 793.33 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 800.47 Tm (Brief description of the )Tj ET /F2 12 Tf BT 1 0 0 1 177.31 800.47 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 33.25 783.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 766.47 Tm (The Centre provides on site work placements which a number of service users from )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 749.47 Tm (Penn house access. Alongside this there is an internet cafe, a shop and restaurant.)Tj ET /F2 12 Tf BT 1 0 0 1 33.25 732.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 715.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 698.47 Tm (There is access to public transport and the home is accessible to Chalfont St Peter )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 681.47 Tm (Village, which allows for access to the towns of Amersham, High Wycombe, Uxbridge )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 664.47 Tm (and Slough.)Tj ET /F2 12 Tf BT 1 0 0 1 33.25 647.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 630.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 613.47 Tm (Please contact the provider for the current range of fees.)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 557/Matrix [1 0 0 1 0 0]>>stream xMo@>vfgg#H'!Uc*@T~>8+Ux;uBO.Fh(w^~Vkę8b C U&WMà S-09<}\ )xO=ׂ̫ۘTkՄ::ܖ^ 'FX dYV%ІPC7!oTfaсUm"̉C(hH YWMhD4U3RiV3Br`U:5#Q13)XJnXȋF>VJW:;R(W`ģҩ`3S!cj 9yj #N"F'S#5J7xM56šlf"q.jrZߔ}o*@1> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm (6XPPDU\\)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 774.7 Tm (This is an overview of what we found during the inspection.)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 754.22 m 381.05 754.22 l S 0.001 w 1 1 1 RG 20.58 w 383.3 754.22 m 566.2 754.22 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 765.64 m 568.4 765.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.81 m 568.4 742.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 766.71 m 30.07 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 382.17 766.71 m 382.17 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 766.71 m 567.32 741.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 749.45 Tm (The quality rating for this )Tj ET /F2 12 Tf BT 1 0 0 1 191.92 749.45 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 255.59 749.45 Tm ( is:)Tj ET /F2 12 Tf BT 1 0 0 1 410.5 749.45 Tm (zero star poor service)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 717.31 Tm (2XUMXGJHPHQWIRUHDFKRXWFRPH)Tj ET /F2 10 Tf BT 1 0 0 1 212.29 641.27 Tm (Choice of home)Tj ET /F2 10 Tf BT 1 0 0 1 145.27 606.82 Tm (Individual needs and choices)Tj ET /F2 10 Tf BT 1 0 0 1 248.74 572.36 Tm (Lifestyle)Tj ET /F2 10 Tf BT 1 0 0 1 127.51 537.91 Tm (Personal and healthcare support)Tj ET /F2 10 Tf BT 1 0 0 1 106.2 503.46 Tm (Concerns, complaints and protection)Tj ET /F2 10 Tf BT 1 0 0 1 226.36 469.02 Tm (Environment)Tj ET /F2 10 Tf BT 1 0 0 1 251.17 434.57 Tm (Staffing)Tj ET /F2 10 Tf BT 1 0 0 1 92.9 400.11 Tm (Conduct and management of the home)Tj ET q 0.75227 0 0 0.75161 305.05 334.32 cm /Xf1 Do Q 1 1 1 RG 20.58 w 31.2 283.08 m 567.85 283.08 l S 0.001 w 206.51 w 32.32 167.28 m 566.72 167.28 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 271.66 m 567.85 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 271.66 m 568.92 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 62.9 m 568.92 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 272.74 m 31.2 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 272.74 m 567.85 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 278.3 Tm (How we did our inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 35.17 255.48 Tm (This unannounced key inspection was conducted over two days and covered all of the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 240.9 Tm (key National Minimum Standards for younger adults. Prior to the inspection, a detailed )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 226.32 Tm (self assessment questionnaire known as the Annual Quality Assurance Assessment )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 211.74 Tm (document was sent to the manager for completion and comment cards were sent to a )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 197.15 Tm (selection of people living at the home, relatives, staff and visiting professionals. Any )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 182.57 Tm (replies that were received have helped to form judgements about the service and their )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 167.99 Tm (responses have been included under the relevant sections of the report. Information )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 153.41 Tm (received by the Commission since the last inspection was also taken into account.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 138.84 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 124.25 Tm (The inspection consisted of discussion with the some staff and service users, )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 109.68 Tm (examination of some of the homes required records, observation of practice and a tour )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 95.1 Tm (of the premises. An expert by experience was involved as part of this inspection. He )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 80.51 Tm (had discussions with two service users and observed practices. His observations and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 65.93 Tm (feedback are included within the body of the report.)Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 23 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 177.96 w 32.32 723.55 m 566.72 723.55 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.12 813.65 m 568.92 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 633.44 m 568.92 633.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 814.73 m 31.2 632.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 814.73 m 567.85 632.37 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 32.92 802.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 788.14 Tm (Feedback on the inspection findings and areas needing improvement was given to the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 773.56 Tm (Deputy Director of Services and manager at the end of the inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 758.98 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 744.4 Tm (The staff and service users are thanked for their co-operation and hospitality during )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 729.82 Tm (this unannounced visit.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 715.24 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 700.66 Tm (Nine requirements from the previous inspection have not been complied with and )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 686.08 Tm (enforcement action is now being considered to address those areas of non compliance. )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 671.5 Tm (This inspection has resulted in a number of further requirements to improve practice )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 656.92 Tm (and outcomes for service users.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 642.34 Tm ()Tj ET endstream endobj 24 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 25 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 20.58 w 31.2 786.36 m 567.85 786.36 l S 0.001 w 268.44 w 32.32 639.6 m 566.72 639.6 l S 0.001 w 20.58 w 32.7 492.84 m 569.35 492.84 l S 0.001 w 253.86 w 33.82 353.37 m 568.22 353.37 l S 0.001 w 20.58 w 33.45 213.9 m 570.1 213.9 l S 0.001 w 137.34 w 34.57 132.7 m 568.97 132.7 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 774.95 m 567.85 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 774.95 m 568.92 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 504.26 m 568.92 504.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 776.03 m 31.2 503.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 504.26 m 569.35 504.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 481.43 m 569.35 481.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 481.43 m 570.42 481.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 225.32 m 570.42 225.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 202.49 m 570.1 202.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 225.32 m 570.1 225.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 202.49 m 571.17 202.49 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 32.7 482.51 m 32.7 224.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 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placements to promote their well being.)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 (Family and friends involvement is promoted which benefits service users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.28 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.7 Tm (Service users have access to a range of health professionals which promotes their )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.12 Tm (health and well being.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.54 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 612.96 Tm (The complaints procedure is updated and displayed which enable service users to raise )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.38 Tm (concerns to safeguard them.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 583.8 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 569.22 Tm (The home is clean and homely which provides a comfortable environment for service )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 554.64 Tm (users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 540.06 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 525.48 Tm (Positive feedback was received from service users and relatives in respect of the care )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 510.9 Tm (provided. )Tj ET /F2 10 Tf BT 1 0 0 1 568.97 638.05 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 490.73 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 32.7 488.07 Tm (What has improved since the last inspection?)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 569.35 491.29 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 351.82 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 465.24 Tm (Service user plans include protocols on restrictions imposed on them which safeguards )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 450.66 Tm (service users.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 436.08 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 421.5 Tm (The home has become fully self catering which provides better quality meals for service )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 406.92 Tm (users.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 392.34 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 377.76 Tm (There has been an increase in the number of permanent staff employed at the home )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 363.18 Tm (which provides continuity of care for service users.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 348.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 334.02 Tm (Staff responsible for supervision of staff have attended training to support them in )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 319.44 Tm (their roles.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 304.86 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 290.28 Tm (Key staff have attended health and safety and COSHH training which promotes service )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 275.7 Tm (users health and safety.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 261.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 246.54 Tm (Improvements have been made to the storage of substances hazardous to health )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 231.96 Tm (which promotes service users safety.)Tj ET /F2 10 Tf BT 1 0 0 1 570.47 351.82 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 212.35 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 33.45 209.13 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 31.2 131.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 186.3 Tm (Service users to the home must be fully assessed with records of assessments in place )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 171.72 Tm (to support this to ensure that the home can meet identified needs and have considered )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 157.14 Tm (compatibility with other service users.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 142.56 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 127.98 Tm (Contracts must be completed in ink and signed to safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 113.4 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 98.82 Tm (Service users care plans must be developed to clearly and specifically outline care )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 84.24 Tm (needs including service users ability to make choices and decisions. These must be )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 69.66 Tm (kept up to date and reviewed to promote continuity of care.)Tj ET endstream endobj 26 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 27 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 732 w 34.57 446.53 m 568.97 446.53 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 32.37 813.65 m 571.17 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 79.4 m 571.17 79.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 814.73 m 33.45 78.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 814.73 m 570.1 78.33 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.17 802.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 788.14 Tm (Service users care plans must outline up to date information of who is supporting a )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 773.56 Tm (service user with their finances to safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.98 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.4 Tm (Service user plans must include up to date risk assessments which address all )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.82 Tm (identified individual risks, including moving and handling. These must be kept up to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.24 Tm (date and reviewed to promote service users safety.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.66 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 686.08 Tm (Opportunities for leisure activities must be improved to enable service users to have )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.5 Tm (access to a wide range of activities. Accurate records should be maintained to reflect )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.92 Tm (the activities that have taken place.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.34 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.76 Tm (Opportunities must be made available to enable service users to develop their )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 613.18 Tm (independence and take a more active role in the day-to-day running of the home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 584.02 Tm (Staff should ensure that visitors to the home knock or ring the door bell prior to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 569.44 Tm (entering to promote service users privacy.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 554.86 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 540.28 Tm (The choice of meals on offer must be increased and evidence provided that service )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 525.7 Tm (users are given more options and that they take an active role in making choices.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 511.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 496.54 Tm (The registered person must ensure that all events, which affect the well being of )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 481.96 Tm (service users is reported to the Commission.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 467.38 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 452.8 Tm (Improvements must be made to medication practices to safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 438.22 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 423.64 Tm (All complaints received must be logged, investigated and responded to in a timely )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 409.06 Tm (fashion to safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 394.48 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 379.9 Tm (Staff must be appropriately trained to recognise when a situation is a potential )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 365.32 Tm (safeguarding situation and report to the relevant bodies to safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 350.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 336.16 Tm (Staff must be inducted into the home and suitably recruited with records maintained to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 321.58 Tm (evidence this to safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 307 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 292.42 Tm (Staff must have the required mandatory and specialist training to enable them to meet )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 277.84 Tm (service users needs in a safe and consistent way and to fulfill their roles.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 263.26 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 248.68 Tm (Staff must be formally supervised and appropriately supported to safeguard service )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 234.1 Tm (users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 219.52 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 204.94 Tm (The registered person must ensure that this service is being effectively managed and )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 190.36 Tm (monitored to ensure that requirements are complied with to improve practice and to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 175.78 Tm (safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 161.2 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 146.62 Tm (The registered person must ensure that the records required for Regulation are well )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 132.04 Tm (maintained, accessible and up to date.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 117.46 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 102.88 Tm (The registered person must ensure that the use of free standing radiators do not pose )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 88.3 Tm (risks to service users.)Tj ET endstream endobj 28 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 29 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 799.09 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 779.1 Tm (If you want to know what action the person responsible for this )Tj ET /F2 12 Tf BT 1 0 0 1 416.37 779.1 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 480.04 779.1 Tm ( is taking )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 761.6 Tm (following this report, you can contact them using the details on page 4.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 741.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 721.61 Tm (The report of this inspection is available from our website )Tj ET /F2 12 Tf BT 1 0 0 1 380.85 721.61 Tm (www.cqc.org.uk.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 701.61 Tm (You can get printed copies from )Tj ET /F2 12 Tf BT 1 0 0 1 225.22 701.61 Tm (enquiries@cqc.org.uk or by telephoning our)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 681.62 Tm (order line 0870 240 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 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (11)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 777.09 Tm (Details of our findings)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 26 w 31.2 744.15 m 565.9 744.15 l S 0.001 w /F1 12 Tf BT 1 0 0 1 34.05 741.14 Tm (&RQWHQWV)Tj ET 1 1 1 RG 16 w 28.35 700.15 m 566.93 700.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 696.09 Tm (Choice of home \(standards 1 - 5\))Tj ET 16 w 28.35 678.15 m 566.93 678.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 674.09 Tm (Individual needs and choices \(standards 6-10\))Tj ET 16 w 28.35 656.15 m 566.93 656.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 652.09 Tm (Lifestyle \(standards 11 - 17\))Tj ET 16 w 28.35 634.15 m 566.93 634.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 630.09 Tm (Personal and healthcare support \(standards 18 - 21\))Tj ET 16 w 28.35 612.15 m 566.93 612.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 608.09 Tm (Concerns, complaints and protection \(standards 22 - 23\))Tj ET 16 w 28.35 590.15 m 566.93 590.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 586.09 Tm (Environment \(standards 24 - 30\))Tj ET 16 w 28.35 568.15 m 566.93 568.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 564.09 Tm (Staffing \(standards 31 - 36\))Tj ET 16 w 28.35 546.15 m 566.93 546.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 542.09 Tm (Conduct and management of the home \(standards 37 - 43\))Tj ET /F2 12 Tf BT 1 0 0 1 28.35 522.09 Tm (Outstanding statutory requirements)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 500.22 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 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (12)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Choice of home )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 172.25 w 32.32 627.38 m 562.53 627.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 68 w 31.2 680.63 m 563.65 680.63 l S 0.001 w 1 1 1 RG 102 w 31.2 593.38 m 563.65 593.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 541.25 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 (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, what they hope for and want to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (achieve, and the support they need.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (People can decide whether the care home can meet their support and accommodation )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (needs. This is because they, and people close to them, can visit the home and get full, )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (clear, accurate and up to date information. If they decide to stay in the home they )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (know about their rights and responsibilities because there is an easy to understand )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (contract or statement of terms and conditions between the person and the care home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (that includes how much they will pay and what the home provides for the money.)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 141.85 w 34.6 403.25 m 562.54 403.25 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 119.35 w 33.47 392 m 563.66 392 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 452.8 m 565.87 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 453.88 m 32.35 330.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 453.88 m 564.79 330.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 452.8 m 564.79 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 331.2 m 565.87 331.2 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 461.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 437.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 437.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 437.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 419.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 392.75 Tm (Prospective service users are provided with the key information on the home however )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.25 Tm (respite admissions are not reassessed to ensure that the home is aware and can meet )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 357.76 Tm (their current needs with contracts not being completed which potentially put service )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 340.26 Tm (users at risk. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 315.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 223.3 w 34.6 193.68 m 562.54 193.68 l S 0.001 w 1 1 1 RG 22.5 w 32.35 296.33 m 564.79 296.33 l S 0.001 w 201.93 w 33.47 181.87 m 563.66 181.87 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 283.96 m 565.87 283.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 285.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 285.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 283.96 m 564.79 283.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 293.02 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.27 Tm (At the previous inspection a requirement was made that the registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 250.78 Tm (ensure that an up to date service users guide is in place and made available to service )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.28 Tm (users. The service user files viewed included a copy of an up to date copy of the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 215.79 Tm (service user guide. This requirement is assessed as being complied with.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.29 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 180.79 Tm (The Annual Quality Assurance assessment document tells us that they ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.3 Tm (prospective service users have the necessary information to make a decision about )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 145.8 Tm (moving to the home. They have an assessment tool in place to carry out assessments )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.31 Tm (on prospective service users which includes a comprehensive assessment )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 110.81 Tm (questionnaire, transition meetings, day visits, overnight stays and weekend stays. It )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.31 Tm (indicates that they ensure all assessments for long term care and respite care are well )Tj ET endstream endobj 37 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 38 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 686.22 w 34.6 468.3 m 562.54 468.3 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 664.85 w 33.47 456.48 m 563.66 456.48 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 121.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 121.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 122.93 m 565.87 122.93 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (documented and comprehensive. The Annual Quality Assurance assessment document )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (tells us that the home has had no admissions since the previous inspection. The acting )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (manager had carried out a recent assessment on a prospective service user using the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (above mentioned assessment tool. This completed assessment was found to be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (comprehensive and informative in outlining the individuals needs. On the day prior to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (the inspection a service user was admitted for respite care. This individual had not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (been reassessed to establish if their needs had changed and was not formally )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (admitted by a doctor as is the procedure within the organisation. Their care plan was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (not updated to reflect their change in circumstances since the last admission and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (there was no record on the daily record sheet of their admission. The first entry in that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (individuals daily record was by the night staff to record a seizure. This is unsafe )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (practice which potentially put the service user at risk. A requirement was made at the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (previous inspection that the registered person must ensure that service users to the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (home are assessed with records of assessments in place to support this. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (requirement is assessed as not being complied with and will be referred to the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (enforcement team for their consideration. The home has a referral and assessment )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (policy which was updated in July 2005. This does not outline the procedure for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (admissions into respite care.)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 (At the previous inspection a recommendation was made that service users contracts )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (should be completed in ink and signed off by staff as outlined on the contract. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (contracts viewed at this inspection were completed in pencil, some were unsigned and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (still included details of the previous manager. This has not been addressed and a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (requirement will be made to address this to safeguard service users.)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 (Written feedback from service users confirm that twelve out of fourteen were asked if )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (they wanted to move into the home and was given enough information about the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (home before they decided if it was the right place for them. One service user indicated )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (they could not remember if they were asked if they wanted to move into the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (and if they were given enough information to decide if it was the right place for them )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (and one service user indicated they were not asked if they wanted to move into the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (home and was not given enough information about the home before they decided if it )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (was the right place for them.)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 (Written feedback from relatives confirm that one relative always get enough )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (information about the care service to help them make decisions and four relatives )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (usually get enough information about the care service to help them make decisions)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm ()Tj ET endstream endobj 39 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 40 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (14)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Individual needs and choices )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.25 w 32.32 618.88 m 562.53 618.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 102 w 31.2 663.63 m 563.65 663.63 l S 0.001 w 1 1 1 RG 85 w 31.2 567.88 m 563.65 567.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 611.5 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 28.99 524.25 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 (Peoples needs and goals are met. The home has a plan of care that the person, or )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (someone close to them, has been involved in making. People are able to make )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (decisions about their life, including their finances, with support if they need it. This is )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (because the staff promote their rights and choices. People are supported to take risks )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (to enable them to stay independent. This is because the staff have appropriate )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (information on which to base decisions.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (People are asked about, and are involved in, all aspects of life in the home. This is )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (because the manager and staff offer them opportunities to participate in the day to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (day running of the home and enable them to influence key decisions. People are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (confident that the home handles information about them appropriately. This is )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (because the home has clear policies and procedures that staff follow.)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 124.35 w 34.6 395 m 562.54 395 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 101.85 w 33.47 383.75 m 563.66 383.75 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 435.8 m 565.87 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 436.88 m 32.35 330.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 436.88 m 564.79 330.62 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 31.27 331.7 m 565.87 331.7 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 444.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 420.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 420.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 420.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 402.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.75 Tm (Service users plans lack detail and are not specific as to how identified needs are to )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.25 Tm (met, risk assessments are not in place for all known risks, kept up to date and )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 340.76 Tm (reviewed which potentially puts service users at risk. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 316.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 223.8 w 34.6 193.93 m 562.54 193.93 l S 0.001 w 1 1 1 RG 22.5 w 32.35 296.83 m 564.79 296.83 l S 0.001 w 202.43 w 33.47 182.12 m 563.66 182.12 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 284.45 m 565.87 284.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 285.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 285.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 284.45 m 564.79 284.45 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 35.5 293.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.77 Tm (Four service user care plans were viewed. Care plans contained a photograph and a )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 251.27 Tm (personal details information sheet. They outlined significant important dates and a pen )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.78 Tm (picture on how best to support the individual. Care plans identified needs associated )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.28 Tm (with epilepsy, medication, behaviours, eating and drinking, finances, social skills, )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.79 Tm (personal care, mobility, communication, cultural and religious preferences, general )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.29 Tm (health, family and friendships and health appointments. The care plans viewed )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.79 Tm (showed evidence of being reviewed and service users involvement. The care plans )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.3 Tm (viewed were not detailed and specific as to how service users needs were to be met. )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.8 Tm (One service users care plan made reference to prompting a service user with their )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.31 Tm (personal care, however it does not outline how they are to be promoted or frequency. )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.81 Tm (One service users care plan outlined that the service user was able to communicate )Tj ET endstream endobj 41 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 42 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (their needs however a recent investigation indicated that they were unable to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (communicate their health needs but the care plan was not updated to reflect this. One )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (service users care plan indicated that they suffered from high muscle tension however )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (there was no explanation as to how this affected the service user and staff on duty )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (were unable to explain what it was. One service users care plan outlined that they had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (difficulty in swallowing. It did not clearly outline what those difficulties were and there )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (was no risk assessment in place to address potential risks associated with this.)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 (Care plans outlined behaviours pre and post seizure but the care plan did not outline )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (how those behaviours were to be managed. One service users care plan made )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (reference to a protocol being in place in relation to the management of challenging )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (behaviour however there was no protocol included in the care plan and staff on duty )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (were not aware of its existence. This is unsafe practice which potentially put the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (service user, other service users and staff at risk. As outlined under standard 3 the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (care plan in place for the service user admitted prior to the day of the inspection was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (out of date and did not reflect their current circumstances with the daily records not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (completed to indicate this individual was admitted.)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 (The Annual Quality Assurance assessment document tells us that comprehensive )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (careplans are in place for every service user which was not assessed as being the case )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (in the sample of care plans viewed. The care plans viewed made no reference as to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (how service users are to be supported in making choices and decisions except for one )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (care plan that made reference to choosing meals. A requirement was made at the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (previous inspection that the registered person must ensure that service user care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (plans are developed which clearly and specifically outline care needs including their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (ability to make choices and decisions. This requirement is assessed as not being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (complied with and will be referred to the enforcement team for their consideration. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (recommendation was made at the previous inspection that service user plans should )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (accurately reflect the service users religion. The care plans viewed included service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (users religious preferences and indicated if they required support to meet their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (religious needs. A recommendation was made at the previous inspection that service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (user files should be reorganised and made, more accessible. The information was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (made more accessible but lacked the details as outlined above.)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 (Care plans makes reference to communication needs but as outlined above does not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (outline how service users were being supported and empowered to make choices and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (decisions. Changing lifestyle meetings have been taking place with service users and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (families to discuss the closure of this service in 2011 and the acting manager )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (confirmed that she had started one to one meetings with service users to discuss their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (future options and obtain their views on what type of accommodation they would like )Tj ET endstream endobj 43 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 44 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (to move to. The Annual Quality Assurance Assessment document tells us monthly )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (resident meetings take place. Minutes seen confirm that a residents meetings took )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (place on the 17th November with previous minutes on file for meetings that took place )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (on the 10th August and the 25th October 2009. This should be developed on with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (meetings take place on a more regular basis to enable service users to raise issues )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (which affect them.)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 (Written feedback from service users confirm that nine out of fourteen service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (always make decisions about what they do each day. Two service users fed back that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (they usually make decisions about what they do each day, two service users fed back )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (that they sometimes make decisions about what they do each day and one service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (user did not answer this question.)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 (Service user plans included money management risk assessments and care plans )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (outlined the support required with finances. In one file viewed the money )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (management risk assessment indicated that the service user required someone to act )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (on their behalf to manage their money however the care plan did not outline who was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (supporting this individual and staff on duty were unaware of the arrangements for this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (individuals finances. The Annual Quality Assurance assessment document tells us that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (the local funding authority had taken responsibility for this individuals money however )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (during the inspection it was clarified that this was not the case. This is unsafe practice )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (in relation to the recording of information which potentially put service users at risk of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (financial abuse. At the previous inspection some service users had restricted access to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (their cigarettes and snacks. A requirement was made that the registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (ensure that restrictions imposed on individuals are within an individual risk )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (assessment framework that does not impact on other service users. Service user plans )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (viewed included protocols on the management of cigarettes. However two of the three )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (protocols viewed were overdue for review. These should now be further developed to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (enable service users to start taking some responsibility in preparation for their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (discharge from the service.)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 (Service user plans included risk assessments in relation to fire, smoking, use of kettle, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (transport, money management risk assessments and medication risk assessments but )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (only for service users who were self medicating. Two of the three money management )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (risk assessments viewed were completed in 2006 and were not reviewed or updated )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (following the changes within the organisation in relation to the management of service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (users finances. Some of the risks assessments viewed were overdue for review. None )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (of the files viewed included risks assessments in relation to the management of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (challenging behaviours, behaviours pre and post seizure and risks associated with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (individuals medical conditions and disabilities. There were no risk assessments on file )Tj ET endstream endobj 45 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 46 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 441.27 w 34.6 590.77 m 562.54 590.77 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 419.9 w 33.47 578.96 m 563.66 578.96 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 366.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 366.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 367.88 m 565.87 367.88 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (for the service user admitted the day prior to the inspection. Service user plans )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (included a moving and handling care plan but there was no moving and handling risk )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (assessment in place to support the care plan. A requirement was made at the previous )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (inspection that the registered person must ensure that up to date risk assessments )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (are in place to address all identified individual risks, including moving and handling. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (These must be kept up to date and reviewed. This requirement is assessed as not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (being complied with and enforcement action is now being considered by the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (Commission to address this non compliance.)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 (Written feedback from relatives indicate that four relatives feel the care service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (usually meets the needs of their relative and one relative indicated that they always )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (meets the needs of their relative.)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 (Written feedback from relatives indicates that three relatives feel they usually support )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (people to live the life they choose, one relative indicated they always support people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (to live the life they choose and one relative indicated they sometimes support people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (to live the life they choose.)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 (Written feedback from staff confirms that four staff indicated they are always given up )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (to date information about the needs of the people they support. Three staff indicated )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (they are usually given enough information about the people they support and one staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (member did not answer this question.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm ()Tj ET endstream endobj 47 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 48 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Lifestyle )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 223.25 w 32.32 601.88 m 562.53 601.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 170 w 31.2 629.63 m 563.65 629.63 l S 0.001 w 1 1 1 RG 51 w 31.2 516.88 m 563.65 516.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 543.5 m 565.85 543.5 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 28.99 543.5 m 565.85 543.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 490.25 m 565.85 490.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 489.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 489.17 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 can take )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (part in activities that are appropriate to their age and culture and are part of their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (local community. The care home supports people to follow personal interests and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (activities. People are able to keep in touch with family, friends and representatives and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (the home supports them to have appropriate personal, family and sexual relationships. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 600.57 Tm (People are as independent as they can be, lead their chosen lifestyle and have the )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 583.57 Tm (opportunity to make the most of their abilities. Their dignity and rights are respected )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 566.57 Tm (in their daily life. People have healthy, well-presented meals and snacks, at a time and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 549.57 Tm (place to suit them.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (People have opportunities to develop their social, emotional, communication and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 513.32 Tm (independent living skills. This is because the staff support their personal development. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 496.32 Tm (People choose and participate in suitable leisure activities.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 472 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 450 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 450 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 427.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 124.35 w 34.6 361 m 562.54 361 l S 0.001 w 1 1 1 RG 22.5 w 32.35 414.17 m 564.79 414.17 l S 0.001 w 101.85 w 33.47 349.75 m 563.66 349.75 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 401.8 m 565.87 401.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 402.88 m 32.35 296.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 402.88 m 564.79 296.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 401.8 m 564.79 401.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 297.7 m 565.87 297.7 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 410.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 386.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 386.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 386.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 368.62 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 36.62 341.75 Tm (Service users do not have access to a range of leisure activities, their independence is )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 324.25 Tm (not promoted and they have limited choice of meals provided which does not benefit )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 306.76 Tm (service users. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 282.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.8 w 34.6 176.93 m 562.54 176.93 l S 0.001 w 1 1 1 RG 22.5 w 32.35 262.83 m 564.79 262.83 l S 0.001 w 168.43 w 33.47 165.12 m 563.66 165.12 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 250.46 m 565.87 250.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 251.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 251.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 250.46 m 564.79 250.46 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 35.5 259.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 234.77 Tm (The Annual Quality Assurance assessment document tells us that the organisation )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 217.27 Tm (provide office based work for service users and is actively helping and supporting )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 199.78 Tm (some service users to find work in the community. The Organisation has put together )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 182.28 Tm (a business plan for a Horticultural Social Enterprise Project and some service users )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 164.79 Tm (have commenced work on this project. Some service users work on other projects on )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 147.29 Tm (site and some service users attend college. Service user plans included a weekly )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 129.79 Tm (timetable of activities with a record maintained in daily records of what individuals )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 112.3 Tm (participated in. One service user fed back to the expert by experience that they were )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 94.8 Tm (currently improving their literacy skills with the aid of another service user which was )Tj ET endstream endobj 49 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 50 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (19)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (their choice as the option of going to college would be too stressful. The Annual )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (Quality Assurance Assessment document tells us that what has improved in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (service is that they provide more regular social and recreational trips out and provide )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (social events as part of a centre wide rota system. They have photographic evidence )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (depicting trips, holidays and activities with written reports included in service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (daily reports. A recommendation was made at the previous inspection that accessible )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (records should be maintained to evidence that leisure activities takes place with a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (requirement made that the registered provider must ensure that opportunities are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (made available to enable service users to access a range of leisure activities. During )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (the two day inspection no leisure activities were observed to take place or be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (organised. A weekly record of activities was put in place as recommended but was not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (being completed to evidence that service users have access to a range of leisure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (activities and there was no time during the inspection to go through individuals daily )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (records to establish if this is the case. Therefore from the evidence provided on the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (day of the inspection it is assessed that this requirement has not been complied with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (and enforcement action is now being considered. The Annual Quality Assurance )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (assessment document tells us that service users have access to an annual holiday )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (with care plans indicating that this was a goal for some individuals.)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 (Care plans outline significant people involved in service users life's and the care plans )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (outline the support required in maintaining those relationships. Feedback from service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (users confirms that their relatives and friends are made to feel welcome.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (A requirement was made at the previous inspection that the registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (ensure that opportunities are made available to enable service users to develop their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (independence and take a more active role in the day to day running of the home. Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (plans viewed do not evidence that service users are promoted to develop their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (independence and this was not evident in practices during the inspection. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (requirement is assessed as not been complied with and enforcement action is now )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (being considered by the Commission to address this non compliance with a regulation. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (A recommendation was made at the previous inspection that service user plans should )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (outline support required with post and a risk assessment should be in place to indicate )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (why an individual do not have a key to the front door of the home. The care plans )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (viewed included a risk assessment on the management of post with one of the three )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (risk assessments viewed overdue for review. Care plans indicated that staff entered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (service users bedrooms at night to check on individuals to promote their safety and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (service users have a key to the front door. During the inspection it was noted that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (maintenance man and builder entered the home without knocking or ringing the bell. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (This is unacceptable practice and intrusion into the service users home which as a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (good practice recommendation should be addressed. Care plans outline service users )Tj ET endstream endobj 51 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 52 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (20)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (preferred form of address and service users can choose when to be alone or in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (company. During the inspection service users who were not involved in work or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (college spent the majority of the day in their bedrooms with little engagement noted )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (with staff. Staff feedback that they were discouraged from sitting talking to service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (users as this was seen as them not doing anything. Service users were not observed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (to be involved in housekeeping tasks apart from setting the table for meals. One care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (plan viewed made reference to staff supporting that individual with spring cleaning )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (their bedroom. The service is due to close in 2011 and is set up with groups of four or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (five service users living together sharing a sitting room and small kitchen which is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (ideal for supporting and enabling service users to develop some life skills. This must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (now be developed on. The staff team meeting minutes of the 24th November include )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (discussions on involving residents more in household tasks. One service user fed back )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (to the expert by experience that they liked to be independent with most aspects of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (their life and this is promoted. However the expert by experience did not witness any )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (other practices which promoted independence and enabled service users but observed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (more of a culture of looking after service users.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (Service users are provided with three meals a day. Four service users make their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (breakfasts in their own kitchenette whilst the others have their breakfast in the dining )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (room. The majority of service users have their lunch and evening meal in the dining )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (room. All of the meals are now catered for in the home which the service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (indicated was an improvement and they indicated that the meals provided were good. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (Staff take full responsibility for the meals with no evidence of service users being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (involved in the planning, shopping, cooking or serving of meals. The home has a four )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (week menu with the weeks menu plan displayed on the notice board in the dining )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (room. The four week menu plan does not evidence service users involvement in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (choosing the meals, it does not indicate service users likes or dislikes and no )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (alternative choices are recorded as being provided. Staff advised that they do cater for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (a vegetarian meal choice and that they do provide alternatives for service users who )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (do not like what is on the menu. This is not recorded to evidence that it takes place. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (Service users have a choice of snack type meals in the evening and this is recorded. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (The acting manager has recently completed a questionnaire with service users in an )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (attempt to improve meals and the feedback from those is to be incorporated into )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (menu plans. Resident meeting minutes of the 17th November and staff meeting )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (minutes of the 24th November include discussions on developing self catering for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (service users who want to with the plan being for this to be introduced in the new )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (year. This will be a positive move in preparing service users for when the service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (closes. The expert by experience observed a meal time. He found that service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (were served large portions of one meal choice, with a lot of waste on the day of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (inspection. Service users were served the meals by staff and there was little )Tj ET endstream endobj 53 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 54 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (21)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 493.76 w 34.6 564.52 m 562.54 564.52 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 472.39 w 33.47 552.71 m 563.66 552.71 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 314.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 314.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 315.39 m 565.87 315.39 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 (interaction or engagement between staff and service users or each other.)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 (Written feedback from service users confirm that twelve out of fourteen service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (can do what they want during the day, in the evening and at the weekend. Two people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (did not answer this question.)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 (Service users commented under what the home does well "good meals and good )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (menu", "they help us to cook and cook my dinner", "day trips and holidays". Service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (users commented under what the home could do better is "more food", "self catering", )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ("provide more outings and easier access to shops".)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 (Written feedback from three relatives indicates that the home always helps their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (relative keep in touch with them, two relatives indicated they usually help their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (relative keep in touch with them. One relative commented that "when they visit they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (are always made welcome and it is a happy atmosphere". One relative commented )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (under what the home does well is "provide food to a good standard". One relative )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (commented under what the home could do better is "activities, off centre activities )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (have recently been shelved, courses such as art and crafts, cookery have stopped. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (Weekends seem to be a dead area as far as organised activities go". One relative )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (commented that "their relative has a full programme of activities and they are helped )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (to be as independent as possible".)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 (Staff commented under what the home could better is "to improve the service by )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (having their own vehicle enabling them to take service users not only on day trips but )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (to the local shops and external services and appointments".)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 ()Tj ET endstream endobj 56 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 57 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (22)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Personal and healthcare support )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 155.25 w 32.32 635.88 m 562.53 635.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 68 w 31.2 593.38 m 563.65 593.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 558.25 m 565.85 558.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 557.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 557.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People receive personal support from staff in the way they prefer and want. Their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (physical and emotional health needs are met because the home has procedures in )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (place that staff follow. If people take medicine, they manage it themselves if they can. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (If they cannot manage their medicine, the care home supports them with it in a safe )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (way.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 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 35.5 598.32 Tm (and help them to feel comfortable and secure. They, and people close to them, are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (reassured that their death will be handled with sensitivity, dignity and respect, and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (take account of their spiritual and cultural wishes. )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 540 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 518 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 518 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 495.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 141.85 w 34.6 420.25 m 562.54 420.25 l S 0.001 w 1 1 1 RG 22.5 w 32.35 482.17 m 564.79 482.17 l S 0.001 w 119.35 w 33.47 409 m 563.66 409 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 469.8 m 565.87 469.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 470.88 m 32.35 347.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 470.88 m 564.79 347.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 469.8 m 564.79 469.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 348.2 m 565.87 348.2 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 478.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 454.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 454.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 454.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 436.62 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 36.62 409.75 Tm (Service users health and personal care needs are met although care plans need to be )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 392.25 Tm (more specific as to the support required to ensure all needs are met in safe and )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 374.76 Tm (consistent way.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 357.26 Tm (Improvements are required to medication practices to safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 332.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 240.3 w 34.6 202.18 m 562.54 202.18 l S 0.001 w 1 1 1 RG 22.5 w 32.35 313.33 m 564.79 313.33 l S 0.001 w 218.93 w 33.47 190.37 m 563.66 190.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 300.96 m 565.87 300.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 302.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 302.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 300.96 m 564.79 300.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 310.02 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 285.27 Tm (Service users plans makes reference to the support required with personal care )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 267.78 Tm (although as outlined under standard 7 this was not detailed and specific enough to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 250.28 Tm (ensure that all staff were consistent in the care being provided. Service users plans )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 232.79 Tm (included moving and handling care plans with no moving and handling risk )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 215.29 Tm (assessment in place to support the care plan. Times for getting and going to bed are )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 197.79 Tm (flexible with service users being encouraged to get up to attend work placements and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 180.3 Tm (colleges during the week. Care plans do not indicate if service users make their own )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 162.8 Tm (choice of clothes and hairstyles. The Annual Quality Assurance assessment document )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 145.31 Tm (tells us that service users have access to a range of specialist health professionals )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 127.81 Tm (with records maintained of appointments with health professionals. Staff act as key )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 110.31 Tm (workers to service users. Some staff spoken with were unclear as to what that role )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 92.82 Tm (entailed and confirmed they were responsible for developing care plans and risk )Tj ET endstream endobj 58 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 59 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (23)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (assessments but had no formal training in this area. This must be addressed to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (improve the quality of care plans. Some service users spoken with knew who their key )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (worker was whilst others did not. Service users plans did not outline service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (preferred routines, likes and dislikes.)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 Annual Quality Assurance assessment document tells us that service users have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (access to specialist epilepsy medical services 24 hours per day which include Epilepsy )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (Nurses, On call Doctor and the Neurologist. It tells us that service users can also )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (access the psychology,psychiatry and physiotherapy departments, pharmacy, dentist )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (and General Practitioner. Service user plans outlined the support required with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (accessing the dentist, chiropodist and optician and in meeting health needs although )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (this was not specific as to the support required specifically when the service user was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (unable to communicate their needs. A recent safeguarding of vulnerable adults )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (investigation concluded that an individuals health needs were not met. The records )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (viewed would indicate that service users have access to a range of health )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (professionals and their health needs are met however accurate records are not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (maintained of concerns raised by relatives which potentially could result in their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (concerns relating to health needs not being addressed in a timely fashion.)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 (At the time of this inspection seven of the sixteen service users were self medicating. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (Care plans made reference to the support required with medication and for service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (users who were self medicating there was a medication assessment in place. In one )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (care plan viewed this was due for review in Sept 2009 with no evidence of it being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (reviewed.For service users who were being supported with their medication there was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (no indication on file as to how this judgement was made. As a good practice )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (recommendation this should be addressed and reviewed to ensure that service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (who may be able to develop those skills can. The home has designated staff who are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (trained to administer medication. Staff confirmed that they undergo medication )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (training and nine assessments prior to being signed off to administer medication. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (Copies of completed medication competency assessments are not kept on staff files to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (evidence this and a part completed one was seen which did not include the page as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (evidence of being signed off by the manager. As a good practice recommendation this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (should be addressed with copies kept on file to support practices. Permanent staff are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (responsible for the ordering, receipt, storage, administration and disposal of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (medications with a record maintained to evidence this. The home has individual )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (medication records with a photograph, which includes a General Practitioner )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (prescription medication administration record and a Consultant medication )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (administration record. All medications administered are prescribed including homely )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (remedies. The records viewed showed gaps in administration of medication for three )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (service users, one which included signing off to say a service user had been given )Tj ET endstream endobj 60 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 61 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (24)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (their weeks supply of medication to self medicate. The service user who was admitted )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (the day prior to the inspection was administered their supply of medication they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (brought to the home with them. This was administered following advice from the first )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (line nurse on duty without the service user being seen by a Doctor and without an up )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (to date medication administration record in place for the staff member administering )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (the medication to record it as being administered. No record was maintained on the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (service users daily record of the medication administered and there was no evidence )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (on file to indicate that it had been established with the service users General )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (Practitioner or family that this was their current prescription. This practice is not in line )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (with the Organisations procedures and medication policy and must be addressed to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (safeguard service users. Service users records include a seizure description sheet and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (a protocol for administration of their as required emergency medication. A medication )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (management incident report is completed for all medication errors, and there was one )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (on file since the previous inspection which was not reported to the Commission. There )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (was seven accident/incident reports on file involving service users which was also not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (reported to the Commission. A requirement was made at the previous inspection that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (the registered person must ensure that all events, which affect the well being of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (service users is reported to the Commission. This has not been complied with. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (pharmacy audit was carried out in October 2009 with a report on file to outline the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (actions required which related mainly to disposing of out of date medication.)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 (Three service users commented under what the home does well is "look after us when )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (we are ill", another service user commented that "they help me when I have a seizure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (and help me with hygiene". One service user commented under what the home could )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (do better was "help with problems" but did not give their name or any examples of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (what assistance they felt they were not getting to enable this feedback to be followed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (up on. Two service users expressed anxiety regarding the future closure of this service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (and this was also fed back to the expert by experience during his visit.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (Written feedback from relatives indicates that four relatives are always kept up to date )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (with important issues affecting their relative and one relative indicated they are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (usually kept up to date with important issues affecting their relative. Three relatives )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (indicated that the care service always give the support and care that they expect or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (agreed. Two relatives indicates that the care service usually give the support and care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (that they expect or agreed. Four relatives indicate that the service usually responds to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (the different needs of individuals and one relative indicates that they sometimes )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (respond to the different needs of individuals.)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 (Relatives commented under what the service does well that "medical care is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (excellent", "they make life as normal as possible and generate a good family )Tj ET endstream endobj 62 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 63 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (25)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 511.26 w 34.6 555.78 m 562.54 555.78 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 489.89 w 33.47 543.96 m 563.66 543.96 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 296.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 296.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 297.89 m 565.87 297.89 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (orientated environment". "They ensure medical and physical needs are met but also )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (provide the peripheral extras that make life individual and pleasant". "They have met )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (my relatives needs very well indeed, there is good medical help on site". "My relative )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (feels safe and that is everything as it keeps their state of mind stable". One person )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (commented that "we are so grateful at the way our relative is looked after and hope it )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (can continue as our relative is very settled".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (One relative commented under what the home does well is "keep their relative warm )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (and take care of the washing". They commented under what the home could do better )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (is "as needs change there needs to be greater understanding and tolerance of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (restrictions they have to live under".)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 (Staff commented under what the home does well is "support service user in all areas )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (of care, including the management of challenging behaviour and they provide a caring )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (and homely environment at the home". Feedback received from two Social and health )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (care professional indicated they were generally happy with the care provided. They )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (commented that what the service does well is "inform clients about their medication", )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm ("manages complex mental health issues", "encourages knowledge of epilepsy and how )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (to manage the condition".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (They commented under what the service could do better is "ensure health needs are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (fully met, not only those related to epilepsy". "Provide a more positive path for those )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (moving on by encouraging and promoting independence". "The accommodation feels )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (very institutional and there is need for more person centred support".)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 (Service users fed back to the expert by experience that staff are quick to respond to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (call bells and deal with medical issues.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET endstream endobj 64 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 65 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (26)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Concerns, complaints and protection )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 87.25 w 32.32 669.88 m 562.53 669.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 68 w 31.2 680.63 m 563.65 680.63 l S 0.001 w 1 1 1 RG 17 w 31.2 635.88 m 563.65 635.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 626.25 m 565.85 626.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 625.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 625.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (If people have concerns with their care, they or people close to them, know how to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (complain. Their 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, neglect and self-harm and takes action to follow )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (up any allegations.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 608 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 586 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 586 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 563.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 505.74 m 562.54 505.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 550.17 m 564.79 550.17 l S 0.001 w 84.36 w 33.47 494.5 m 563.66 494.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 537.8 m 565.87 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 538.88 m 32.35 450.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 538.88 m 564.79 450.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 537.8 m 564.79 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 451.19 m 565.87 451.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 546.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 522.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 522.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 522.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 504.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 477.75 Tm (Policies and procedures are in place to safeguard service users however practices, )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.25 Tm (recording and lack of training potentially put service users at risk. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 435.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 343.3 w 34.6 253.67 m 562.54 253.67 l S 0.001 w 1 1 1 RG 22.5 w 32.35 416.32 m 564.79 416.32 l S 0.001 w 321.93 w 33.47 241.86 m 563.66 241.86 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 403.95 m 565.87 403.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 405.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 405.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 403.95 m 564.79 403.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 413.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 388.27 Tm (The Organisation has a complaints procedure in place, which was reviewed in March )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 370.77 Tm (2009. A summary of the complaints procedure is displayed on the notice board in the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.27 Tm (dining room and includes the Commissions up to date contact details. A requirement )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 335.78 Tm (was made at the previous inspection that the complaints procedure must be updated )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.28 Tm (with the correct contact details of the Commission, which has been complied with. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 300.79 Tm (Annual Quality Assurance assessment document tells us that the home has one )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.29 Tm (complaint which was dealt with within 28 days. The complaints log included two )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 265.79 Tm (complaints, one from a service user in relation to meals which was not investigated )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.3 Tm (and responded to and one from a relative received by the Commission which was sent )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 230.8 Tm (to the organisation to deal with. This complaint did not include the outcome and was )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.31 Tm (not dealt with within 28 days as the complainant came back to the Commission to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 195.81 Tm (follow up on a response. The Regulation 26 report dated the 29th July 2009 makes )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.31 Tm (reference to a complaint from a relative which was not logged in the complaints log )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 160.82 Tm (and this was not followed up at subsequent Regulation 26 visits so there is no )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.32 Tm (evidence to indicate if this was dealt with. This must be addressed with accurate )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 125.83 Tm (records maintained of all complaints received which include the outcome of the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.33 Tm (investigation into the complaint. Written feedback from service users confirm that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 90.83 Tm (thirteen out of fourteen service users that responded know who to speak to if they are )Tj ET endstream endobj 66 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 67 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (27)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (not happy and fourteen know how to make a complaint.)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 (Written feedback from relatives confirm that four relatives know how to make a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (complaint and the home always responds appropriately to concerns raised. One )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (relative indicated they did not know how to make a complaint and the home usually )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (responds appropriately to concerns raised.)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 (Written feedback from staff confirms that they all know what to do if someone has )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (concerns about the home.)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 (The Organisation has a vulnerable adults and whistle blowing policy in place. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (whistle blowing policy was reviewed and updated in March 2008. The abuse policy was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (last updated in March 2004.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (The home has had one safeguarding of vulnerable adults referral and investigation. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (The outcome of this investigation was that the allegation was upheld.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (The accident and incident reports viewed included incidents between service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (which should have been reported to the Commission and the safeguarding of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (vulnerable adults team. The Deputy Director of Services agreed after the inspection )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (for the acting manager to review all of the accident and incident reports on file and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (make safeguarding of vulnerable adults referrals in retrospect of incidences which )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (were assessed as safeguarding.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (Staff spoken with confirmed their responsibility to report bad practice and abuse )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (however the lack of reporting of potential safeguarding of vulnerable incidents would )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (indicate that staff do not fully understand what is a potential safeguarding situation )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (and this must be addressed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (A requirement was made at the previous inspection that the registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (ensure that all staff including night staff have up to date safeguarding of vulnerable )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (adults training, and all other mandatory training as required. The training records )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (supplied evidences that four out of the ten permanent staff team members have up to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (date safeguarding of vulnerable adults training with five staff overdue updates in this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (training and one staff not having had this training. The update for some staff members )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (had been booked and cancelled by them with no explanation as to why it was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (cancelled and not rescheduled. This requirement is assessed as not been complied )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (with and enforcement action is now being considered to address this non compliance.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (The service has some service users with challenging behaviours. The Annual Quality )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (Assurance assessment document tells us staff attend mandatory challenging )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (behaviour training to ensure that service users who present with this type of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (behaviour are treated safely and appropriately.It tells us that behavioural guidelines )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (are developed to support service users emotional needs and behavioural guidelines )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (are reviewed quarterly, or sooner if required, with the Psychiatrist.The care plans )Tj ET endstream endobj 68 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 69 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (28)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 231.32 w 34.6 695.74 m 562.54 695.74 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 209.95 w 33.47 683.93 m 563.66 683.93 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 576.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 576.75 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 31.27 577.83 m 565.87 577.83 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 (viewed did not include behavioural guidelines where this was required and the training )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (records evidence that five out of the ten staff do not have challenging behaviour )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (training.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (A requirement was made at the previous inspection that the registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (ensure that all staff have access to a range of specialist training to support them in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (their roles including challenging behaviour training. This requirement is assessed as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (not being complied with and enforcement action is now being considered to address )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (this non compliance.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (Service user plans made reference to support required with finances but as outlined )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (under standard 7 for one service user the care plan did not actually reflect the current )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (practices as to how that individuals money was being managed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (Three service users money and records were checked and found to be in order.)Tj ET endstream endobj 70 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 71 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (29)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Environment )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 121.25 w 32.32 652.88 m 562.53 652.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 34 w 31.2 697.63 m 563.65 697.63 l S 0.001 w 1 1 1 RG 85 w 31.2 635.88 m 563.65 635.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 679.5 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 28.99 592.25 m 565.85 592.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 591.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 591.17 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, comfortable, )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (pleasant and 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. People have )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (enough privacy when using toilets and bathrooms.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 574 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 552 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 552 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 529.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 471.74 m 562.54 471.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 516.17 m 564.79 516.17 l S 0.001 w 84.36 w 33.47 460.5 m 563.66 460.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 503.8 m 565.87 503.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 504.88 m 32.35 416.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 504.88 m 564.79 416.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 503.8 m 564.79 503.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 417.19 m 565.87 417.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 512.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 488.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 488.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 488.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 470.62 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 36.62 443.75 Tm (The home is clean, homely and adequately maintained, with some improvements )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 426.25 Tm (being made to areas of the home to promote a positive environment for service users. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 401.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 309.3 w 34.6 236.67 m 562.54 236.67 l S 0.001 w 1 1 1 RG 22.5 w 32.35 382.32 m 564.79 382.32 l S 0.001 w 287.93 w 33.47 224.86 m 563.66 224.86 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 369.95 m 565.87 369.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 371.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 371.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 369.95 m 564.79 369.95 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 35.5 379.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 354.27 Tm (The home is a detached house situated in the grounds of the Chalfont Centre. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.77 Tm (house consists of five flats, each of between three and six bedrooms. There are four )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 319.27 Tm (flats on the ground floor and one on the first floor. Each flat comprises of single )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.78 Tm (bedrooms, kitchenette, lounge, shower, toilet and storage area. One of the lounges is )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 284.28 Tm (used as a smoking area as the service users who live in that flat all smoke. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.79 Tm (Annual Quality Assurance Assessment document tells us that the smoking room has )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 249.29 Tm (been refurbished. The expert by experience fed back that this room seemed untidy )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.79 Tm (and did not appear to be cleaned to the same standard as the rest of the home. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 214.3 Tm (home does not have a lift. The ground floor is accessible to a wheelchair user. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.8 Tm (home has a bathroom with chairlift for service users who require support. The home )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 179.31 Tm (has a communal sitting area and main kitchen. Bedrooms are personalised and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.81 Tm (homely. On the day of the inspection the home was found to be clean and generally )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 144.31 Tm (well maintained. One of the shower rooms on the ground floor was noted to be damp )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.82 Tm (and this must be addressed. The Annual Quality Assurance Assessment document tells )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 109.32 Tm (us that the home have employed a housekeeper and this has helped to keep the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.83 Tm (house clean, tidy and odour free. It has also helped to take the pressure off care staff )Tj ET endstream endobj 72 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 73 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (30)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 318.8 w 34.6 652 m 562.54 652 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 297.43 w 33.47 640.19 m 563.66 640.19 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 489.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 489.27 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 31.27 490.35 m 565.87 490.35 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 (leaving them with more time to spend with the Service Users. At the time of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (inspection the housekeepers post had been changed to a support worker post with all )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (staff being responsible for cleaning. During the tour of the home it was noted that free )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (standing electric heaters were being used to supplement the heating in the home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (These were hot to the touch and potentially put service users with seizures at risk. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (risk assessment must be completed for each service user and the required action )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (taken to safeguard service users from the potential risk of scalding. The home is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (scheduled to close in 2011 and whilst the environment is not ideal it is currently )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (adequate in providing a comfortable and homely environment for service users.)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 (Written feedback from service users confirm that seven out of fourteen service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (think that the home is fresh and clean. Five service users fed back that the home is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (usually fresh and clean, one service user fed back that the home is sometimes fresh )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (and clean and one service user did not answer this question.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (Relatives commented that "the house is always clean".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm ()Tj ET endstream endobj 74 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 75 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (31)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Staffing )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 121.25 w 32.32 652.88 m 562.53 652.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 34 w 31.2 610.38 m 563.65 610.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 592.25 m 565.85 592.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 591.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 591.17 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, qualified )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (staff on duty at all times. They have confidence in the staff at the home because )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (checks have been done to make sure that they are suitable. Peoples needs are met )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (and they are supported because staff get the right training, supervision and support )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (they need from their managers.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People are supported by an effective staff team who understand and do what is )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (expected of them.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 574 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 552 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 552 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 529.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 471.74 m 562.54 471.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 516.17 m 564.79 516.17 l S 0.001 w 84.36 w 33.47 460.5 m 563.66 460.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 503.8 m 565.87 503.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 504.88 m 32.35 416.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 504.88 m 564.79 416.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 503.8 m 564.79 503.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 417.19 m 565.87 417.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 512.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 488.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 488.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 488.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 470.62 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 36.62 443.75 Tm (Staff are not suitably inducted, trained, supervised and supported in their roles which )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 426.25 Tm (potentially put service users at risk. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 401.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 309.3 w 34.6 236.67 m 562.54 236.67 l S 0.001 w 1 1 1 RG 22.5 w 32.35 382.32 m 564.79 382.32 l S 0.001 w 287.93 w 33.47 224.86 m 563.66 224.86 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 369.95 m 565.87 369.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 371.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 371.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 369.95 m 564.79 369.95 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 35.5 379.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 354.27 Tm (Staff on duty during the inspection were found to be approachable and comfortable )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.77 Tm (with service users, although the expert by experience reported that there was a lack )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 319.27 Tm (of interaction between staff and service users. Staff spoken with fed back that certain )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.78 Tm (members of the management team discourage them from sitting talking with service )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 284.28 Tm (users. Staff spoken with felt they had the skills and training to do the job required )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.79 Tm (although felt they lacked the training in key working roles, care planning and risk )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 249.29 Tm (assessments. The training records indicate that all staff have attended specialist )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.79 Tm (training in epilepsy and the majority of staff have attended equality and diversity )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 214.3 Tm (training. The Annual Quality Assurance Assessment document tells us that six staff )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.8 Tm (have achieved a National Vocational Qualification.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 179.31 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.81 Tm (At the time of the inspection the home had eleven full time staff which included a )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 144.31 Tm (deputy, two team leaders, one shift leader and seven support staff. Alongside this )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.82 Tm (there was a deputy from another home who had taken on the role of acting manager )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 109.32 Tm (as the manager waiting registration was only in the service two to three days a weeks. )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.83 Tm (The acting manager had worked in the service for three weeks prior to the inspection. )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 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (32)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (The rota indicates that there is four staff each shift with two staff at night. During the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (day time shift there is always a team leader or shift leader on duty. There is back up )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (medical cover 24 hours a day. The manager confirmed that the home has three full )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (time support worker vacancies with interviews planned for the week following the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (inspection. The home has recruited more staff since the last inspection and still rely on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (regular bank staff to cover the vacancies with agency staff being used to cover short )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (notice absences. Staff are responsible for the cooking and cleaning and the home has )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (a part time administrator. The manager is not included on the rota and the deputy and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (acting manager do a mixture of admin days and work on shift. The Annual Quality )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (Assurance Assessment document tells us that three staff have left employment in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (last 12 months. Staff meetings take place although minutes of meetings available )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (evidence that meetings took place on ad hoc basis. Since the acting manager has )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (been in post she has facilitated two staff meetings.)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 (Three staff recruitment files were viewed. The files viewed included an application )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (form, copies of terms and conditions, job descriptions, pre employment health check, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (confirmation of Criminal Records bureau check with a further Criminal Bureau check )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (being obtained where there was a gap in employment. Two of the staff files viewed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (contained copies of two references and in one file there was only one reference, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (following a break in employment. This must be addressed. Bank and agency staff are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (managed centrally and there was not time during this inspection to check a sample of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (those records. The organisation must ensure that the required checks are in place for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (those individuals.)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 (The Annual Quality Assurance Assessment document tells us that house inductions are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (provided for all staff and comprehensive training and training updates are made )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (available. No induction records were available to evidence that staff are inducted into )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (the home with the assumption made by senior staff on duty that staff must have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (taken them home with them. Staff spoken with confirmed that they worked alongside )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (existing experienced staff prior to working on their own but none of the three staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (spoken with were able to recall if they had completed a written induction and were not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (informed of what their role entailed other than what they learned from others.This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (must be addressed with all new staff being properly inducted into the home and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (records maintained to evidence this. All new staff complete mandatory training as part )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (of their initial induction by the organisation. The training records viewed indicate that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (a number of staff have infection control training which includes training on COSHH. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (requirement was made at the previous inspection that the registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (ensure that the housekeeper attends health and safety training and COSHH training to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (support her in her role. The housekeeper role no longer exists and as outlined above a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (number of staff have attended infection control training. This requirement is assessed )Tj ET endstream endobj 79 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 80 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (33)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (as being complied with. The training records viewed evidences that two staff have not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (got food hygiene training even though staff are responsible for cooking meals. Four )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (staff have not got up to date first aid training, four staff have not got up to date )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (moving and handling training and four staff have not got up to date fire awareness )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (training. As outlined under standard 23 a number of staff do not have up to date )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (safeguarding of vulnerable adults and challenging behaviour training. A requirement )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (was made at the previous inspection that the registered person must ensure that all )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (staff including night staff have up to date safeguarding of vulnerable adults training, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (and all other mandatory training as required. This requirement is assessed as not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (being complied with and will be referred to the enforcement team for consideration. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (recommendation was made at the previous inspection that the organisation should )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (consider making available to the home confirmation of recruitment checks and training )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (for bank staff used at the home on a regular basis. This has not being actioned and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (there was not sufficient time during the inspection to go to the human resources )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (department to view those records. It is the organisations responsibility to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (the bank staff supplied to the home have the required mandatory training. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (recommendation was made that training records should be reorganised, made more )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (accessible and kept up to date. This has not been addressed with two systems in place )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (for recording training. The acting manager had attempted to address this and had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (obtained an up to date copy of training from the training department and had started )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (the process of identifying training that was due and getting it booked.)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 (Staff spoken with confirmed that they do not get regular supervision and the required )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (support. The sample of supervision records accessible during the inspection would )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (evidence that staff are not being supervised in line with the contract on supervision )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (which indicates that supervision take place at least 6 weekly. This must be addressed. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (A requirement was made at the previous inspection that supervision training must be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (made available to staff undertaking supervision. The training records available do not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (include external courses and therefore there was no record of supervision training for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (one of the team leaders. The team leader was on duty and confirmed they had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (attended this training but had the certificate of training at home as opposed to being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (kept on file in the home. Feedback from staff indicates that they feel they do not get )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (sufficient support to do their job, they commented that some members of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (management team spend their time in the office and do not work alongside them or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (provide support except in an emergency. They feel they are not treated equally and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (fairly and some staff felt that they were being bullied and intimidated. Staff feedback )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (that they felt they did not work as a team but that there were clicks within the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (management team which made their life very difficult when on shift with individuals. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (This was fed back to the Deputy Director of services who was proactive in dealing with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (the issues raised and confirmed after the inspection that she had commenced an )Tj ET endstream endobj 81 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 82 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (34)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (internal investigation. The outcome of the investigation and actions taken must be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (reported to the Commission.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (Written feedback from service users confirm that eight out of fourteen service user )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (feedback that the care staff and managers always treats them well with seven service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (users indicating that carers always listens and act on what they say. Six service users )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (fed back that the care staff and managers usually treats them well and five service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (users fed back that care staff and managers usually listens and act on what they say. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (Two service users fed back that carers sometimes listen and act on what they say.)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 (Service users commented under what the home does well that "some staff are very )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (good to me". "Most staff are helpful". "Penn house is peaceful and friendly". "They )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (create a friendly house". One service user commented under what the home could do )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (better was "understand more".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (Relatives commented that "staff are always helpful", "very caring staff who carry on in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (spite of difficult circumstances at the moment". One relative commented that "staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (are adequately trained for the purpose of the care home however more training in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (needs and requirements of people with other disabilities was needed".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (Written feedback from staff confirms that they have all had the required recruitment )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (checks carried out on them before commencing work. Five staff indicated that their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (induction mostly covered everything they needed to know to do the job, two staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (indicated that their induction covered everything they needed to know about the job, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (very well. One person indicated that their induction partly covered everything they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (needed to know to do the job. Four staff confirmed that they have being given training )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (relevant to their role and that helps them understand and meet service users needs, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (three staff confirmed that they have been given training that keeps them up to date )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (with new ways of working and gives them enough knowledge about health care and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (medication. One staff member confirmed they have not been given training that keeps )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (them up to date with new ways of working and that gives them enough knowledge )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (about health care and medication. Four staff did not answer this question.)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 (Written feedback from staff confirms that four staff feels the way they share )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (information about the people they support or care for with others and the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (manager always works well. Three staff feel the way they share information about the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (people they support or care for with others and the home manager usually works well )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (and one staff member feel the way they share information about the people they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (support or care for with others and the home manager sometimes works well.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm ()Tj ET endstream endobj 83 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 84 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (35)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 336.3 w 34.6 643.26 m 562.54 643.26 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 314.93 w 33.47 631.44 m 563.66 631.44 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 471.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 471.78 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 31.27 472.86 m 565.87 472.86 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 (Two staff fed back that there is always enough staff to meet individual needs of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (service users, five staff fed back that there is usually staff to meet individual needs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (and one staff member fed back that there is sometimes enough staff to meet )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (individual needs.)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 (Five staff feels they always have enough support, experience and knowledge to meet )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (the different needs of people who live at the home. Three staff feels they usually have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (enough support, experience and knowledge to meet the different needs of people who )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (live at the home. Written feedback from staff commented under what the home does )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (well is "provide consistent care to service users", "good communication with service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (users".)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 (Written feedback from staff commented under what the home could do better is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm ("better staff communication and more input to create a better more relaxed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (atmosphere", "a shift planner", "teamwork and all staff should be treated the same", )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm ("enough staff to meet the individual needs of all the people who use the service and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (changing needs of service users".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm ()Tj ET endstream endobj 85 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 86 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Conduct and management of the 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 172.25 w 32.32 627.38 m 562.53 627.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 85 w 31.2 584.88 m 563.65 584.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 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 28.99 541.25 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 (People have confidence in the care home because it is run and managed appropriately. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (Peoples opinions are central to how the home develops and reviews their practice, as )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (the home has appropriate ways of making sure they continue to get things right. The )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (environment is safe for people and staff because health and safety practices are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (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. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (They are safeguarded because the home follows clear financial and accounting )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (procedures, keeps records appropriately and makes sure staff understand the way )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (things should be done. )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 89.36 w 34.6 429.49 m 562.54 429.49 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 66.86 w 33.47 418.24 m 563.66 418.24 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 452.8 m 565.87 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 453.88 m 32.35 382.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 453.88 m 564.79 382.61 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 31.27 383.69 m 565.87 383.69 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 461.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 437.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 437.12 Tm (poor)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 290.57 437.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 419.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 392.75 Tm (The home is not been effectively managed and monitored to safeguard service users. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 368 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 275.79 w 34.6 219.92 m 562.54 219.92 l S 0.001 w 1 1 1 RG 22.5 w 32.35 348.82 m 564.79 348.82 l S 0.001 w 254.42 w 33.47 208.11 m 563.66 208.11 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 336.45 m 565.87 336.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 337.52 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 337.52 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 336.45 m 564.79 336.45 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 35.5 345.51 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 320.76 Tm (At the time of the inspection the home was being managed by a registered manager )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 303.27 Tm (from another service. He has been spending two to three days a week in the home )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 285.77 Tm (since April 2009 and was due to attend for an interview with the Commission the week )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.27 Tm (following the inspection to become the registered manager of this service with the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 250.78 Tm (acting manager being brought in to support this role. At this inspection it was )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.28 Tm (assessed that nine requirements from the previous inspection have not been complied )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 215.79 Tm (with even though the Annual Quality Assurance assessment document tells us )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.29 Tm (requirements and recommendations are acheived to a high standard which was )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 180.79 Tm (assessed as not being the case on this inspection. This inspection has resulted in a )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.3 Tm (number of other requirements to improve practice to safeguard service users. Staff )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 145.8 Tm (confirmed that the manager was approachable and listened but was not proacitve in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.31 Tm (dealing with issues raised by staff.They confirmed he had been made aware of the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 110.81 Tm (issues raised during this inspection but had not acted on them. A requirement was )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.31 Tm (made at the previous inspection that the registered person must consider how this )Tj ET endstream endobj 87 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 88 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (37)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (service will be managed to ensure that requirements are complied with to improve )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (practice.The current arrangement of a part time manager was not effective in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (addressing issues within this service to improve the quality of care being provided and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (in meeting requirements.Therefore this requirement was assessed as not being met )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (and enforcement action is now being considered to address this non complaince. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (Deputy Director of Services confirmed at the end of the inspection that the current )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (management arrangement would cease and she confirmed after the inspection that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (they had appointed the person who was in the role of acting manager at the time of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (the inspection to become the reigstered manager of this service on a full time basis. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (This person has been proactive in introducing positive changes to the home in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (short time they have been there.)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 (The manager confirmed that there is currently no formal annual quality assurance )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (audit tool in place but this is being developed with the intention being for a quality )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (audit to commence thoroughout the Organisation by the end of December 2009. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (progress with this will be assessed at the next key inspection. There is currently a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (system in place to audit aspects of care including accidents, incidents, seizures, safe )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (guarding referrals, and complaints for the whole organisation as well as a health and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (safety audit of the service. The home has monthly Regulation 26 visits carried out by )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (a governor with the report for January, March, April, May and Sept 2009 not on file. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (The Regulation 26 reports were being filed in three different places. The Regulation 26 )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (reports evidences that visits range from 45 minutes up to a maximum of 2 hours. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (However those monitoring visits have been ineffective in monitoring this service in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (relation to compliance with regulations and improving the standard of care for service )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (users. The Deputy Director of Services confirmed that they are piloting a new form of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (Regulation 26 reporting and visits which will include a governor and a manager from )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (another service on site. The progress and impact of this will be assessed at the next )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (key inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (The Organisation has the required policies and procedures in place, some of those )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (policies are overdue for review with some recently being updated.)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 (Some records required for regulation were disorganised, being filed in more than one )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (place, with some records missing. This must be addressed to ensure that records )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (required for regulation are well maintained, up to date and accessible.)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 (All staff have not got up to date mandatory training as outlined under standard 35.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (A requirement was made at the previous key inspection that the registered person )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (must ensure that all substances hazardous to health is stored securely and in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (approriate labelled containers.This was assessed as being complied with during this )Tj ET endstream endobj 89 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 90 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 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 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 436.79 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 (inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (Accident and incident records are completed but are not being reported as required )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (under Regulation 37 and are not being reported to the local safeguarding of vulnerable )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (adults team where this is required. A requirement was made at the previous )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (inspection that the registered person must ensure that all events, which affect the well )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (being of service users is reported to the Commission. This is assessed as not being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (complied with and enforcement action is now being considered to address this non )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (compliance.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (As reported on under standard 24 free standing electric heaters were being used )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (which potentially poses risks to service users and must be addressed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (The Annual Quality Assurance Assessment document tells us that the maintenance )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (and servicing of equipment is up to date.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (A sample of health and safety records were viewed and found to be in order.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (A requirement was made at the previous inspection that the registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (ensure that the response to the fire alarm and resetting of the fire alarm is in line with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (the organisations policy and procedure.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (The fire records viewed evidences that staff are evacuating the home for all fire )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (alarms however fire drills are being recorded in two different places and in different )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (formats. 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National Minimum Standards.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 731.05 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 728.05 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 728.05 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 728.05 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 728.05 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 715.9 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 292.3 698.74 Tm (range of leisure activities. )Tj ET /F2 12 Tf BT 1 0 0 1 292.3 678.16 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 292.3 663.58 Tm (To promote social )Tj ET /F2 12 Tf BT 1 0 0 1 292.3 649 Tm (engagement. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 626.92 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 623.92 Tm (16)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 623.92 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 623.92 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 609.34 Tm (ensure that opportunities are )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 594.76 Tm (made available to enable )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 580.18 Tm (service users to develop their )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 565.6 Tm (independence and take a )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 551.02 Tm (more active role in the day )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 536.44 Tm (to day running of the home. )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 518.86 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 504.28 Tm (To promote independence. )Tj ET /F2 12 Tf BT 1 0 0 1 478.9 623.92 Tm (30/03/2009)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 484.45 Tm (6)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 481.45 Tm (20)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 481.45 Tm (37)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 481.45 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 466.87 Tm (ensure that all events, which )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 452.29 Tm (affect the well being of )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 437.71 Tm (service users is reported to )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 423.13 Tm (the Commission. )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 405.55 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 390.97 Tm (As required under Regulation )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 376.39 Tm (37. )Tj ET /F2 12 Tf BT 1 0 0 1 478.9 481.45 Tm (30/01/2009)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 356.56 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 353.56 Tm (35)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 353.56 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 353.56 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 338.98 Tm (ensure that all staff including )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 324.4 Tm (night staff have up to date )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 309.82 Tm (safeguarding of vulnerable )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 295.24 Tm (adults training, and all other )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 280.66 Tm (mandatory training as )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 266.08 Tm (required. )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 248.5 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 233.92 Tm (To promote service users )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 219.34 Tm (safety. )Tj ET /F2 12 Tf BT 1 0 0 1 478.9 353.56 Tm (28/02/2009)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 199.51 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 196.51 Tm (35)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 196.51 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 196.51 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 181.93 Tm (ensure that all staff have )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 167.35 Tm (access to a range of )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 152.77 Tm (specialist training to support )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 138.19 Tm (them in their roles including )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 123.61 Tm (challenging behavior )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 109.03 Tm (training. )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 91.45 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 76.87 Tm (To promote staff and service )Tj ET /F2 12 Tf BT 1 0 0 1 478.9 196.51 Tm (28/02/2009)Tj ET endstream endobj 96 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 97 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (41)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 276.36 w 32.32 673.22 m 564.97 673.22 l S 0.001 w 1 1 1 RG 17.58 w 31.2 699.76 m 91.05 699.76 l S 0.001 w 17.58 w 93.3 699.76 m 197.4 699.76 l S 0.001 w 17.58 w 199.65 699.76 m 289.45 699.76 l S 0.001 w 17.58 w 291.7 699.76 m 473.8 699.76 l S 0.001 w 17.58 w 476.05 699.76 m 566.1 699.76 l S 0.001 w 154.8 w 31.2 611.32 m 91.05 611.32 l S 0.001 w 154.8 w 93.3 611.32 m 197.4 611.32 l S 0.001 w 154.8 w 199.65 611.32 m 289.45 611.32 l S 0.001 w 154.8 w 291.7 611.32 m 473.8 611.32 l S 0.001 w 154.8 w 476.05 611.32 m 566.1 611.32 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 689.84 m 568.3 689.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 710.75 m 30.07 531.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 710.75 m 567.22 531.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.22 m 568.4 742.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 709.67 m 568.3 709.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 710.75 m 92.17 531.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 710.75 m 198.52 531.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 710.75 m 290.57 531.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 710.75 m 474.92 531.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.4 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.22 m 568.4 742.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 709.67 m 568.4 709.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 689.84 m 568.3 689.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 532.79 m 568.3 532.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 743.3 m 92.12 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 743.3 m 198.52 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 743.3 m 290.62 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 743.3 m 475.02 708.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 814.73 m 567.32 708.6 l S 0.001 w [] 0 d /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 796.45 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 778.03 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 763.45 Tm (been met.)Tj ET /F2 12 Tf BT 1 0 0 1 95.57 763.45 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 104.02 763.45 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 748.87 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 731.05 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 728.05 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 728.05 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 728.05 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 728.05 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 715.9 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 292.3 698.74 Tm (users safety. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 676.66 Tm (9)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 673.66 Tm (37)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 673.66 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 673.66 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 659.08 Tm (consider how this service will )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 644.5 Tm (be managed to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 629.92 Tm (requirements are complied )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 615.34 Tm (with to improve practice. )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 597.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 583.18 Tm (To ensure that the service is )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 568.6 Tm (effectively managed and )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 554.02 Tm (monitored to benefit service )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 539.44 Tm (users. )Tj ET /F2 12 Tf BT 1 0 0 1 478.9 673.66 Tm (28/02/2009)Tj ET endstream endobj 99 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 100 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (42)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 797.57 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 782.15 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 108.12 w 32.32 719.78 m 564.97 719.78 l S 0.001 w 1 1 1 RG 20.58 w 31.2 677.13 m 91.05 677.13 l S 0.001 w 20.58 w 93.3 677.13 m 197.4 677.13 l S 0.001 w 20.58 w 199.65 677.13 m 289.45 677.13 l S 0.001 w 20.58 w 291.7 677.13 m 473.8 677.13 l S 0.001 w 20.58 w 476.05 677.13 m 566.1 677.13 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 689.63 m 30.07 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 689.63 m 567.22 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.3 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 689.63 m 92.17 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 689.63 m 198.52 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 689.63 m 290.57 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 689.63 m 474.92 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 776.09 m 568.4 776.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.4 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 665.72 m 568.3 665.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 777.17 m 30.07 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 722.18 m 92.12 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 722.18 m 198.52 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 722.18 m 290.62 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 722.18 m 475.02 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 777.17 m 567.32 687.47 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 759.9 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 742.32 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 727.74 Tm (The registered person had to meet these within 48 hours.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 709.92 Tm (No.)Tj ET /F2 10 Tf BT 1 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 0.95294 0.95294 0.95294 RG 563.19 w 32.32 345.62 m 564.97 345.62 l S 0.001 w 1 1 1 RG 119 w 31.2 467.3 m 91.05 467.3 l S 0.001 w 119 w 93.3 467.3 m 197.4 467.3 l S 0.001 w 119 w 199.65 467.3 m 289.45 467.3 l S 0.001 w 119 w 291.7 467.3 m 473.8 467.3 l S 0.001 w 119 w 476.05 467.3 m 566.1 467.3 l S 0.001 w 187 w 31.2 312.05 m 91.05 312.05 l S 0.001 w 187 w 93.3 312.05 m 197.4 312.05 l S 0.001 w 187 w 199.65 312.05 m 289.45 312.05 l S 0.001 w 187 w 291.7 312.05 m 473.8 312.05 l S 0.001 w 187 w 476.05 312.05 m 566.1 312.05 l S 0.001 w 153.4 w 31.2 139.6 m 91.05 139.6 l S 0.001 w 153.4 w 93.3 139.6 m 197.4 139.6 l S 0.001 w 153.4 w 199.65 139.6 m 289.45 139.6 l S 0.001 w 153.4 w 291.7 139.6 m 473.8 139.6 l S 0.001 w 153.4 w 476.05 139.6 m 566.1 139.6 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 406.68 m 568.3 406.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 217.43 m 568.3 217.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 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 28.99 406.68 m 568.3 406.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 217.43 m 568.3 217.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 61.78 m 568.3 61.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 630.55 m 30.07 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 561.56 m 92.12 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 561.56 m 198.52 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 561.56 m 290.62 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 561.56 m 475.02 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 630.55 m 567.32 526.85 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 616.28 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 596.28 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 581.7 Tm (Standards Act 2000, Care Homes)Tj ET /F2 12 Tf BT 1 0 0 1 239.77 581.7 Tm (Regulations 2001 and the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 567.12 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 549.3 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 546.3 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 546.3 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 546.3 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 546.3 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 534.15 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 514.74 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 514.74 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 514.74 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 514.74 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 497.74 Tm (ensure that service users )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 480.74 Tm (contracts are completed in )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 463.74 Tm (ink, signed and dated by the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 446.74 Tm (relevant people. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 429.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 412.74 Tm (To safeguard service users. )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 514.74 Tm (28/12/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 514.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 393.49 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 393.49 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 393.49 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 393.49 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 376.49 Tm (ensure that service user )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 359.49 Tm (plans clearly and accurately )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 342.49 Tm (reflect the arrangements in )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 325.49 Tm (place in relation to who is )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 308.49 Tm (supporting a service user )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 291.49 Tm (with their finances, how it is )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 274.49 Tm (accessed and what support )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 257.49 Tm (is required from staff. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 240.49 Tm (To safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 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/F2 12 Tf BT 1 0 0 1 298.05 247.93 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 230.93 Tm (ensure that the Commission )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 213.93 Tm (is informed of the outcome )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 196.93 Tm (of their internal investigation )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 179.93 Tm (into issues raised by staff. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 162.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 145.93 Tm (To promote service users )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 128.93 Tm (well being )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 247.93 Tm (14/03/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 247.93 Tm ()Tj ET endstream endobj 105 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 106 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 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The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 733.49 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 730.49 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 730.49 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 730.49 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 730.49 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 718.34 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 698.93 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 698.93 Tm (36)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 698.93 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 698.93 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 681.93 Tm (ensure that staff are )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 664.93 Tm (regularly supervised to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 647.93 Tm (support them in their role. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 630.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 613.93 Tm (To safeguard service users.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 698.93 Tm (31/03/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 698.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 594.68 Tm (14)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 594.68 Tm (39)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 594.68 Tm (26)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 594.68 Tm (The registered person must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 577.68 Tm (ensure that the service is )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 560.68 Tm (being effectively monitored )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 543.68 Tm (with records on file to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 526.68 Tm (evidence the monitoring that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 509.68 Tm (is taking place. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 492.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 475.68 Tm (To monitor practices to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 458.68 Tm (safeguard service users. )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 594.68 Tm (31/03/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 594.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 439.43 Tm (15)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 439.43 Tm (41)Tj ET /F2 12 Tf 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BT 1 0 0 1 34.05 228.47 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 213.89 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 34.05 199.31 Tm (improving their service.)Tj ET /F2 10 Tf BT 1 0 0 1 34.05 178.49 Tm (No)Tj ET /F2 10 Tf BT 1 0 0 1 96.15 178.49 Tm (Refer to Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.45 178.49 Tm (Good Practice Recommendations)Tj ET endstream endobj 107 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 108 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Adults \(18-65 years\))Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (46)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 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information. If you would like a summary in a )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 662.12 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 622.62 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 605.13 Tm (reproduced in whole or in part, free of charge, in any format or medium provided that it )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 587.63 Tm (is not used for commercial gain. This consent is subject to the material being )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 570.13 Tm (reproduced accurately and on proviso that it is not used in a derogatory manner or )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 552.64 Tm (misleading context. 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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 112 0 obj<> endobj 113 0 obj<>/Subtype/CIDFontType2/Type/Font/W [3[312]]/CIDToGIDMap/Identity/DW 1000>> endobj 114 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 115 0 obj <>stream %!PS-AdobeFont-1.0: ArialMT Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Thu Oct 09 15:49:19 2008 % Converted from TrueType font 'ARIAL.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Arial) readonly def /FamilyName (Arial) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -106 def /UnderlineThickness 73 def end readonly def /FontName /ArialMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-46 -210 1000 896} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B T13҂uGFsnA S1_ z.H@sV-umQ/ rgrVFcSctóinuk̾uA M[\b y9_ )(ib]o7PaZk=JI4wr QeR-ӐhX}Qt 1ݫja@K^ }= j"D3XU:*u?| 6&f]'(VY k?YODn7Or>TɩZfZvZ7N-N}.^1>dL,͝0n8^|0~ZPFP^̵x} Tj9th ?H2wr=\aK&cE"*X8)nXZI- Rҿ mRdokh_`V#wp; նגdRyf,jL%>lzr{,V\d6koXp a~( q;(I9zF<2(u4Z+(9%%W# )3Z+B gmMJۿ;5t2&M}wP-B*' lC7AEÐ-XaTu:RD/ ~Xmv@JO"Ⲕ!d #\8_A#~#aMzNNZ2>ieec5+#TMg]Ⴤ]p9jqe^alǣ̏:Ϯ6~O(SW™^tpTeͦVzĻ[ u}R'S;W`W^3OYEcN,&$/A90O &&!g.˚ޅהB ,x#*jMn6̰HU9͌%|mv0QU>>&9zTLJG]ˁ6=0.PKjzc ۟7]y"5zCVD't(rK!uۥe-w8=cI\AZGd!6Mel xMgh5DJxCj0=QFDO$nIxS%~Wtm?$Ӻa8#c3zω̥/b &wEMMэnŨy)e!}{5y`$[ldxNp>A.|@+j`edyeɘHjxG}i d ϕa˻y: !#F*a0SJf3J(WkS4O1^Հ3c%bL(g.s!QS+ Ui)!;*DDP=<pQUCIKSYaMBG#a!Qke ԮVV V:T \݋qnaY<[IC=ǃJ$R@N߀'pH͎{Y!^^e-8)Ic A$`KPy 5v,'w[ԜWo oP%WV8*vg i?Aא5Np+EO8Gf:f-6JK;E@wOv}w{LB{DQ/2Znf#UL8ц]Asy9$xUOg'.̺}'l68[}{."׼_N& e.%&;JL)G]VPtVZO%eznh+p갦~̱ډ o?w)+VäaOTwۑƔmwE4u*8iARNx)Df"m4%{36/« wQ43֖U/hu~Vy{ +< ^{65yyaP>g(:4xW23,f{rƝBρzWܚP$`'Iҕbu:N&f^^2em77;Lf`'l  f3|g|e;PF+gy^/K6>5// |B~eU[zr:j<C}WĆ1DY܂ڒ)Sc<6iJ$_«wDq't]{O tFU&1A%Ą7y&< PHҞĹɠ1B<>^{[4QH 1drVkyX,rs:H^zD?ـ[ d. nJώ&i\h|iAufbi;t?cL{KˍMlbTi-dߴ!_=s*dHhG8k ,H,f㳃󕴿1UozdmW&׿DOԙ20zQXH2TF &&Y*=EI`{2 G] h*V\ֳkx=_U1$ˠH;҆1*BeÔFuǝ/ـA秳pZ*ۇ{+0Ei'a{}v%}SoG߲0$iE炕/pKAVS >C_xS/KMWE/9 uqD$`l׎:D$@^P04'(ZU,uw{/U=-ü =é^ͣ5F G;W=+wf{ԗH$[sR^ ۯP^}"ZOlz9x[A5^"UN['4 *&I=H@(92(ZnVmW&l(;}}uyFex0iGC7ٿ×;."&^\$UX_vл$`,['"g[,X9< W~TAB X@;Ldk5 7ȵҺ*&0V~"])|+2)\aU|~aڍO@7Q 5 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!k@^B\Xi\M'}lb7zȋ_xU-$y/'gv+i;0J~]Z*e}O<\jry싯Gf#٩sdJŢʨ'{x@W,ک! pն_ ep׼!c&uLA{`\ 9Ia.c4 <6Z%^66853y̌{0rf\F3O<Յb4 2 0Uj~em&A$؜P_kqaM}x]|#&m.}?{- { ٔbDBw'n|Our 7=xKs_H./bɞob#p{Xkc*b yꍋQB_u}~?ށ8i<ֳ,#Rlw>g钑yLu$]UþCi Rhr+9aa9wuA&DKw^Qe|Z 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 cleartomark endstream endobj 116 0 obj<> endobj 35 0 obj<> endobj 117 0 obj <>stream  cvt gxfpgm;_glyfˬ ^head< H6hhea$ $hmtx ploca76maxp 1t prepF 8}11c1bbDu1c111D1>}1(111{-1(3c1J`7]1bP2Jb2(11124bb(()_b{8P>2;IV`bbz!&BF7>>TtNmmn{{(hxAYiU\.t/J\cx{{{ ""(/23>CFHPSfijkrsx,.88AMP\ik| ,,Alx=>o:BX~9`/111:<JJLWstx  ((-WYZZZZprr."+`x =.:WX]]SlCcM*SclAq],C]"D>;KeJPBQLQLT7Z\WU:rrE@78743210/.-,+*)('&%$#"!  ,E#F` &`&#HH-,E#F#a &a&#HH-,E#F` a F`&#HH-,E#F#a ` &a a&#HH-,E#F`@a f`&#HH-,E#F#a@` &a@a&#HH-, <<-, E# D# ZQX# D#Y QX# MD#Y &QX# D#Y!!-, EhD ` EFvhE`D-, C#Ce -, C#C -,F#pF>F#pFE: -,EJ#DEI#D-, E%EadPQXED!!Y-,Cc#b#B+-, EC`D-,CCe -, i@a ,b`+ d#da\XaY-,E+G#DGz-,TX CTXJIDDYY-,CXE+#DzEi #D QX+#Dz!zYY-,-,KRX!ED#E %ERXD!!YY-,/-, %EI#DEJ#DEe#E %`j #B#hj`a Ry!J@JE TX#!?#YaDRyI@ IE TX#!?#YaD-,C#C -,C#C -, C#C -, C#Ce -,C#Ce -,C#Ce -,KRXED!!Y-, %#I@` c RX#%8#%e8c8!!!!!Y-,Ei C`:-,%# `#-,%# a#-,%-, ` <<-, a <<-,++**-,CC -,>**-,5-,vK#p KE PXaY:/-,!! d#d@b-,!QX d#d b@/+Y`-,!QX d#dUb/+Y`-, d#d@b`#!-,&&&&Eh:-,&&&&Ehe:-,E# E %PX&a&`YD-,F#F`F# F`ab# #KKpE` PXa@Yh:-,3+**-,CXY-,CXY-#@/?103!%!!8 P@+  { /999?999/10&''&&'632!!!!67`,9) KgJ*JJ&J (""" """ zJzJee") """"!!""+ ]+PV =`9PPPP""""""""""""""""""""""kk4!!!!!!!!!!!!o!!!!!!!o!!!!!!!!!po==!!!!!!!!!!!!!!!!!!b!Q!?!.!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!}!&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&`9_@ FF@H H2 %H2 #H2 "H2 !H2  H2 H2 H2 H2 @[H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 yH2 nH2 dH2 _H2 ]H2 ZH2 XH2 H2 H2 H2 H2 H2 H2 H2 @LH2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 \H2& & 7E@CzweaWU$"   KKSBKcKb S# QZ#BKKTB8+TXCXYY++++++++++++++++++++++++++++++++KPyAP*&+++++KSyAP*&+++++P2Ka`+++++++++++++++++++++++++++++++++++++++++++++++++++++++++EiSBKPXBYC\XBY CX`!YBp>CX;!~ +Y #B #BCX-A-A +Y#B#BCX~;! +Y#B#B endstream endobj 118 0 obj<> endobj 119 0 obj<>/Subtype/CIDFontType2/Type/Font/W [53[891]133[891]]/CIDToGIDMap/Identity/DW 1000>> endobj 120 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0035><0085> endcodespacerange 2 beginbfrange <0035><0035><0052> <0085><0085><00a3> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 92 0 obj<> endobj 121 0 obj <>stream %!PS-AdobeFont-1.0: Verdana Typeface and data 1996 Microsoft Corporation. All Rights Reserved %%CreationDate: Thu Oct 09 15:25:10 2008 % Converted from TrueType font 'VERDANA.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.35) readonly def /Notice (Typeface and data 1996 Microsoft Corporation. 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$$S Cp`Ӎ+Wǧ`q4{W_E&9YXs1sZQ<*`(SaD~e 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CUXY@TX CTXY CTX%8YYYY!!!!-,KRXCe8!!Y-,KRXC8!!Y-,!! d#d@b-,!QX d#d b@/+Y`-,!QX d#dUb/+Y`-, d#d@b`#!-,&&&&Eh:-,&&&&Ehe:-,CXY-,CXY-, +# <+-,(+# #+X59O4v" % A6O;*0Ș}-.$ ]G-#) C@/44 4CC CSVf B @  qn22????10]4&#"326%#"&'!!6632mfj/]-#G#}fT|F^Mi: &(8BR4*e@)$!;3!DO KE'* 7@ 7@7@ $@ 7$$@ $@ 7$$,p+3/+3?3/+?3/+10++]"&'&&54676632#&&'&&#"32676673UT^fWT{]^-=$&`;Bd$#2-O)3YFIIݖIFC+/0- " 6#C@-; ;L Lp#* 7* 7A!B o% p$22????10++]!!5#"4676632!&&#"326"W!*R9LC=aXqK^T~eq.^u@> PIU%'"' $4%g@#% 4 AOA S$sz* 7%< ">7@ 7@  q''% p&2]3/?3/++]?9/10+] ! !32676673&&#"<8.-xG=v1+I%+G>9yadfs0H~Ni,otziTY@<@ ?  0 @  /  /]3/]/2/9/]??32?2/10#&&#"!!!#5354632TU&jML0 Nk o 6Y9p@Q<K@C$pyzp6)* 7 7* 7* 79A4 B+ 0p!A 7(o;@.p:3/]22?3/]???10++++]&&#"326#"&'332676655#"46766327!%L&~Q?/[ZNNڅpJ)G$+R+Yw;RIA>_V8 Sb Ie'&' Ü=>7  %"#_H4?"JGM,%29@$4 E p D o`  n2]??D?C?B?A?@??5233554455@!5 6@q::6q@q 6ppo@o6n@n 6pfff@g 6ed@;d 6@ ?_  k@khhhPh`ha0[@[[[8@ 6@@ +*p*,--  C! C <$e2"H/ 0@PpP`p0/?o /?o 7 7 **& 9999PKKTBKKSB 2+KdRBKRXYKTXYKSXY++++++++st+ststEEha#DsEEha#DsEEha#DEh#Dst++tu++++u+++++++++s+++++++++ss++sssstssssss+ss+s+u+us+u++s+++++++++++++++++++++++++++ss+s+sss++s+s++s+++++ss+++s+++s+++++ts+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ endstream endobj 124 0 obj<> endobj 125 0 obj<>/Subtype/CIDFontType2/Type/Font/W [3[292]29[363]38[667]44[483]46[696]50[770]53[726 633 612]68[598 631 527 629 593 382 629 640 301 362]79[301 953 640 617 629]85[433 514 415 640]90[889 604 575]]/CIDToGIDMap/Identity/DW 1000>> endobj 126 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0003><005c> endcodespacerange 31 beginbfrange <0003><0003><0020> <001d><001d><003a> <0026><0026><0043> <002c><002c><0049> <002e><002e><004b> <0032><0032><004f> <0035><0035><0052> <0036><0036><0053> <0037><0037><0054> <0044><0044><0061> <0045><0045><0062> <0046><0046><0063> <0047><0047><0064> <0048><0048><0065> <0049><0049><0066> <004a><004a><0067> <004b><004b><0068> <004c><004c><0069> <004d><004d><006a> <004f><004f><006c> <0050><0050><006d> <0051><0051><006e> <0052><0052><006f> <0053><0053><0070> <0055><0055><0072> <0056><0056><0073> <0057><0057><0074> <0058><0058><0075> <005a><005a><0077> <005b><005b><0078> <005c><005c><0079> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 3 0 obj<> endobj 127 0 obj <>stream %!PS-AdobeFont-1.0: TimesNewRomanPSMT Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Fri Oct 10 11:48:26 2008 % Converted from TrueType font 'TIMES.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Times New Roman) readonly def /FamilyName (Times New Roman) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -109 def /UnderlineThickness 49 def end readonly def /FontName /TimesNewRomanPSMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-77 -216 1009 877} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put 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 TY˞߹NC!RhUeySNqEobm"QQL!H0agylrҳxc: HWmֻDc,A';{ 8rnGMGduDcb ʮ_`gJuDQO>c٨~b_s/%~`/ 8Ayq. -v -%=6 ̟sjՊ6a FZ#Ԉeֆ1TRwY Կ'$s|I9ƲRM&89>N ]<3z h_/-|UN%b=̱ IuȌ>pq-t<.4Pk2\1Ko7fXH%<#+nUU[D-Jeʤvɴ;\G?W<}eH}p?_F5$wG.~< J s]tY 6Xk6UNJRg_pZ=܌JR(lh9ҥӏjwb"MF&纺ÄjhjX,Ƒwjnd-4:$fN4IyFNgXٺmS`d'G8^Ir1[cÎ$-0[d]v2O8͸\GQk_Y\2\Gp2i2^cT:ʲ 9,]YnZh?35Ƴ2Y_F]ùD"=RI:3?Gv9p= K.~hZo!Y&Bn7kECVsEvpԛt3Qk{% 񚡽ACIG#-"Uo| qB:` h͑p>gϒe$P*[!{}#1p%,H'ɷz[0 }3"" u'~Tɗϛ}:>1PQApt & / XJ4%dha ?$] |67A U)>4q Q3Kn|n  uL1tNpZB?)sWxbpi⩢խd_ŏ<\Y@D\_߰17Q"ݚ}Ž^FGW5߀klZ5srĿLZ"R"[STl(#9˳;/:7Hz4MM S^f FH|ݽ0NQy@`\|fȊP)^uĖs4$ m1*.١.fU Q>\( d{hk}%$fm aS5&i%)LdTz7&Nl$ vM?O]پ,/KTbx`~/3Ks8kÜ' CsBCY;qrRș^.[`gҪ]┛o}8H#H/g\?}7Y#*ZV PvO߃ ~bXaAI`CD ҷDO[(1YBo*uKYlLђDi6Y0@̗Ōy 0W s$}FD=-Y'r3EUð7mN/I$K̳ܨ=h!ۧ {H™Naqm*}h8だ3N++kyhB^gRţ-LjQ9h% s6?FnAnٽ6t6LMlt&n'#i^)֤0)G7a;]U@d#1Mn$]mU}iigTQ5=80"Ӯ2sl`ݗַc%7Ɉʝ;.7Rҿ¸>~ot"IģqWu)b,mXT=s5c؊m{6|HlsI%ر95Oq2&宠9hbLTu˷| iHKC6 Dί!isaX4r]Clq )_Ħr98y&XZ%.ЏB'$9.Htxl8s~*lq}rM⹟8_j_V~%)_EW_K/3ND^3BpGݩ|G9jS6@`'XȽ$` Y&ypCeֳHΪFzjt) d4?56_Sf:[߮vmЉIs2i6cV87փw|A4Ӭ:9gGBTc^ws:kӼ.!yDR=KY'rLg#@ {q_ki@&Y66(ӡ%M;d&yB46r8ѹχP@ʚ `"sxXr;c7w@Bad"ߡ1\:g݈-[oDS|fPve>JDz9qGC|<3'5$*Y6\4G)L!,#G/&R> Wb?r<)xV%֫$z85Y4_Lt+a$l zGjql0EdQ[{wo`=ycn%(&9y-WgՋ%~h\O!@q㙑  X0/[.C:)]xCpx##GBY"1/n>*JIxEӼ1Q*р'Th& vzf_Fh".MVX2V p0#)w*|DUd[wb*ZY~`eBD W+@'pշF`2JE%jsdSvΟdk*_|{bWЩwlEm#U\t֨ Y}rKO|fKR"a8F@5VlvhmxqGHoGiT0e^^gx8Ys_]l{$^'{2hތ4m佳Od2sWt3AEzXj F\QɃC)pd=ԗSl*EXq dƚS*G][M7Y.ŗ1(gM.C̮Ӏ E`inB.fPM"/' ..oHti@Bd2MCAy>m;<`grxf?$Pz8㤨E|xw,վUf-J/:SC 4bɌ~eY{Wz6)q{o4Epr%! kPY@:pSC$ sg <=XAx"1U{' ަk#]5ZMxƸ&\5" 3$nw(1)#`Pb2nlx]\z'߰[kQB `*eָ5[C)<Ѩ3f9cuE9CxcV+L Y g\ /EIHxK^=u)f=,( :0wu9?CP4(&wxX= u?Q3*!4e?O XCJ.~dMT.ɂbؒ"c,dƔ'pv#eY.,cЦpi@HP2ñ#}xL5ݡPkч]x{nȕdrdG1 ~Ed8"abo&g 吤,x(:J刖;8'-[ dO-|Q[.A`S+A+qrLO8ZĊKLПDōHr?"4lRr+) 2)Ql΄!M}xRi2Hm;p ߳SZgle1b0)LZm O48' ȏ*MOX Vi,δ^ d~u6/bqhS [\A(Z沣׈n}T@<^fLvɩaq4-KRȔŋl,n:6 kұ?@OC'~ӸMh.&0Ki }dW;1|jZPѰxTzDSz(GR2ʱW;ezT3P0S< yk$&mPI2D!:x>I璱{_Y%v 4f-rDFg[T!^lB#\wM* do(-µ׼Tb uALQtsS( BKJzv͈*qnQ#*CSu m#wY gATA,SsS1{?c;pxZc_GqNYPnn<HL(|M\')I%l!'43>x 3(_~! f%~r*IfnQ52}/b̳ 7v$JFy #e<:6~4܋%ZDacAC-c)=džN/&k- ;8C3A>0!Mkh?iv\XboثOVD-Sũ5je $nP<]54:.)`iؽyiҀcgQҬF_hnA,=;էn Iy>sK2AY R$y@pQ̬޵Ҡ#wlħ&oDs;8pZvai~=Ûa)Kו'1?2M?e:렝1P3q3#Uʭ211 sj Y酫vzR : BmKUpV+RxVtb= 0hFS-?`?L?*p‡'}EɅ$,Vv=i t3{>N Y 7Lylzn􋙡4F/&mw !:%/OxQny̼r"1@,Nئ /#o}Cz[u؁şkwFvvitd '1DzNqiNW}&Y>-~Ǖ..6"7I E^oWM j ĥ/hv]C{O~tt izIš1tycY dlÂe!$̽3v7@ Qx83Ig/S</4.FcDnH cT9(gM5=fg"[ҹbe5X#V_@4'pǖoEqR)e5 +}i E%o͠Ƚly(;-%C) }5* adQ-Zf`>2_ZSD׌a&dҀÒ,&6Q\zmv,peʤFQO?`ϦsVH,|.~LT"9FBnjq,\ٳ?_*]hIIe;HnԑG"C3|z0^$*'ZH%usդ/D8AOm&Y Y#eIگ8:}x,Oo:S>GT8b<@P&COܑX.j᝛ ?:C8hYq_350=0!Vw@UW+8Knn!gޑ]%Pv͸ߒ}.`wԀ+Vhֻx!B,J|g0[d@6#~H8˪Et9:J1KTд>b|04²jRju O!(ɬh/0}!n_p 2^:+œOި`|eT*N hd*bR%~Gy;K $ V^ ܰZ?p[7TU!\ĩZ KT4~Ajx.s&\ 3pJ1UT*'PE]i.uHH8_xi3 }QO߈HPC0Ȏd}\pDh (te!;Y&^ 7c)æ^"e›{OKQ4y(%V<Nވـ/K#Q-~ n!!<.٧{>IZo{(Cn6wժyvVV+4 ( :Lrb%l| s=Y|,A̓!(XF1D7T8Wۈø^,>@ϡI eFIRBVǿ(LH߃kF P+vr]h͂˖ 0yDέ8- [GlGS)$1r:k{+e $#b1ɢɗRqz@zϷ$݄/-CHco'’_u>a;Pr,'{aG" }~ph e- lـz0([=4(S,'l 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u\m&EO'-ȵ}KhdyϗNcLFf8FhLv)-OrﳡNr9iUyJ7 &À,s6#]Q`E\> Ma z)"lOkw)}g"#^| 9[5b";NcsY.db,_YƋw]Di}9KWQ>O1k[:"?Km ¾|jVbr˂@?g}#׭LRQp1i?Yn_&CE7G%.)zľTI0柨o:5\Fh>hak?6`J̬SkdcBR4B{hz qV#$jg䰴$gIP#ŦGkzC.cTcy|,wm"w8|/ +h.B..OUtc5'UcIcH܏>mCob$:ɧ.Qo j=QѳӵiZڒiXΕf)cd";&k)=(y߽bᗿ0a᩽@ʍ%]y|c#܈;EN`xTӬKzek(hc8J"p5,ڨjeʹ2L;IKl*#=Sȁt1jDȋbyZư2"^`}Lk8 d£B)󕷐S~n wh )3w"]{CR"51i ;g.{PRP2%N5"I%v }8pd^2S?ߟy_hqcN :A\fCk1g*>qp\UC9ހ$_"ρY~+i1yUH1?@I5[9M2a!@5 =ep*sr*Ď[8<XRk%^eR.qtpDH{]ޟWub+UU+3f,HxKp58d|';I>ÿ/qb@IبڢEfihQ R©ˬ$\5g īҏnS"ӌWQʤwُHLxF]" B`<y իt.X '=ݸ] K˒1 4,p\ žA#R>{ɼ<5];A1d‚ \[CB4a= [f `a'Ig[_g? 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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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