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*{;i?})2De+1>pq C3pj4ZjL&y n36#NkStY TUB5(b}Bi'Bhn>9ZZ^ gZv5v7Z4M*ď$h")`]Ao/>?ö9[[kW_ 5=[X$ 5čL/soƥ_GNK _cZDo hW4PǧhvhB +gOȕ |I_^s<1b+Ѩy=_aPqYʞ"p=tiC!uG ,J)0p] (TR|cƷ4»B/׾*ьůI-?诫8?ۯwW |#xwúϊMCB.񵥾[kY]G%u-c_XZ Q>stream 0 J q 538.5 0 0 61.5 28.35 14.2 cm /img0 Do Q 0.98431 0.78824 0.08627 RG 135.75 w 24.07 742.4 m 558.15 742.4 l S 0.001 w [] 0 d 2.25 w 20.74 812.53 m 561.48 812.53 l S 0.001 w [] 0 d [] 0 d 2.25 w 20.74 674.53 m 561.48 674.53 l S 0.001 w [] 0 d [] 0 d 2.25 w 21.82 813.61 m 21.82 673.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 560.4 813.61 m 560.4 673.45 l S 0.001 w [] 0 d q 191.25 0 0 117.75 28.35 685.65 cm /img1 Do Q /F1 12 Tf 0.6 0.6 0.6 rg BT 1 0 0 1 136.35 656.27 Tm (,QVSHFWLQJIRUEHWWHUOLYHV)Tj ET /F1 28 Tf 0 0 0 rg BT 1 0 0 1 147.05 596.27 Tm (.H\\LQVSHFWLRQUHSRUW)Tj ET 20.58 w 27.33 552.19 m 557.15 552.19 l S 0.001 w /F2 24 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 504.5 Tm (Care homes for older people)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 6 Tf BT 1 0 0 1 28.35 493.46 Tm ()Tj ET /F1 6 Tf BT 1 0 0 1 28.35 486.22 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 472.44 m 160.38 472.44 l S 0.001 w 1 1 1 RG 20.58 w 162.63 472.44 m 563.65 472.44 l S 0.001 w 0.99608 0.9451 0.76078 RG 108.48 w 31.2 405.66 m 160.38 405.66 l S 0.001 w 1 1 1 RG 108.48 w 162.63 405.66 m 563.65 405.66 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 461.02 m 565.85 461.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 483.85 m 565.85 483.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 461.02 m 565.85 461.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 350.29 m 565.85 350.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 484.93 m 30.07 349.21 l S 0.001 w [] 0 d [] 0 d 2.25 w 161.5 484.93 m 161.5 349.21 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 484.93 m 564.78 349.21 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 467.67 Tm (Name:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 165.48 467.67 Tm (Bybrook House Nursing Home)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 444.84 Tm (Address:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 165.48 444.84 Tm (The Lodge)Tj ET /F2 12 Tf BT 1 0 0 1 165.48 427.26 Tm (Bybrook House )Tj ET /F2 12 Tf BT 1 0 0 1 165.48 409.68 Tm (Middlehill)Tj ET /F2 12 Tf BT 1 0 0 1 165.48 392.1 Tm (Box)Tj ET /F2 12 Tf BT 1 0 0 1 165.48 374.52 Tm (Wiltshire)Tj ET /F2 12 Tf BT 1 0 0 1 165.48 356.94 Tm (SN13 8QP)Tj ET /F3 10 Tf BT 1 0 0 1 28.35 338.04 Tm ()Tj ET /F3 10 Tf BT 1 0 0 1 28.35 321.04 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 301.5 m 358.95 301.5 l S 0.001 w 1 1 1 RG 20.58 w 361.2 301.5 m 565.9 301.5 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 312.92 m 568.1 312.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 290.09 m 568.1 290.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 313.99 m 30.07 289.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 360.07 313.99 m 360.07 289.01 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 313.99 m 567.02 289.01 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 296.73 Tm (The quality rating for this )Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 191.92 296.73 Tm (care home)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 255.59 296.73 Tm ( is:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 400.14 296.73 Tm (two star good service)Tj ET /F3 10 Tf BT 1 0 0 1 28.35 277.83 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 258.78 Tm (A quality rating is our assessment of how well a care home, agency or scheme is )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 241.78 Tm (meeting the needs of the people who use it.)Tj ET /F2 12 Tf BT 1 0 0 1 295.2 241.78 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 303.65 241.78 Tm (We give a quality rating following a full )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 224.78 Tm (assessment of the service.)Tj ET /F2 12 Tf BT 1 0 0 1 189.22 224.78 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 197.67 224.78 Tm (We call this a key inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 207.78 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 190.3 m 315.25 190.3 l S 0.001 w 20.58 w 317.5 190.3 m 565.9 190.3 l S 0.001 w 1 1 1 RG 20.58 w 317.5 167.47 m 346.55 167.47 l S 0.001 w 20.58 w 348.8 167.47 m 377.9 167.47 l S 0.001 w 20.58 w 380.15 167.47 m 409.2 167.47 l S 0.001 w 20.58 w 411.45 167.47 m 440.55 167.47 l S 0.001 w 20.58 w 442.8 167.47 m 471.9 167.47 l S 0.001 w 20.58 w 474.15 167.47 m 503.2 167.47 l S 0.001 w 20.58 w 505.45 167.47 m 534.55 167.47 l S 0.001 w 20.58 w 536.8 167.47 m 565.9 167.47 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 178.88 m 568.1 178.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 201.71 m 568.1 201.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 178.88 m 568.1 178.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 156.05 m 568.1 156.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 202.79 m 30.07 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 202.79 m 316.37 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 179.96 m 347.67 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 179.96 m 379.02 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 179.96 m 410.32 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 179.96 m 441.67 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 179.96 m 473.02 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 179.96 m 504.32 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 179.96 m 535.67 154.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 202.79 m 567.02 154.98 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 185.53 Tm (Lead inspector:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 320.35 185.53 Tm (Date:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 162.7 Tm (Susie Stratton)Tj ET /F2 12 Tf BT 1 0 0 1 329.63 162.7 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 360.95 162.7 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 392.28 162.7 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 423.61 162.7 Tm (6)Tj ET /F2 12 Tf BT 1 0 0 1 454.95 162.7 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 486.28 162.7 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 517.6 162.7 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 548.96 162.7 Tm (9)Tj ET /F3 10 Tf BT 1 0 0 1 28.35 143.8 Tm ()Tj ET /F3 10 Tf BT 1 0 0 1 28.35 126.8 Tm ()Tj ET /F1 10 Tf BT 1 0 0 1 297.64 109.8 Tm ()Tj ET /F1 10 Tf BT 1 0 0 1 297.64 97.73 Tm ()Tj ET /F1 10 Tf BT 1 0 0 1 297.64 85.66 Tm ()Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 10 0 obj<>>> endobj 11 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (2)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 297.64 803.65 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 787.03 Tm (This is a report of an inspection where we looked at how well this )Tj ET /F2 12 Tf BT 1 0 0 1 428.32 787.03 Tm (care home is meeting )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 769.53 Tm (the needs of people who use it.)Tj ET /F2 12 Tf BT 1 0 0 1 226.66 769.53 Tm (There is a summary of what we think this service does )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 752.03 Tm (well, what they have improved on and, where it applies, what they need to do better.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 734.54 Tm (We use the national minimum standards to describe the outcomes that people should )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 717.04 Tm (experience.)Tj ET /F2 12 Tf BT 1 0 0 1 106.61 717.04 Tm (National minimum standards are written by the Department of Health for )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 699.54 Tm (each type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 679.55 Tm (After the summary there is more detail about our findings. The following table explains )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 662.05 Tm (what you will see under each outcome area.)Tj ET [] 0 d 0.5 w 0 0 0 RG 22.69 653.87 m 572.15 653.87 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.69 320.23 m 572.15 320.23 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.7 653.87 m 22.7 320.23 l S 0.001 w [] 0 d [] 0 d 0.5 w 572.15 653.87 m 572.15 320.23 l S 0.001 w [] 0 d /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 640.57 Tm (Outcome area \(for example )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 173.59 640.57 Tm (Choice of home\))Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 610.27 Tm (These are the outcomes that people )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 216.34 610.27 Tm (staying in care homes should experience.)Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 435.79 610.27 Tm (They reflect the things )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 598.12 Tm (that people have said are important to them:)Tj ET 0 0 0 RG 0.001 w 0 Tr 1 0.9451 0.76078 RG 82.23 w 30.6 533.38 m 562.45 533.38 l S 0.001 w 1 1 1 RG 39.99 w 29.47 513.38 m 563.57 513.38 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 27.27 534.5 m 565.77 534.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 576.74 m 565.77 576.74 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 534.5 m 565.77 534.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 492.26 m 565.77 492.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 577.82 m 28.35 491.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 577.82 m 564.7 491.18 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 561.06 Tm (This box tells you the outcomes that we will always inspect against when we do a key )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 543.56 Tm (inspection)Tj ET /F2 10 Tf BT 1 0 0 1 95.78 543.56 Tm (.)Tj ET /F2 12 Tf BT 1 0 0 1 34.87 518.82 Tm (This box tells you any additional outcomes that we may inspect against when we do a )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 501.32 Tm (key inspection.)Tj ET /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 461.81 Tm (This is what people )Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 131.32 461.81 Tm (staying in this care home experience:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 424.65 Tm (Judgement:)Tj ET 1 0.9451 0.76078 RG 39.99 w 30.6 393.35 m 562.45 393.35 l S 0.001 w 1 1 1 RG 39.99 w 29.47 394.47 m 563.57 394.47 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 27.27 415.59 m 565.77 415.59 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 373.35 m 565.77 373.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 416.67 m 28.35 372.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 416.67 m 564.7 372.27 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 399.91 Tm (This box tells you our opinion of what we have looked at in this outcome area.)Tj ET /F2 12 Tf BT 1 0 0 1 517.79 399.91 Tm (We )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 382.41 Tm (will say whether it is excellent, good, adequate or poor.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 356.54 Tm (Evidence:)Tj ET 1 0.9451 0.76078 RG 22.5 w 30.6 333.98 m 562.45 333.98 l S 0.001 w 1 1 1 RG 22.5 w 29.47 335.11 m 563.57 335.11 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 27.27 347.48 m 565.77 347.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 322.73 m 565.77 322.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 348.55 m 28.35 321.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 348.55 m 564.7 321.65 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 331.79 Tm (This box describes the information we used to come to our judgement.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 285.18 Tm (Copies of the)Tj ET /F2 12 Tf BT 1 0 0 1 111.71 285.18 Tm (National Minimum Standards )Tj ET /F2 12 Tf BT 1 0 0 1 290.49 285.18 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 302.34 285.18 Tm (Care Homes for Older People)Tj ET /F2 12 Tf BT 1 0 0 1 477.18 285.18 Tm ( can be found )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 267.68 Tm (at www.dh.gov.uk or bought from The Stationery Office \(TSO\) PO Box 29, St Crispins, )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 250.18 Tm (Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 232.69 Tm (Stationery Office is also available: )Tj ET /F2 12 Tf 0 0 1 rg BT 1 0 0 1 238.73 232.69 Tm (www.tso.co.uk/bookshop)Tj ET /F2 12 Tf 0 0 0 rg BT 1 0 0 1 28.35 192.7 Tm (The Commission for Social Care Inspection aims to:)Tj ET /F4 12 Tf BT 1 0 0 1 46.35 172.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 64.35 172.7 Tm (Put the people who use social care first)Tj ET /F4 12 Tf BT 1 0 0 1 46.35 155.06 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 64.35 155.06 Tm (Improve services and stamp out bad practice)Tj ET /F4 12 Tf BT 1 0 0 1 46.35 137.42 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 64.35 137.42 Tm (Be an expert voice on social care)Tj ET /F4 12 Tf BT 1 0 0 1 46.35 119.78 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 64.35 119.78 Tm (Practise what we preach in our own organisation)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 79.64 Tm (Our duty to regulate social care services is set out in the Care Standards Act 2000.)Tj ET endstream endobj 12 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 13 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (3)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm (5HDGHU,QIRUPDWLRQ)Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 28.35 774.22 m 224.05 774.22 l S 0.001 w 1 1 1 RG 20.58 w 226.3 774.22 m 567 774.22 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 28.35 751.39 m 224.05 751.39 l S 0.001 w 1 1 1 RG 20.58 w 226.3 751.39 m 567 751.39 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 28.35 728.56 m 224.05 728.56 l S 0.001 w 1 1 1 RG 20.58 w 226.3 728.56 m 567 728.56 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 28.35 705.73 m 224.05 705.73 l S 0.001 w 1 1 1 RG 20.58 w 226.3 705.73 m 567 705.73 l S 0.001 w 0.99608 0.9451 0.76078 RG 151.8 w 28.35 617.29 m 224.05 617.29 l S 0.001 w 1 1 1 RG 151.8 w 226.3 617.29 m 567 617.29 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 28.35 528.85 m 224.05 528.85 l S 0.001 w 1 1 1 RG 20.58 w 226.3 528.85 m 567 528.85 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 26.14 762.8 m 569.2 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 739.97 m 569.2 739.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 717.14 m 569.2 717.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 694.31 m 569.2 694.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 540.26 m 569.2 540.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 785.63 m 569.2 785.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 762.8 m 569.2 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 739.97 m 569.2 739.97 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 717.14 m 569.2 717.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 694.31 m 569.2 694.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 540.26 m 569.2 540.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 517.43 m 569.2 517.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 786.71 m 27.22 516.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 225.17 786.71 m 225.17 516.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 568.12 786.71 m 568.12 516.35 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 31.2 769.45 Tm (Document Purpose)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 769.45 Tm (Inspection report)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 746.62 Tm (Author)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 746.62 Tm (CSCI)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 723.79 Tm (Audience)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 723.79 Tm (General public)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 700.96 Tm (Further copies from)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 700.96 Tm (0870 240 7535 \(telephone order line\))Tj ET /F2 12 Tf BT 1 0 0 1 31.2 678.13 Tm (Copyright)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 678.13 Tm (Copyright \()Tj ET /F2 12 Tf BT 1 0 0 1 313.49 678.13 Tm (2009)Tj ET /F2 12 Tf BT 1 0 0 1 344.02 678.13 Tm (\) Commission for Social Care )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 663.55 Tm (Inspection \(CSCI\). This publication may be reproduced )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 648.97 Tm (in whole or in part, free of charge, in any format or )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 634.39 Tm (medium provided that it is not used for commercial )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 619.81 Tm (gain. This consent is subject to the material being )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 605.23 Tm (reproduced accurately and on proviso that it is not )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 590.65 Tm (used in a derogatory manner or misleading context. )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 576.07 Tm (The material should be acknowledged as CSCI )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 561.49 Tm (copyright, with the title and date of publication of the )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 546.91 Tm (document specified.)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 524.08 Tm (Internet address)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 524.08 Tm (www.cqc.org.uk)Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 15 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (4)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm (,QIRUPDWLRQDERXWWKHFDUHKRPH)Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 774.22 m 267.95 774.22 l S 0.001 w 1 1 1 RG 20.58 w 270.2 774.22 m 565.65 774.22 l S 0.001 w 0.99608 0.9451 0.76078 RG 108.48 w 31.2 707.44 m 267.95 707.44 l S 0.001 w 1 1 1 RG 108.48 w 270.2 707.44 m 565.65 707.44 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 640.66 m 267.95 640.66 l S 0.001 w 1 1 1 RG 20.58 w 270.2 640.66 m 565.65 640.66 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 617.83 m 267.95 617.83 l S 0.001 w 1 1 1 RG 20.58 w 270.2 617.83 m 565.65 617.83 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 595 m 267.95 595 l S 0.001 w 1 1 1 RG 20.58 w 270.2 595 m 565.65 595 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 572.17 m 267.95 572.17 l S 0.001 w 1 1 1 RG 20.58 w 270.2 572.17 m 565.65 572.17 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 762.8 m 567.85 762.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 652.07 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 28.99 785.63 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 (Bybrook House Nursing Home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 746.62 Tm (Address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 746.62 Tm (The Lodge)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 729.04 Tm (Bybrook House )Tj ET /F2 12 Tf BT 1 0 0 1 273.05 711.46 Tm (Middlehill)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 693.88 Tm (Box)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 676.3 Tm (Wiltshire)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 658.72 Tm (SN13 8QP)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 (01225743672)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 1 273.05 613.06 Tm (01225744281)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 1 273.05 590.23 Tm (pen.b@talk21.com)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 567.4 Tm (Provider web address:)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 548.45 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 28.35 531.45 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 511.96 m 353.25 511.96 l S 0.001 w 1 1 1 RG 20.58 w 355.5 511.96 m 565.9 511.96 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 523.38 m 568.1 523.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 500.55 m 568.1 500.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 524.45 m 30.07 499.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 524.45 m 354.37 499.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 524.45 m 567.02 499.47 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 507.19 Tm (Name of registered provider\(s\):)Tj ET /F2 12 Tf BT 1 0 0 1 355.5 507.19 Tm (Avon Care Homes Limited)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 488.25 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 468.76 m 353.25 468.76 l S 0.001 w 1 1 1 RG 20.58 w 355.5 468.76 m 565.9 468.76 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 445.93 m 353.25 445.93 l S 0.001 w 1 1 1 RG 20.58 w 355.5 445.93 m 565.9 445.93 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 457.34 m 568.1 457.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 480.17 m 568.1 480.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 457.34 m 568.1 457.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 434.51 m 568.1 434.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 481.25 m 30.07 433.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 481.25 m 354.37 433.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 481.25 m 567.02 433.43 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 463.99 Tm (Type of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 463.99 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 441.16 Tm (Number of places registered:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 441.16 Tm (30)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 422.21 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 28.35 405.21 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 385.72 m 565.6 385.72 l S 0.001 w 41.16 w 31.2 352.6 m 297.2 352.6 l S 0.001 w 20.58 w 299.45 362.89 m 565.6 362.89 l S 0.001 w 20.58 w 299.45 342.31 m 432.52 342.31 l S 0.001 w 20.58 w 432.52 342.31 m 565.6 342.31 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 374.31 m 567.8 374.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 397.14 m 567.8 397.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 374.31 m 567.8 374.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 330.9 m 567.8 330.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 398.21 m 30.07 329.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 375.38 m 298.32 329.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 398.21 m 566.72 329.82 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 380.95 Tm (Conditions of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 358.12 Tm (Category\(ies\) :)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 358.12 Tm (Number of places \(if applicable\):)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 337.54 Tm (Under 65)Tj ET /F2 12 Tf BT 1 0 0 1 435.37 337.54 Tm (Over 65)Tj ET 1 1 1 RG 35.16 w 31.2 308.82 m 297.3 308.82 l S 0.001 w 35.16 w 299.55 308.82 m 431.45 308.82 l S 0.001 w 35.16 w 433.7 308.82 m 565.6 308.82 l S 0.001 w 0.99608 0.9451 0.76078 RG 20.58 w 31.2 278.7 m 565.6 278.7 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 290.11 m 567.8 290.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 267.28 m 567.8 267.28 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 244.45 m 568.1 244.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 327.52 m 567.8 327.52 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 290.11 m 567.8 290.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 267.28 m 568.1 267.28 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 244.45 m 568.1 244.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 177.88 m 568.1 177.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 328.6 m 30.07 176.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.42 328.6 m 298.42 289.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.57 328.6 m 432.57 289.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 328.6 m 566.72 176.8 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 311.34 Tm (old age, not falling within any other )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 296.76 Tm (category)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 311.34 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 311.34 Tm (30)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 273.93 Tm (Additional conditions: )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 251.1 Tm (The maximum number of service users who can be accommodated is 30)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 228.27 Tm (The registered person may provide the following category of service only: Care home )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 213.69 Tm (with nursing - Code N to service users of either gender whose primary care needs on )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 199.11 Tm (admission to the home are within the following category: Old age, not falling within )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 184.53 Tm (any other category \(Code OP\))Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 163.09 m 315.25 163.09 l S 0.001 w 1 1 1 RG 20.58 w 317.5 163.09 m 346.55 163.09 l S 0.001 w 20.58 w 348.8 163.09 m 377.9 163.09 l S 0.001 w 20.58 w 380.15 163.09 m 409.2 163.09 l S 0.001 w 20.58 w 411.45 163.09 m 440.55 163.09 l S 0.001 w 20.58 w 442.8 163.09 m 471.9 163.09 l S 0.001 w 20.58 w 474.15 163.09 m 503.2 163.09 l S 0.001 w 20.58 w 505.45 163.09 m 534.55 163.09 l S 0.001 w 20.58 w 536.8 163.09 m 565.9 163.09 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 174.51 m 568.1 174.51 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 151.68 m 568.1 151.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 175.58 m 30.07 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 175.58 m 316.37 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 175.58 m 347.67 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 175.58 m 379.02 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 175.58 m 410.32 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 175.58 m 441.67 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 175.58 m 473.02 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 175.58 m 504.32 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 175.58 m 535.67 150.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 175.58 m 567.02 150.6 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 158.32 Tm (Date of last inspection)Tj ET /F2 12 Tf BT 1 0 0 1 328.2 158.32 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 359.53 158.32 Tm (6)Tj ET /F2 12 Tf BT 1 0 0 1 390.86 158.32 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 422.18 158.32 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 453.53 158.32 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 484.86 158.32 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 516.18 158.32 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 547.53 158.32 Tm (8)Tj ET 0.99608 0.9451 0.76078 RG 17 w 31.2 139.8 m 565.9 139.8 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 130.18 m 568.1 130.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 131.25 m 30.07 55.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 131.25 m 567.02 55.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 149.43 m 568.1 149.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 130.18 m 568.1 130.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 56.15 m 568.1 56.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 150.5 m 30.07 129.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 150.5 m 567.02 129.1 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 136.24 Tm (Brief description of the )Tj ET /F2 12 Tf BT 1 0 0 1 177.31 136.24 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 116.99 Tm (Bybrook House provides care and accommodation for up to 30 older people. The home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 99.99 Tm (is privately owned by Avon Care Homes Ltd. The company owns other services, )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 82.99 Tm (including a nursing home in Wells, Somerset, where its administrative operations are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 65.99 Tm (based. The principal company director is Mrs Maria Cristina Bila, who regularly visits )Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 17 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (5)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 0.99608 0.9451 0.76078 RG 17 w 31.2 804.03 m 565.9 804.03 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 794.4 m 568.1 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 795.48 m 30.07 638.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 795.48 m 567.02 638.08 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 28.99 639.15 m 568.1 639.15 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 (Bybrook House. The home does not currently have a registered manager. A person is )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 766.47 Tm (working into this role and they are in the process of applying to be the registered )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 749.47 Tm (manager of the home. This person leads a team of registered nurses, care and )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 732.47 Tm (anciliary staff. The home is in a rural area, close to the village of Box. The city of Bath )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 715.47 Tm (is approximately five miles away. The house is an older building set in extensive )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 698.47 Tm (grounds, with views of surrounding countryside. There is car parking on site. Fees )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 681.47 Tm (charged to residents range from 700 pounds to 1,200 pounds per week. Information )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 664.47 Tm (for prospective residents is provided in the main entrance hall, in their rooms and on )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 647.47 Tm (request. )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 529/Matrix [1 0 0 1 0 0]>>stream xMo1+|KGJ%N qm*%rRiRމ=~^`kBq8qdQ=>`9 8[- 2K',)MP!BNquU J/G/.ZIźO$-,VZ[S{zle+ҴFiN߅GV&2Nv\k|u4* {;?y*Ȧ<#d<ɛP5Z:hU)xAʌ}*#cg+yIyFe]+ EʮV2#lH6t]첋=Il'wt5s]gjBk;jMdϾ+zvYiӹH6t9vmbq𙾸#]4нs1qxk:N0\psQlʩ/6= ٥:mYcg~- xـ2opfq;s}ffw |YqfoRg7-u94닿7n7l~} endstream endobj 20 0 obj<> endobj 21 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 40.96 m 566.93 40.96 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 37.19 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 489.47 37.19 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 520 37.19 Tm (6)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 526.99 37.19 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 545.29 37.19 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 778.65 Tm (6XPPDU\\)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 757.7 Tm (This is an overview of what we found during the inspection.)Tj ET 0.99608 0.9451 0.76078 RG 20.58 w 31.2 737.22 m 381.05 737.22 l S 0.001 w 1 1 1 RG 20.58 w 383.3 737.22 m 566.2 737.22 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 748.64 m 568.4 748.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 725.81 m 568.4 725.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 749.71 m 30.07 724.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 382.17 749.71 m 382.17 724.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 749.71 m 567.32 724.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 732.45 Tm (The quality rating for this )Tj ET /F2 12 Tf BT 1 0 0 1 191.92 732.45 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 255.59 732.45 Tm ( is:)Tj ET /F2 12 Tf BT 1 0 0 1 411.34 732.45 Tm (two star good service)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 700.31 Tm (2XUMXGJHPHQWIRUHDFKRXWFRPH)Tj ET /F2 10 Tf BT 1 0 0 1 212.29 624.27 Tm (Choice of home)Tj ET /F2 10 Tf BT 1 0 0 1 164.41 584.02 Tm (Health and personal care)Tj ET /F2 10 Tf BT 1 0 0 1 145.18 543.77 Tm (Daily life and social activities)Tj ET /F2 10 Tf BT 1 0 0 1 157.95 503.52 Tm (Complaints and protection)Tj ET /F2 10 Tf BT 1 0 0 1 226.36 463.27 Tm (Environment)Tj ET /F2 10 Tf BT 1 0 0 1 251.17 423.02 Tm (Staffing)Tj ET /F2 10 Tf BT 1 0 0 1 127.47 382.77 Tm (Management and administration)Tj ET q 0.75227 0 0 0.75161 305.05 317.32 cm /Xf1 Do Q 1 1 1 RG 20.58 w 31.2 266.08 m 567.85 266.08 l S 0.001 w 201.16 w 32.32 152.96 m 566.72 152.96 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.2 254.66 m 567.85 254.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 254.66 m 568.92 254.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 51.25 m 568.92 51.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 255.74 m 31.2 50.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 255.74 m 567.85 50.17 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 261.3 Tm (How we did our inspection:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 35.17 238.48 Tm (As part of the inspection, 30 questionnaires were sent out and 10 were returned. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 223.9 Tm (Comments made by people in the questionnaires and to us during the inspection )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 209.32 Tm (process have been included when drawing up the report. As part of this inspection, the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 194.74 Tm (home's file was reviewed and information provided since the previous inspection )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 180.15 Tm (considered, including the improvement plan from the last inspection. We also received )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 165.57 Tm (an Annual Quality Assurance Assessment \(AQAA\) from the home. This was their own )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 150.99 Tm (assessment of how they are performing. It also gave us information about what has )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 136.41 Tm (happened during the last year. We looked at the AQAA, the surveys and reviewed all )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 121.83 Tm (the other information that we have received about the home since the last inspection. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 107.25 Tm (This helped us to decide what we should focus on during the visit to the home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 92.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 78.1 Tm (One inspector performed the site visit. This person is referred to as "we" throughout )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 63.51 Tm (the report, as the report is made on behalf of the Care Quality Commission \(CQC\). The )Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 23 0 obj <>stream 0 J 1 1 1 RG 250.86 w 32.32 687.1 m 566.72 687.1 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 30.12 813.65 m 568.92 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 560.54 m 568.92 560.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 814.73 m 31.2 559.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 814.73 m 567.85 559.47 l S 0.001 w [] 0 d /F2 12 Tf 0 0 0 rg BT 1 0 0 1 32.92 802.72 Tm (site visit was on Friday 12th June 2009, between 9:10am and 3:55pm. It was )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 788.14 Tm (unannounced. The manager designate came on duty during the inspection. The )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 773.56 Tm (manager designate was available for all of the feed-back and the provider was able to )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 758.98 Tm (make herself available for much of the feedback, at the end of the site visit.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 744.4 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 729.82 Tm (During the site visit, we met with five residents and observed care for four residents )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 715.24 Tm (for whom communication was difficult. We toured all of the home and observed care )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 700.66 Tm (provided at different times of day and in different areas of the home. We reviewed care )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 686.08 Tm (provision and documentation in detail for four residents, including a resident who had )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 671.5 Tm (recently been admitted to the home.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 656.92 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 642.34 Tm (As well as meeting with residents, we met with a registered nurse, three carers, the )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 627.76 Tm (housekeeper, a domestic, the activities person, the chef and a catering assistant. We )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 613.18 Tm (observed a lunchtime meal and an activities session. We reviewed systems for storage )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 598.6 Tm (of medicines and observed one medicines administration round. A range of records )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 584.02 Tm (were reviewed, including staff training records, staff employment records, complaints )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 569.44 Tm (records and maintenance records.)Tj ET endstream endobj 24 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 25 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (8)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 1 1 1 RG 20.58 w 31.2 786.36 m 567.85 786.36 l S 0.001 w 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 416.28 w 33.82 272.17 m 568.22 272.17 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.2 774.95 m 567.85 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 774.95 m 568.92 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 504.26 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 62.9 m 570.42 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 482.51 m 32.7 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 776.03 m 567.85 503.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 569.35 482.51 m 569.35 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 781.59 Tm (What the )Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 90.52 781.59 Tm (care home)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 154.2 781.59 Tm ( does well:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 567.85 784.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.76 Tm (Bybrook House is a large country house, set in attractive, peaceful grounds. All of the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.18 Tm (rooms are different from each other and exceed minimum standards for room size. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.6 Tm (People can bring in their own items if they wish and some of the rooms had a highly )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.02 Tm (personalised appearance. The home has enthusiastic catering staff, who are keen to )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.44 Tm (respond to individual resident's likes and dislikes. Meals are attractively presented. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 685.86 Tm (Care staff take much care and attention when assisting residents who are frail to eat )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.28 Tm (their meals. Staff were keen to ensure that residents received the care that they )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.7 Tm (needed, this included domestic as well as nursing and care staff.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.54 Tm (People commented on the home. One person described Bybrook House as "a lovely )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 612.96 Tm (place" and that the situation was "great" and another that "my report would be )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.38 Tm (favourable". One resident reported that they had been in hospital recently and that it )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 583.8 Tm (was "so nice to get back here." People commented on the staff. One person reported )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 569.22 Tm (that staff listened and acted on what they said "all down the line", another that staff )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 554.64 Tm ("deserve high praise for the standards they set" and another "all the staff are helpful". )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 540.06 Tm (Staff also talked about their enjoyment of their work. One person reported "it's a )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 525.48 Tm (pleasure to come to work" and another that they loved their job and "should have done )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 510.9 Tm (it years ago".)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 0.99216 0.89804 0.5451 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 31.2 270.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 465.24 Tm (The home have put in many improvements since the last inspection, to the extent that )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 450.66 Tm (now they are assessed as providing good outcome for residents, where previously they )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 436.08 Tm (were assessed as providing poor outcomes to residents.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 421.5 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 406.92 Tm (The home have ensured that communal use of clothing, particularly under-clothing no )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 392.34 Tm (longer takes place. Improvements have been made in care planning, care records and )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 377.76 Tm (audit of care provision, to ensure that residents are protected from risk such as )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 363.18 Tm (pressure damage and manual handling. Care plans are now clearer and describe )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 348.6 Tm (actions to be taken in measurable terms. Management systems for disposal of )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 334.02 Tm (Controlled Drugs have been improved. Records relating to changes in medicines )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 319.44 Tm (prescriptions have improved.)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 (Residents are now given full information about the services offered by the home. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 275.7 Tm (home have made a range of improvements to ensure that residents are safeguarded. )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 261.12 Tm (All staff have been trained in abuse awareness and showed understanding of the )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 246.54 Tm (importance of this area. The provider has put in safeguards to the home environment, )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 231.96 Tm (including alarms to fire doors, to protect residents who may put themselves at risk by )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 217.38 Tm (wandering behaviours.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 202.8 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 188.22 Tm (The public areas of the home have been fully re-decorated and re-carpeted. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 173.64 Tm (number of hours devoted to maintenance has been increased. A full review of )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 159.06 Tm (equipment such as commode chairs has taken place and any deteriorated equipment )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 144.48 Tm (disposed of. Plans are being developed to improve a range of areas, including bathing )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 129.9 Tm (facilities for people with a complex disability and the home's sluice rooms. The provider )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 115.32 Tm (has ensured that the home provides suitable beds for people with complex nursing )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 100.74 Tm (needs and equipment to support frail people is now correctly used. Practice in )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 86.16 Tm (prevention of spread of infection has improved, including safe use of topical creams )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 71.58 Tm (and cleaning of mop-heads.)Tj ET /F2 10 Tf BT 1 0 0 1 570.47 270.61 Tm ()Tj ET endstream endobj 26 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 27 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (9)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 1 1 1 RG 90.48 w 33.82 767.29 m 568.22 767.29 l S 0.001 w 20.58 w 33.45 709.51 m 570.1 709.51 l S 0.001 w 355.92 w 34.57 519.01 m 568.97 519.01 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.62 813.65 m 570.42 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 720.92 m 570.42 720.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 569.35 814.73 m 569.35 719.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 698.09 m 570.1 698.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 720.92 m 570.1 720.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 698.09 m 571.17 698.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 339.92 m 571.17 339.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 814.73 m 32.7 719.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 699.17 m 33.45 338.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 699.17 m 570.1 338.85 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.42 802.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.42 788.14 Tm (The home have much improved its systems to ensure the health and safety of people )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 773.56 Tm (in the home. This includes protecting people from risks associated with hot water and )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 758.98 Tm (surfaces, safety in storage of oxygen cylinders, correct use of bed rails and fire safety )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 744.4 Tm (procedures. The provider has set up regular health and safety meetings, which includes )Tj ET /F2 12 Tf BT 1 0 0 1 34.42 729.82 Tm (staff and residents.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 707.96 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 33.45 704.74 Tm (What they could do better:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 31.2 517.46 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 681.91 Tm (The home needs to continue its development of care plans. There continue to be some )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 667.33 Tm (areas where staff know about resident's care needs but these are not documented. )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 652.75 Tm (Documentation is needed to ensure that all staff know about significant matters for )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 638.17 Tm (residents and provide care in a consistent manner. Not all people who are unable to )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 623.59 Tm (move themselves, give themselves food or fluids have monitoring charts in place. This )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 609.01 Tm (is needed, so that staff on each shift know what care has been given and managers )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 594.43 Tm (can monitor how effective interventions have been. Some details in care plans need )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 579.85 Tm (improvements, for example to document the precise consistency of fluids for people )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 565.27 Tm (who need thickening agent in their drinks and what topical applications are being used )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 550.69 Tm (for a person.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 536.11 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 521.53 Tm (Some improvements are needed in medicines administration and storage. To ensure )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 506.95 Tm (that access to Controlled Drugs cupboards is kept to a minimum, only Controlled Drugs )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 492.37 Tm (may be stored in the Controlled Drugs cupboard. Where a person is prescribed a )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 477.79 Tm (medicine on an "as required" basis, there needs to be a protocol or care plan to direct )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 463.21 Tm (registered nurses on the reasons for administration of such drugs. Where people are )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 448.63 Tm (prescribed drugs which can affect their daily lives such as mood altering drugs or )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 434.05 Tm (painkillers, care plans should be drawn up, so that staff can evaluate the drug's )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 419.47 Tm (effectiveness.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 404.89 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 390.31 Tm (Further systems should be developed in certain areas, including more detailed quality )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 375.73 Tm (audit of accidents, assessments of benefits of activities provided to residents and )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 361.15 Tm (management systems to ensure that staff fully complete all records at the time care is )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 346.57 Tm (given. )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 325.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 305.37 Tm (If you want to know what action the person responsible for this )Tj ET /F2 12 Tf BT 1 0 0 1 416.37 305.37 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 480.04 305.37 Tm ( is taking )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 287.87 Tm (following this report, you can contact them using the details set out on page 4.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 267.88 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 247.88 Tm (The report of this inspection is available from our website )Tj ET /F2 12 Tf BT 1 0 0 1 380.85 247.88 Tm (www.cqc.org.uk.)Tj ET /F2 12 Tf BT 1 0 0 1 490.78 247.88 Tm (You can get )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 230.38 Tm (printed copies from )Tj ET /F2 12 Tf BT 1 0 0 1 149.87 230.38 Tm (enquiries@cqc.org.uk or by telephoning our order line )Tj ET /F2 12 Tf BT 1 0 0 1 488.4 230.38 Tm (0870 240 )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 212.89 Tm (7535.)Tj ET endstream endobj 28 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 29 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (10)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 777.09 Tm (Details of our findings)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 26 w 32.32 740.77 m 562.53 740.77 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 756.02 m 565.85 756.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 727.77 m 565.85 727.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 757.1 m 30.07 726.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 757.1 m 564.78 726.7 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 738.89 Tm (&RQWHQWV)Tj ET 1 1 1 RG 16 w 28.35 694.52 m 566.93 694.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 690.46 Tm (Choice of home \(standards 1 - 6\))Tj ET 16 w 28.35 672.52 m 566.93 672.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 668.46 Tm (Health and personal care \(standards 7 - 11\))Tj ET 16 w 28.35 650.52 m 566.93 650.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 646.46 Tm (Daily life and social activities \(standards 12 - 15\))Tj ET 16 w 28.35 628.52 m 566.93 628.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 624.46 Tm (Complaints and protection \(standards 16 - 18\))Tj ET 16 w 28.35 606.52 m 566.93 606.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 602.46 Tm (Environment \(standards 19 - 26\))Tj ET 16 w 28.35 584.52 m 566.93 584.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 580.46 Tm (Staffing \(standards 27 - 30\))Tj ET 16 w 28.35 562.52 m 566.93 562.52 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 558.46 Tm (Management and administration \(standards 31 - 38\))Tj ET /F2 12 Tf BT 1 0 0 1 28.35 538.46 Tm (Outstanding statutory requirements)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 516.59 Tm (Requirements and recommendations from this inspection)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 33 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (11)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Choice of home )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 206.25 w 32.32 610.38 m 562.53 610.38 l S 0.001 w 1 1 1 RG 119 w 31.2 567.88 m 563.65 567.88 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 507.25 m 565.85 507.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 506.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 506.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People are confident that the care home can support them. This is because there is an )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (accurate assessment of their needs that they, or people close to them, have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (involved in. This tells the home all about them and the support they need. People who )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (stay at the home only for intermediate care, have a clear assessment that includes a )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (plan on what they hope for and want to achieve when they return home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People can decide whether the care home can meet their support and accommodation )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (needs. This is because they, or people close to them, have been able to visit the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and have got full, clear, accurate and up to date information about the home. If they )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (decide to stay in the home they know about their rights and responsibilities because )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (there is an easy to understand contract or statement of terms and conditions between )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (them and the care home that includes how much they will pay and what the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 513.32 Tm (provides for the money.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 489 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 467 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 467 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 444.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 124.35 w 34.6 378 m 562.54 378 l S 0.001 w 1 1 1 RG 22.5 w 32.35 431.17 m 564.79 431.17 l S 0.001 w 101.85 w 33.47 366.75 m 563.66 366.75 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 418.8 m 565.87 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 419.88 m 32.35 313.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 419.88 m 564.79 313.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 418.8 m 564.79 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 314.7 m 565.87 314.7 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 427.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 403.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 403.12 Tm (good)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 403.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 385.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.75 Tm (Prospective residents and their supporters will be given information about the home )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 341.25 Tm (and have a full assessment, so that they can be assured that the home will be able to )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 323.76 Tm (meet their needs, prior to admission.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 299.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 206.8 w 34.6 185.43 m 562.54 185.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 279.83 m 564.79 279.83 l S 0.001 w 185.43 w 33.47 173.62 m 563.66 173.62 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 267.45 m 565.87 267.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 268.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 268.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 267.45 m 564.79 267.45 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 35.5 276.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 251.77 Tm (In their AQAA, the home reported that they had fully revised their service users' )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 234.27 Tm (guide. We reviewed this information. We observed that the guide now fully conformed )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.78 Tm (to our guidelines. The guide was in a format which would be easy to access and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 199.28 Tm (provided a range of information to people who may be considering admission to the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.79 Tm (home. A range of information is available in the front entrance of the home, including )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 164.29 Tm (our full inspection report, as well as being provided to people individually. All of the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.79 Tm (five people who responded to this section of the questionnaire reported that they had )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 129.3 Tm (received enough information about the home prior to admission. One relative )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.8 Tm (described the information as "excellent".)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 94.31 Tm ()Tj ET endstream endobj 35 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 36 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (12)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 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 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 314.31 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 (The manager reported that they go to visit all prospective residents before admission, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (so as to assess if they could meet the person's needs. One person reported "My )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm ([relative] was visited by the Matron in charge in their home and had a long talk. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (were given every opportunity to visit Bybrook and ask questions". Another person )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (reported "It was selected by [my relatives] after a couple of visits as it is only a short )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (distance from home and they were favourably impressed by the staff.")Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (Bybrook House is in a rural area, close the the large village of Box and not far from )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (the city of Bath. Several people reported that they had chosen Bybrook because of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (this, liking its peaceful rural location, but pleased that it was close to local amenities. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (One person reported that the proximity of the home to Bath meant that friends from )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (Bath could also visit them, as well as their family from Box.)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 (In their AQAA, the home reported that they had up-dated their admissions )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (documentation. We met with one person who had been recently admitted and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (reviewed their records. We noted that the home had performed an assessment before )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (the person was admitted, this outlined the person's nursing and care needs. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (Immediately after admission, the home completed a more detailed assessment of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (person's nursing and care needs, including detailing information which had not been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (fully available at the assessment visit. The assessment formed a sound basis for the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (development of the person's care plan. We noted that assessments included social )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (needs as well as nursing and care needs, described the person's past life, the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (importance of family to them and how they preferred to spend their days.)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 (Staff we spoke with reported that they were fully informed of prospective new )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (admissions. The chef reported that they would try and go and visit any newly admitted )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (person soon after admission, to find out their needs and preferences for meals.)Tj ET endstream endobj 37 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 38 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (13)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Health and personal care )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 172.25 w 32.32 627.38 m 562.53 627.38 l S 0.001 w 1 1 1 RG 68 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 541.25 m 565.85 541.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 540.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 540.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Peoples health, personal and social care needs are met. The home has a plan of care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (that the person, or someone close to them, has been involved in making. If they take )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (medicine, they manage it themselves if they can. If they cannot manage their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (medicine, the care home supports them with it, in a safe way. Peoples right to privacy )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (is respected and the support they get from staff is given in a way that maintains their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (dignity.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (If people are approaching the end of their life, the care home will respect their choices )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and help them feel comfortable and secure. They, and people close to them, are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (reassured that their death will be handled with sensitivity, dignity and respect, and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (take account of their spiritual and cultural wishes. )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 523 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 501 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 501 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 478.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 124.35 w 34.6 412 m 562.54 412 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 101.85 w 33.47 400.75 m 563.66 400.75 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 452.8 m 565.87 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 453.88 m 32.35 347.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 453.88 m 564.79 347.62 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 31.27 348.7 m 565.87 348.7 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 (good)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 437.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 419.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 392.75 Tm (People will be generally fully supported by the home's systems for ensuring that their )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.25 Tm (personal and healthcare needs are met. A few areas need to be addressed to further )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 357.76 Tm (reduce risk to people.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 333.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 240.8 w 34.6 202.43 m 562.54 202.43 l S 0.001 w 1 1 1 RG 22.5 w 32.35 313.83 m 564.79 313.83 l S 0.001 w 219.43 w 33.47 190.62 m 563.66 190.62 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 301.45 m 565.87 301.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 302.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 302.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 301.45 m 564.79 301.45 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 35.5 310.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 285.77 Tm (All of the five people who responded to this section of the questionnaire reported that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.27 Tm (they received the care and support that they needed. One person commented )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 250.78 Tm ("Bybrook staff are always kind, considerate and patient", another "no trouble seems to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.28 Tm (be too much" and another "I am always impressed by the level of care an support". )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 215.79 Tm (Some people commented to us on care. One person reported "I'm very well looked )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.29 Tm (after" and another "they always gives me a good wash down". A relative commented )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 180.79 Tm ("staff have acted on all times with advice given by [a doctor] on communicating with )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.3 Tm ([my relative] and this seems to have been effective".)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 145.8 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.31 Tm (We observed that staff consistently knocked on residents doors prior to entering the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 110.81 Tm (person's room. All personal care was performed behind closed doors. We met with one )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.31 Tm (very frail person, who was asleep most of the time and we observed that they were )Tj ET endstream endobj 39 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 40 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (14)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (nicely turned out, including fresh attractive nightwear.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (Staff commented that they were given up to date information about the needs of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (people they cared for. One person commented "care plans are reviewed monthly and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (added to as and when things change". A registered nurse we spoke to during the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (inspection was very aware of residents' needs and was open to suggestions about how )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (documentation could be further developed. A carer knew residents individually and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (reported on how they were encouraged to read care plans and how useful they found )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (them.)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 (In their AQAA, the home reported on the high standards of care provided, particularly )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (for people with terminal care needs, reporting that they liaised closely with the local )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (hospice. They also reported that they were aware that they needed to continue to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (work on improving documentation. In their AQAA they reported that they had two )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (people who had sustained pressure ulceration in the home. When we performed the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (site visit, the registered nurse reported that both people had had only minor pressure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (ulceration, that they had responded well to interventions and that both peoples' ulcers )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (had now healed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (The home performs regular assessment of need, including risk assessments, for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (residents. Assessments include risk of pressure ulceration, risk of falls and nutritional )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (risk. Assessments were regularly reviewed, including if a person's need changed. For )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (example, a person's manual handling assessment had been reviewed when they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (started to spend most of their time in bed.)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 (If a person was identified as having a need or a risk, care plans are drawn up to direct )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (staff on how the person's need was to be met or risk reduced. For example one )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (person's records indicated that they had difficulties with communication. They had had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (a care plan drawn up, which directed staff on how the person was to be supported in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (communication. The plan was clear and written in non-judgemental language. Another )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (person had a care plan which directed how their continence needs were to be met, this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (was detailed and directed staff on the type\(s\) of continence aids needed to support )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (the person.)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 (Some areas in care planning would benefit from improvement. One person had a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (particular need in relation to their breathing, which they were able to tell us about and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (which the registered nurse also knew about, but this was not documented in their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (records. Several of the residents were assessed as being at high risk of pressure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (ulceration. Staff spoken with were aware of interventions to perform to prevent risk )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (and the home had a robust review process for if a person showed any signs of )Tj ET endstream endobj 41 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 42 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (15)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (pressure ulceration. However while equipment to be used to prevent risk was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (documented, other interventions, such as how often the person needed to be turned )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (or additional food supplements, were not documented in a care plan.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (Where people were very frail and not able to support themselves with activities of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (daily living, such as moving their position, feeding themselves or giving themselves )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (drinks, there was a lack of consistency in approach. One person who needed to have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (their position changed by staff had clear records, which were observed to be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (accurately completed, showing that they had their position changed regularly to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (prevent risks of pressure ulceration. However two other people who were also unable )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (to more their positions did not. Observations indicated that one of these peope )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (remained in the same position for in excess of five hours. Some people had food and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (fluid charts completed to assess their daily dietary and fluid intake. Whilst some charts )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (were fully completed, others were not, indicating some days and times when the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (person was documented as not having any fluids or meals. Discussions with staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (indicated that staff were supporting residents but not documenting care provided. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (Such records need to be accurate, so that people can assess that the person's needs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (have been met. It was also discussed that such records provide much data which can )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (be used when evaluating responses to treatment in care plans.)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 (Most of the care plans were very detailed. For example one person's care plan )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (documented which parts of personal care the person was able to perform and which )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (parts they needed full assistance with. Another person's care plan documented how )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (they liked their door to be closed very quietly at night when people came to check on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (them, as otherwise they would be disturbed. The resident reported that they were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (pleased that staff kept to this plan. Some care plans needed more detail. Where a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (person was prescribed thickening agent to enable them to swallow safely, care plans )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (did not state how thick the person needed their drinks to be. Some care plans directed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (which topical applications they needed, whilst others just stated "apply creams", )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (although the person was prescribed more than one cream. Some food charts )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (documented that the person had eaten a "cooked lunch" without documenting what )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (the lunch was. The chef confirmed that residents who need to be fed their meals were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (able to have choices of meals. Full records of the meal given are needed, so that staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (can assess what very frail people are able to eat and to indicate what may be their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (preference, if they are unable to communicate verbally. Where a person is prescribed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (oxygen, the care plan should state how often the tubing for the oxygen needed to be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (changed, to prevent risk of re-infection.)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 (We observed a medicines round and noted that it was performed in a safe manner, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (with the registered nurse carefully checking the medicines administration record, )Tj ET endstream endobj 43 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 44 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (16)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 266.32 w 34.6 678.25 m 562.54 678.25 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 244.94 w 33.47 666.44 m 563.66 666.44 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 541.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 541.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 542.84 m 565.87 542.84 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (selecting the correct drugs, dispensing them and signing only after they were assured )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (that the resident had safely taken the drug. All medicines records were fully )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (completed. Medicines were safely stored, including Controlled Drugs. We observed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (that two different envelopes for valuables were stored in the Controlled Drugs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (cupboard. This is contrary to the Medicines Act which states that only Controlled Drugs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (may be stored in a medicines cupboard. This is to ensure that access to Controlled )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (Drugs cupboards is kept to a minimum. We noted that some residents were prescribed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (medicines on an "as required" basis. Where this is the case, a protocol or care plan for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (each drug for each resident needs to be drawn up, so that registered nurses are fully )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (aware of the indicators for such drugs and the resident is consistently given the drugs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (by registered nurses when they need them. Some residents were prescribed drugs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (which can affect their daily lives, such as painkillers, aperients or mood altering drugs. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (It is advisable that care plans be drawn up about such drugs, so that their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (effectiveness in practice can be evaluated and prescribers informed.)Tj ET endstream endobj 45 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 46 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (17)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Daily life and social activities )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 138.25 w 32.32 644.38 m 562.53 644.38 l S 0.001 w 1 1 1 RG 17 w 31.2 584.88 m 563.65 584.88 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 575.25 m 565.85 575.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 574.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 574.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Each person is treated as an individual and the care home is responsive to his or her )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (race, culture, religion, age, disability, gender and sexual orientation. They are part of )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (their local community. The care home supports people to follow personal interests and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (activities. People are able to keep in touch with family, friends and representatives. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (They are as independent as they can be, lead their chosen lifestyle and have the )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (opportunity to make the most of their abilities. People have nutritious and attractive )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 600.57 Tm (meals and snacks, at a time and place to suit them.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 557 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 535 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 535 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 512.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 454.74 m 562.54 454.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 499.17 m 564.79 499.17 l S 0.001 w 84.36 w 33.47 443.5 m 563.66 443.5 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 486.8 m 565.87 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 487.88 m 32.35 399.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 487.88 m 564.79 399.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 486.8 m 564.79 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 400.19 m 565.87 400.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 495.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 471.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 471.12 Tm (good)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 471.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 453.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 426.75 Tm (People will be supported in exercising choice in how they live their lives, including )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 409.25 Tm (recreational activities and at meal times.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 384.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 292.3 w 34.6 228.17 m 562.54 228.17 l S 0.001 w 1 1 1 RG 22.5 w 32.35 365.32 m 564.79 365.32 l S 0.001 w 270.93 w 33.47 216.36 m 563.66 216.36 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 352.95 m 565.87 352.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 354.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 354.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 352.95 m 564.79 352.95 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 35.5 362.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 337.27 Tm (A new activities coordinator has been appointed since the last inspection. This person )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 319.77 Tm (had only recently come in post. They had worked in the home in another capacity )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 302.27 Tm (previously, so knew the residents and their needs. During the inspection, we observed )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 284.78 Tm (an activities session, where the residents were taking part in a game of drafts. One of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 267.28 Tm (the residents was helping the activities person in the details of the game, all the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 249.79 Tm (people were participating and we observed that there was laughter from all parties )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 232.29 Tm (during the game. Some residents did not wish or were unable to come out of their )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 214.79 Tm (rooms and the activities coordinator reported that they visited such people and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 197.3 Tm (provided individual activities. For example they knew much about the past life of one )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 179.8 Tm (resident and reported that they engaged them in conversation about this, to support )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 162.31 Tm (them in memory retention and in communicating. One person commented about the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 144.81 Tm (activities person "she's very good, we play games and I'm going to teach them all how )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 127.31 Tm (to play chess".)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 109.82 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 92.32 Tm (We noted that all residents had records completed relating to their past lives, what )Tj ET endstream endobj 47 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 48 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (18)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (had been important to them and how they wished to spend their lives. Many people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (had been supported in bringing items of their own into the home and one person's )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (room in particular was very personal, very much reflecting their likes and preferences. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (One person reported to us "you can do what you like here." Records were maintained )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (of activities participated in, these would be improved if the benefit to the resident )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (were also included.)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 (Residents and relatives in questionnaires reported on how the home had introduced )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (residents and supporters meetings. The home have also started producing a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (newsletter for people of events and happenings. Residents were enabled to go out of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (the home. One person reported that they usually went out with their family every )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (Sunday. The manager reported on how they had continued to work to develop closer )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (links with the local community. One relative reported on how they appreciated being )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (able to join in with church services from the local clergy in the home. One person's )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (records detailed the importance to them of continued practice of their faith and how )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (they were to be supported in this. Relatives also commented on how the home kept in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (touch with them. One relative commented on how the home had kept in "close" )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (contact with them about their relatives changing condition.)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 (All people responded in questionnaires favourably about the meals. One person )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (commented "we have a choice and they will make me something else if I do not like )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (the menu". another person commented "My [relative] says the food is good which is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (high praise from [the person] as [the person] was an excellent cook". During the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (inspection, we talked to people about the meals. One person said "the food is very )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (good, this is although I'm not interested in food", another "the food is excellent, I )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (have to ask for a smaller portion", another "I like what's on the menu" and another )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm ("we have very good food".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (We met with the chef during the inspection. They reported that they have started )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (going out regularly to meet with the residents and hear what they have to say about )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (meals. The chef showed a flexible approach to meals provision and reported that they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (were happy to cook something different if the resident asked. They reported that they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (cooked nearly all their meals from raw ingredients.)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 (We observed a meal during the inspection. Many of the residents eat in the dining )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (room, which is laid out in a similar manner to a hotel. People sat at tables and were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (supported in conversing with each other. People were offered a choice of drinks with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (their meals. Meals were attractively laid out, with attention paid to colour of foods on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (the plate. Aids to support people in independently giving themselves their meals were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (provided. Where people needed assistance to eat, staff sat with them and supported )Tj ET endstream endobj 49 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 50 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (19)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 108.85 w 34.6 756.98 m 562.54 756.98 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 87.48 w 33.47 745.17 m 563.66 745.17 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 699.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 699.23 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 31.27 700.3 m 565.87 700.3 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 (them. Residents could eat in their own room if they preferred. We observed a carer )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (carefully assisting a person to eat who had swallowing difficulties. We observed that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (their meal was finely chopped, rather than liquidised. The carer supported the resident )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (in eating their meal, whilst at the same time carefully observing if they were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (swallowing safely.)Tj ET endstream endobj 51 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 52 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (20)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Complaints and protection )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 87.25 w 32.32 669.88 m 562.53 669.88 l S 0.001 w 1 1 1 RG 17 w 31.2 635.88 m 563.65 635.88 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 626.25 m 565.85 626.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 625.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 625.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (If people have concerns with their care, they or people close to them know how to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (complain. Any concern is looked into and action taken to put things right. The care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (home safeguards people from abuse and neglect and takes action to follow up any )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (allegations.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (Peoples legal rights are protected, including being able to vote in elections.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 608 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 586 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 586 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 563.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 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 0.99216 0.89804 0.5451 RG 31.27 537.8 m 565.87 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 538.88 m 32.35 450.12 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 (good)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 522.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 504.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 477.75 Tm (People will be listened to when they raise issues of concern to them and people will be )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.25 Tm (safeguarded by the home's procedures.)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 0.99216 0.89804 0.5451 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 (People are informed of the complaints procedure in the service users' guide and the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 370.77 Tm (procedure is also displayed in the entrance area of the home. All of the people who )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.27 Tm (commented to us in questionnaires reported that they knew how to make a complaint. )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 335.78 Tm (One person reported that their relative "obviously raises whatever is on [their] mind )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.28 Tm (with staff, who either deal with it or discuss it with me". All of the staff who returned )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 300.79 Tm (questionnaires to us also reported that they knew what to do if a person had concerns )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.29 Tm (about the home.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 265.79 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.3 Tm (We also asked people during the inspection about how they raised concerns. One )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 230.8 Tm (person reported "I could always talk to sister - very easy to talk to", another "in the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.31 Tm (first instance I'd go to [the manager], she'd fix it for me" and another "I'd talk to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 195.81 Tm (Matron or one of the others - they're very good." In their AQAA, the manager reported )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.31 Tm (on their "open door" policy, which reduced complaints, as they could take action when )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 160.82 Tm (issues were first identified. The manager reported that they had received no formal )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.32 Tm (complaints since the last inspection. They had had several issues of concern raised )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 125.83 Tm (with them. Records showed that they had documented these and ensured action was )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.33 Tm (taken if matters were identified.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 90.83 Tm ()Tj ET endstream endobj 53 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 54 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (21)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 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 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 576.75 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 (The manager reported to us that they had continued their review of security in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (home, to ensure that people with additional dementia care needs could be kept safe. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (Since the last inspection, they had invested in a range of equipment to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (they would be alerted if someone inadvertently tried to exit the building by using an )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (external fire escape. At the time of the inspection, they were receiving costings for a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (security device for the front door.)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 (The manager was aware of local procedures for safeguarding people and this )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (information was also freely available in the home. Records showed that staff had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (trained in protection of vulnerable adults. Discussions with staff showed that they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (were aware of the importance in their role in ensuring that vulnerable people were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (safeguarded.)Tj ET endstream endobj 56 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 57 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (22)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Environment )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 1 1 1 RG 68 w 31.2 644.38 m 563.65 644.38 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People stay in a safe and well-maintained home that is homely, clean, pleasant and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (hygienic. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 666.32 Tm (People stay in a home that has enough space and facilities for them to lead the life )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 649.32 Tm (they choose and to meet their needs. The home makes sure they have the right )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (specialist equipment that encourages and promotes their independence. Their room )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (feels like their own, it is comfortable and they feel safe when they use it.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 488.74 m 562.54 488.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 84.36 w 33.47 477.5 m 563.66 477.5 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 433.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 433.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 434.19 m 565.87 434.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (good)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 505.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.75 Tm (Residents will be supported by a well maintained home, which is clean and where the )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm (principals of infection control are up-held.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 418.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 326.3 w 34.6 245.17 m 562.54 245.17 l S 0.001 w 1 1 1 RG 22.5 w 32.35 399.32 m 564.79 399.32 l S 0.001 w 304.93 w 33.47 233.36 m 563.66 233.36 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 386.95 m 565.87 386.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 388.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 388.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 386.95 m 564.79 386.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 396.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 371.27 Tm (Bybrook House is a large country house, where accommodation is provided on )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.77 Tm (different floors and at different levels. There is a passenger lift between the three )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.27 Tm (main floors. Four rooms are provided down a small flight of stairs. Only one of these )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.78 Tm (rooms was occupied and this person could manage the stairs. Another two rooms were )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm (provided up two steps. Only one of these rooms was occupied and the person did not )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (choose to come out of their room. As the home was originally a country house, all of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm (the rooms are different from each other. Nearly all are large and much exceed our )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm (minimum standards. Some of the rooms are en-suite and where they do not, all have )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (wash hand basins. Rooms all overlook the home's garden areas or the front entrance )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (area. The garden areas have been improved since the last inspection, with attractive )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm (planting and attention to tidiness of areas.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm (Since the last inspection, all of the entrance hall, corridor and stair areas have been )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (redecorated and re-carpeted. This gives the home a much more attractive )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm (atmosphere. One person commented how they appreciated that there were "always )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm (fresh flowers" in the home. The manager was able to describe plans they were )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (developing for the home, including improved bathing facilities for people with a range )Tj ET endstream endobj 58 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 59 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (23)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 458.77 w 34.6 582.02 m 562.54 582.02 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 437.4 w 33.47 570.21 m 563.66 570.21 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 349.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 349.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 350.38 m 565.87 350.38 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (of disabilities and sluicing facilities. In their AQAA, the manager reported that they had )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (invested in new equipment such as chairs, slings and slide sheets. Flat screen )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (televisions had also been provided. All frail people were now cared for in profiling )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (beds. Equipment used commonly, such as commode chairs were of a good standard )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (and systems had been put in place so that they were not used communally.)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 (The hours dedicated the maintenance have been increased since the last inspection. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (The housekeeper was able to clearly describe the systems for ensuring that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (maintenance is regularly performed. They also described how improvements are made )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (to rooms which have been vacated before they are offered to a future resident. Where )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (emergency maintenance is needed, the manager has a list of local contractors who )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (can take action if needed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (The home was clean throughout, including difficult reach equipment such as the backs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (of bath hoists and the undersides of raised toilet seats. A domestic reported that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (home had revised its policies and procedure on use of cleaning materials in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (accordance with current national guidelines. They reported that they had a good )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (supply of disposable gloves and aprons, including a range of sizes to meet the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (different needs of staff working in the home. The laundry has been improved and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (there was no dust visible behind the machines. Full systems had been put in place to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (stop communal use of underclothing. Many of the topical creams were named, but not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (all. This is advisable to ensure that risks associated with communal use of creams are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (reduced. In order to ensure that modern guidance on infection control are followed, it )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (is advisable that wall glove dispensers be placed in all areas where they they are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (needed, such as residents' en-suites, bathrooms and toilets.)Tj ET endstream endobj 60 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 61 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (24)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Staffing )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 1 1 1 RG 17 w 31.2 618.88 m 563.65 618.88 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have safe and appropriate support as there are enough competent staff on duty )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (at all times. They have confidence in the staff at the home because checks have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (done to make sure that they are suitable to care for them. Their needs are met and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (they are cared for by staff who get the relevant training and support from their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (managers.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 488.74 m 562.54 488.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 533.17 m 564.79 533.17 l S 0.001 w 84.36 w 33.47 477.5 m 563.66 477.5 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 433.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 433.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 520.8 m 564.79 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 434.19 m 565.87 434.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (good)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 505.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.75 Tm (People will be supported by staff who have been safely recruited and who are trained )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm (to perform their role.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 418.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 326.3 w 34.6 245.17 m 562.54 245.17 l S 0.001 w 1 1 1 RG 22.5 w 32.35 399.32 m 564.79 399.32 l S 0.001 w 304.93 w 33.47 233.36 m 563.66 233.36 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 386.95 m 565.87 386.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 388.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 388.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 386.95 m 564.79 386.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 396.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 371.27 Tm (In their AQAA, the home commented on staff, reporting that they were loyal, )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.77 Tm (committed to the home and to each other. Information from the home indicated that )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.27 Tm (there was a low turn-over in staff and that agency staff had only been needed on )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.78 Tm (three occasions since the last inspection. One person commented on the "good no of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm (staff per shift". When we discussed staffing levels with people during the inspection, )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (we also received favourable comments. One person reported "I ring the bell and they )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm (come, they're very helpful", another that staff were "quite prompt" when they rang )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm (their bell and another "yeah, they come quickly" when they rang the bell. One person )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (reported that this did not change with the night shifts, reporting "with me, it's at )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (night, they're very good about coming to see me and that". One resident asked to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm (show us a demonstration of how quick staff were by ringing their bell when we were )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm (with them, and this was observed to be the case.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (We looked at systems for staff recruitment, reviewing the files of three recently )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm (employed members of staff. We observed that all staff had two references, a full )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm (employment history and proof of identity. Where a member of staff's clearance from )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (the protection of vulnerable adults list had been returned and they had started work )Tj ET endstream endobj 62 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 63 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (25)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 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 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 489.27 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 (before their criminal records clearance had been returned, there were clear systems to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (show that they were fully supervised, until criminal records clearance was obtained. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (The manager reported on the improved induction which had been developed, to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (support newly employed staff. One person who had been employed for a longer period )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (of time reported that they had not been given an induction when they started )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (working, some time ago. Another person reported "induction to new workers is now )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (being carried out" and another "a lot to take in but with the help of my colleagues I )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (got there!". We met with two members of staff who reported that they were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (undergoing induction and they reported that they felt supported.)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 (In their AQAA, the home reported on improvements to training and supports from the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (provider's training officer. The manager has systems for ensuring that all people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (undertake mandatory training as and when required. People are also encouraged to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (undertake training in areas relating to residents' needs. Recent training has included )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (palliative care, dementia care and the home report they are planning to have support )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (from the speech and language therapist shortly. Staff are supported in undertaking )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (national vocational qualifications.)Tj ET endstream endobj 64 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 65 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (26)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Management and administration )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.25 w 32.32 618.88 m 562.53 618.88 l S 0.001 w 1 1 1 RG 102 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 524.25 m 565.85 524.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 523.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 523.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have confidence in the care home because it is led and managed appropriately. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (People control their own money and choose how they spend it. If they or someone )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (close to them cannot manage their money, it is managed by the care home in their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (best interests. The environment is safe for people and staff because appropriate health )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (and safety practices are carried out.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People get the right support from the care home because the manager runs it )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (appropriately with an open approach that makes them feel valued and respected. The )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (people staying at the home are safeguarded because it follows clear financial and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (accounting procedures, keeps records appropriately and ensures their staff understand )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (the way things should be done. They get the right care because the staff are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (supervised and supported by their managers.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 506 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 484 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 484 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 461.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 106.85 w 34.6 403.74 m 562.54 403.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 448.17 m 564.79 448.17 l S 0.001 w 84.36 w 33.47 392.5 m 563.66 392.5 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 435.8 m 565.87 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 436.88 m 32.35 348.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 436.88 m 564.79 348.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 435.8 m 564.79 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 349.19 m 565.87 349.19 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 444.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 420.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 420.12 Tm (good)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 420.12 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 (People will be protected by the management systems in the home, which will ensure )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.25 Tm (their health and safety.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 333.51 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 241.3 w 34.6 202.67 m 562.54 202.67 l S 0.001 w 1 1 1 RG 22.5 w 32.35 314.32 m 564.79 314.32 l S 0.001 w 219.93 w 33.47 190.86 m 563.66 190.86 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 301.95 m 565.87 301.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 303.03 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 303.03 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 301.95 m 564.79 301.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 311.01 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 286.27 Tm (The manager has been in post for nearly a year. This person has applied to be the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.77 Tm (registered manager, in accordance with our processes. The manager is experienced in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 251.27 Tm (their role. They are also a registered nurse. Several people commented on the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.78 Tm (manager. One person commented "The running of Bybrook House has gone through )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.28 Tm (various phases since..... [the manager] has initiated considerable changes, which are )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.79 Tm (good. [The manager] is also clearly respected by other staffers". Another person )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.29 Tm (described the "excellent manager and staff team". In their AQAA, the home described )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.79 Tm (how they had worked on developing a friendly and professional atmosphere. They )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.3 Tm (commented also on the development of resident, relatives and staff meetings to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.8 Tm (improve communication and supports to people. Meetings include a health and safety )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.31 Tm (group, which includes a resident representative, so that the impact of health and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.81 Tm (safely issues for residents can be fully considered. As the home is part of a group of )Tj ET endstream endobj 66 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 67 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (27)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 721.21 w 34.6 450.8 m 562.54 450.8 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 699.84 w 33.47 438.99 m 563.66 438.99 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 86.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 86.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 87.94 m 565.87 87.94 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (homes, it was discussed with the provider that it might be beneficial for groups of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (people, such as the activities organiser and chefs to meet across the group, to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (exchange ideas and further develop quality programmes in these more specialist )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (areas.)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 manager reported that they regularly seek the views of people. Most recently they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (have completed a staff survey and analysed the reports. Currently they are surveying )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (residents and their supporters and will analyse results in a similar manner when they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (have been returned. The provider regularly visits the home and completes a report. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (Following the last inspection, they provided us with an improvement plan when we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (asked for it. We are aware that after the last inspection, the Health and Safety )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (Executive issued directives. The provider ensured that issues detailed in these )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (directives were fully addressed within timescales.)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 (The home reviews a range of other matters as part of its quality audit, such as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (incidence of infection and pressure ulceration. They have set up a system for reviews )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (of care plan documentation. We advise that that management systems should be put )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (in place to ensure that all monitoring records are always fully completed by the person )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (providing the care. The home do perform reviews of accidents. We advice that reviews )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (of accidents be extended, to include time of day and day of the week. The home has )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (clear systems for ensuring that charges for additional services, such as chiropody and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (hairdressing, are correctly managed and charged to individual's accounts. At present )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (there is not a full receipted system of valuables handed in for safekeeping and we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (recommend that this should be considered, to ensure that there is a full audit trail )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (relating to residents' valuables.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (The manager has established clear systems for supervision of staff. As part of these )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (systems they ensure that all relevant areas, such as protection of vulnerable adults, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (health and safety and meeting residents' care needs are regularly considered during )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (supervisions. One member of staff described the "very supportive manager" and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (another "I feel confident and efficient in working because of the right )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (support/knowledge from my supervisors".)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 (The home now has clear systems to ensure that the health and safety of people is )Tj ET /F2 12 Tf BT 1 0 0 1 535.98 201.73 Tm (up-)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (held.)Tj ET /F2 12 Tf BT 1 0 0 1 64.2 184.23 Tm ( This includes management of hot water temperatures, ensuring that people are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (protected from risks of contact with hot surfaces and that windows above the ground )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (floor are safe. There are safe systems for the use of bed rails, including assessment of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (need, regular evaluations and use of safe equipment. Records showed that equipment )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (and services to the home are regularly services and maintained. The home's fire log )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (book was fully up to date.)Tj ET endstream endobj 68 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 70 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (28)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 0.99216 0.9451 0.76078 RG 36.25 w 29.47 793.28 m 564.97 793.28 l S 0.001 w 0.99608 0.9451 0.76078 RG 17 w 28.35 784.78 m 422.1 784.78 l S 0.001 w 17 w 424.35 784.78 m 467.1 784.78 l S 0.001 w 1 1 1 RG 17 w 469.35 784.78 m 494.1 784.78 l S 0.001 w 0.99608 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0.001 w [] 0 d [] 0 d 2.25 w 290.57 616.75 m 290.57 591.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 616.75 m 474.92 591.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 719.65 m 568.4 719.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 648.22 m 568.4 648.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 615.67 m 568.4 615.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 592.84 m 568.3 592.84 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 720.73 m 30.07 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 649.3 m 92.12 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 649.3 m 198.52 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 649.3 m 290.62 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 649.3 m 475.02 614.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 720.73 m 567.32 614.6 l S 0.001 w [] 0 d /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 702.45 Tm (Outstanding statutory requirements)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 684.03 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 669.45 Tm (been met.)Tj ET /F2 12 Tf BT 1 0 0 1 95.57 669.45 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 104.02 669.45 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 654.87 Tm (Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 637.05 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 634.05 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 634.05 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 634.05 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 634.05 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 621.9 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 602.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 96.15 599.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 202.5 599.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 599.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 478.9 599.49 Tm ()Tj ET endstream endobj 71 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 72 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (29)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 797.57 Tm (Requirements and recommendations from this inspection:)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 782.15 Tm ()Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 0.99608 0.9451 0.76078 RG 52.74 w 31.2 748.59 m 566.2 748.59 l S 0.001 w 30.3 w 31.2 704.82 m 91 704.82 l S 0.001 w 30.3 w 93.25 704.82 m 197.4 704.82 l S 0.001 w 30.3 w 199.65 704.82 m 289.5 704.82 l S 0.001 w 30.3 w 291.75 704.82 m 473.9 704.82 l S 0.001 w 30.3 w 476.15 704.82 m 566.2 704.82 l S 0.001 w 1 1 1 RG 20.58 w 31.2 677.13 m 91.05 677.13 l S 0.001 w 20.58 w 93.3 677.13 m 197.4 677.13 l S 0.001 w 20.58 w 199.65 677.13 m 289.45 677.13 l S 0.001 w 20.58 w 291.7 677.13 m 473.8 677.13 l S 0.001 w 20.58 w 476.05 677.13 m 566.1 677.13 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 30.07 689.63 m 30.07 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 689.63 m 567.22 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.3 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 689.63 m 92.17 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 689.63 m 198.52 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 689.63 m 290.57 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 689.63 m 474.92 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 776.09 m 568.4 776.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.4 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 665.72 m 568.3 665.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 777.17 m 30.07 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 722.18 m 92.12 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 722.18 m 198.52 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 722.18 m 290.62 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 722.18 m 475.02 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 777.17 m 567.32 687.47 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 759.9 Tm (Immediate requirements:)Tj ET 0.99216 0.89804 0.5451 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 742.32 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 727.74 Tm (The registered person had to meet these within 48 hours.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 709.92 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 706.92 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 706.92 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 706.92 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 706.92 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 694.77 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 675.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 96.15 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 202.5 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 478.9 672.36 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 66.74 w 31.2 594.97 m 566.2 594.97 l S 0.001 w 30.3 w 31.2 544.2 m 91 544.2 l S 0.001 w 30.3 w 93.25 544.2 m 197.4 544.2 l S 0.001 w 30.3 w 199.65 544.2 m 289.5 544.2 l S 0.001 w 30.3 w 291.75 544.2 m 473.9 544.2 l S 0.001 w 30.3 w 476.15 544.2 m 566.2 544.2 l S 0.001 w 1 1 1 RG 221 w 31.2 416.3 m 91.05 416.3 l S 0.001 w 221 w 93.3 416.3 m 197.4 416.3 l S 0.001 w 221 w 199.65 416.3 m 289.45 416.3 l S 0.001 w 221 w 291.7 416.3 m 473.8 416.3 l S 0.001 w 221 w 476.05 416.3 m 566.1 416.3 l S 0.001 w 240.65 w 31.2 183.23 m 91.05 183.23 l S 0.001 w 240.65 w 93.3 183.23 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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 31.2 549.3 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 (7)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 514.74 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 514.74 Tm (Care plans must include all )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 497.74 Tm (factors, to direct staff on )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 480.74 Tm (how residents needs are to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 463.74 Tm (be met.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 446.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 429.74 Tm (Where some staff are aware )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 412.74 Tm (of how to meet residents' )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 395.74 Tm (needs but care plans are not )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 378.74 Tm (drawn up about this, there is )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 361.74 Tm (a risk that not all staff will )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 344.74 Tm (be aware and residents will )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 327.74 Tm (not have their needs met in )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 310.74 Tm (a consistent manner.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 514.74 Tm (17/07/2009)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 35.5 291.49 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 291.49 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 291.49 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 291.49 Tm (If a person needs assistance )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 274.49 Tm (with changing their position, )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 257.49 Tm (drinking fluids or eating )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 240.49 Tm (meals, a monitoring chart )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 223.49 Tm (must always be put in place )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 206.49 Tm (and all interventions be )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 189.49 Tm (documented.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 172.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 155.49 Tm (Where people are frail and )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 138.49 Tm (not able to perform activities )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 121.49 Tm (of daily living for )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 104.49 Tm (themselves, they may be at )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 87.49 Tm (risk, so monitoring charts )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 70.49 Tm (are needed so that )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 291.49 Tm (17/07/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 291.49 Tm ()Tj ET endstream endobj 73 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 74 0 obj <>stream 0 J 0.98431 0.78824 0.08627 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (30)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (32)Tj ET 0.98431 0.78824 0.08627 RG 0.001 w 0 Tr 0.99608 0.9451 0.76078 RG 66.74 w 31.2 779.16 m 566.2 779.16 l S 0.001 w 30.3 w 31.2 728.39 m 91 728.39 l S 0.001 w 30.3 w 93.25 728.39 m 197.4 728.39 l S 0.001 w 30.3 w 199.65 728.39 m 289.5 728.39 l S 0.001 w 30.3 w 291.75 728.39 m 473.9 728.39 l S 0.001 w 30.3 w 476.15 728.39 m 566.2 728.39 l S 0.001 w 1 1 1 RG 51 w 31.2 685.49 m 91.05 685.49 l S 0.001 w 51 w 93.3 685.49 m 197.4 685.49 l S 0.001 w 51 w 199.65 685.49 m 289.45 685.49 l S 0.001 w 51 w 291.7 685.49 m 473.8 685.49 l S 0.001 w 51 w 476.05 685.49 m 566.1 685.49 l S 0.001 w 204 w 31.2 555.74 m 91.05 555.74 l S 0.001 w 204 w 93.3 555.74 m 197.4 555.74 l S 0.001 w 204 w 199.65 555.74 m 289.45 555.74 l S 0.001 w 204 w 291.7 555.74 m 473.8 555.74 l S 0.001 w 204 w 476.05 555.74 m 566.1 555.74 l S 0.001 w 238 w 31.2 332.49 m 91.05 332.49 l S 0.001 w 238 w 93.3 332.49 m 197.4 332.49 l S 0.001 w 238 w 199.65 332.49 m 289.45 332.49 l S 0.001 w 238 w 291.7 332.49 m 473.8 332.49 l S 0.001 w 238 w 476.05 332.49 m 566.1 332.49 l S 0.001 w [] 0 d 2.25 w 0.99216 0.89804 0.5451 RG 28.99 658.86 m 568.3 658.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 452.61 m 568.3 452.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 713.19 m 30.07 211.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 713.19 m 567.22 211.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 744.66 m 568.4 744.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 712.11 m 568.3 712.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 713.19 m 92.17 211.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 713.19 m 198.52 211.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 713.19 m 290.57 211.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 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The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 733.49 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 730.49 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 730.49 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 730.49 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 730.49 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 718.34 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 295.8 701.18 Tm (management and staff can )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 684.18 Tm (ensure that people's needs )Tj ET /F2 12 Tf BT 1 0 0 1 295.8 667.18 Tm (are being met.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 645.68 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 645.68 Tm (9)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 645.68 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 645.68 Tm (Only Controlled Drugs may )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 628.68 Tm (be stored in the Controlled )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 611.68 Tm (Drugs cupboard.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 594.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 577.68 Tm (Due to the nature of )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 560.68 Tm (Controlled Drugs, access to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 543.68 Tm (the Controlled Drugs )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 526.68 Tm (cupboard needs to be )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 509.68 Tm (reduced to a minimum, )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 492.68 Tm (therefore other items must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 475.68 Tm (never be strored in )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 458.68 Tm (Controlled Drugs cupboards.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 645.68 Tm (30/06/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 645.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 439.43 Tm (4)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 439.43 Tm (9)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 439.43 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 439.43 Tm (Where a person is rescribed )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 422.43 Tm (a drug on an "as required" )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 405.43 Tm (basis, a protocol or care plan )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 388.43 Tm (must always been put in )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 371.43 Tm (place.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 354.43 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 337.43 Tm (People need to know that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 320.43 Tm (they will be given their )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 303.43 Tm (drugs in accordance with )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 286.43 Tm (their needs and in a )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 269.43 Tm (consistent manner, )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 252.43 Tm (therefore the registered )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 235.43 Tm (nurses need to be informed )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 218.43 Tm (of these factors.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 439.43 Tm (31/07/2009)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 439.43 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 67.32 w 31.2 160.58 m 566.2 160.58 l S 0.001 w 18.15 w 31.2 115.59 m 91.05 115.59 l S 0.001 w 18.15 w 93.3 115.59 m 197.35 115.59 l S 0.001 w 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meals, records whould )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 674.21 Tm (state what the person has eaten, not just that they have )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 659.63 Tm (eaten a meal.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 636.8 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 636.8 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 636.8 Tm (Care plans relating to adminstration of oxygen should also )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 622.22 Tm (state how often oxygen tubing needs to be changed.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 599.39 Tm (4)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 599.39 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 599.39 Tm (Where a person needs thickening agent to enable them to )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 584.81 Tm (swallow safely, their care plan should state the consistency )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 570.23 Tm (of their drinks.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 547.4 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 547.4 Tm (9)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 547.4 Tm (Where a resident is prescribed a medicine which can affect )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 532.82 Tm (their daily lives, a care plan should be drawn up so that )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 518.24 Tm (staff can evaluate the effectiveness of the medicine for the )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 503.66 Tm (resident.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 480.83 Tm (6)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 480.83 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 480.83 Tm (The benefits to resident of activities they have participated )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 466.25 Tm (in should be documented.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 443.42 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 443.42 Tm (31)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 443.42 Tm (Management systems should be put in place to ensure that )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 428.84 Tm (staff consistently complete monitoring records at the time )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 414.26 Tm (nursing and care is given.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 391.43 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 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If you would like a summary in a )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 642.12 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 602.63 Tm (Copyright \()Tj ET /F2 12 Tf BT 1 0 0 1 112.69 602.63 Tm (2009)Tj ET /F2 12 Tf BT 1 0 0 1 143.22 602.63 Tm (\) Commission for Social Care Inspection \(CSCI\). This publication may )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 585.13 Tm (be reproduced in whole or in part, free of charge, in any format or medium provided )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 567.63 Tm (that it is not used for commercial gain. This consent is subject to the material being )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 550.14 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 28.35 532.64 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 83 0 obj<> endobj 84 0 obj<>/Subtype/CIDFontType2/Type/Font/W [3[312]]/CIDToGIDMap/Identity/DW 1000>> endobj 85 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 86 0 obj <>stream %!PS-AdobeFont-1.0: SymbolMT Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Fri Oct 10 11:50:06 2008 % Converted from TrueType font 'SYMBOL.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 1.60) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Symbol) readonly def /FamilyName (Symbol) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -109 def /UnderlineThickness 49 def end readonly def /FontName /SymbolMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {0 -220 1113 1005} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /universal put dup 35 /numbersign put dup 36 /existential put dup 37 /percent put dup 38 /ampersand put dup 39 /suchthat put dup 40 /parenleft put dup 41 /parenright put dup 42 /asteriskmath put dup 43 /plus put dup 44 /comma put dup 45 /minus put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /congruent put dup 65 /Alpha put dup 66 /Beta put dup 67 /Chi put dup 68 /Delta put dup 69 /Epsilon put dup 70 /Phi put dup 71 /Gamma put dup 72 /Eta put dup 73 /Iota put dup 74 /theta1 put dup 75 /Kappa put dup 76 /Lambda put dup 77 /Mu put dup 78 /Nu put dup 79 /Omicron put dup 80 /Pi put dup 81 /Theta put dup 82 /Rho put dup 83 /Sigma put dup 84 /Tau put dup 85 /Upsilon put dup 86 /sigma1 put dup 87 /Omega put dup 88 /Xi put dup 89 /Psi put dup 90 /Zeta put dup 91 /bracketleft put dup 92 /therefore put dup 93 /bracketright put dup 94 /perpendicular put dup 95 /underscore put dup 96 /radicalex put dup 97 /alpha put dup 98 /beta put dup 99 /chi put dup 100 /delta put dup 101 /epsilon put dup 102 /phi put dup 103 /gamma put dup 104 /eta put dup 105 /iota put dup 106 /phi1 put dup 107 /kappa put dup 108 /lambda put dup 109 /mu put dup 110 /nu put dup 111 /omicron put dup 112 /pi put dup 113 /theta put dup 114 /rho put dup 115 /sigma put dup 116 /tau put dup 117 /upsilon put dup 118 /omega1 put dup 119 /omega put dup 120 /xi put dup 121 /psi put dup 122 /zeta put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /similar put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /.notdef put dup 131 /.notdef put dup 132 /.notdef put dup 133 /.notdef put dup 134 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/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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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) 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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 91 0 obj<> endobj 92 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[433 514 415 640 578 889 604 575]]/CIDToGIDMap/Identity/DW 1000>> endobj 93 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0003><005c> endcodespacerange 32 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> <0059><0059><0076> <005a><005a><0077> <005b><005b><0078> <005c><005c><0079> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 3 0 obj<> endobj 94 0 obj <>stream %!PS-AdobeFont-1.0: ArialMT Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Thu Oct 09 15:49:19 2008 % Converted from TrueType font 'ARIAL.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Arial) readonly def /FamilyName (Arial) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -106 def /UnderlineThickness 73 def end readonly def /FontName /ArialMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-46 -210 1000 896} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B T13҂uGFsnA S1_ z.H@sV-umQ/ rgrVFcSctóinuk̾uA M[\b y9_ )(ib]o7PaZk=JI4wr QeR-ӐhX}Qt 1ݫja@K^ }= j"D3XU:*u?| 6&f]'(VY k?YODn7Or>TɩZfZvZ7N-N}.^1>dL,͝0n8^|0~ZPFP^̵x} Tj9th ?H2wr=\aK&cE"*X8)nXZI- Rҿ mRdokh_`V#wp; նגdRyf,jL%>lzr{,V\d6koXp a~( q;(I9zF<2(u4Z+(9%%W# )3Z+B gmMJۿ;5t2&M}wP-B*' lC7AEÐ-XaTu:RD/ ~Xmv@JO"Ⲕ!d #\8_A#~#aMzNNZ2>ieec5+#TMg]Ⴤ]p9jqe^alǣ̏:Ϯ6~O(SW™^tpTeͦVzĻ[ 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!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$]UþCi Rhr+9aa9wuA&DKw^Qe|Z 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 cleartomark endstream endobj 95 0 obj<> endobj 32 0 obj<> endobj 96 0 obj <>stream  cvt gxfpgm;_glyfˬ ^head< H6hhea$ $hmtx ploca76maxp 1t prepF 8}11c1bbDu1c111D1>}1(111{-1(3c1J`7]1bP2Jb2(11124bb(()_b{8P>2;IV`bbz!&BF7>>TtNmmn{{(hxAYiU\.t/J\cx{{{ ""(/23>CFHPSfijkrsx,.88AMP\ik| ,,Alx=>o:BX~9`/111:<JJLWstx  ((-WYZZZZprr."+`x =.:WX]]SlCcM*SclAq],C]"D>;KeJPBQLQLT7Z\WU:rrE@78743210/.-,+*)('&%$#"!  ,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 97 0 obj<> endobj 98 0 obj<>/Subtype/CIDFontType2/Type/Font/W [53[891]133[891]]/CIDToGIDMap/Identity/DW 1000>> endobj 99 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0035><0085> endcodespacerange 2 beginbfrange <0035><0035><0052> <0085><0085><00a3> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 69 0 obj<> endobj 100 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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