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()Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 10 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (2)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (38)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F1 10 Tf BT 1 0 0 1 297.64 803.65 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 787.03 Tm (This is a review of quality of outcomes that people experience in this )Tj ET /F2 12 Tf BT 1 0 0 1 448.39 787.03 Tm (care home. We )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 769.53 Tm (believe high quality care should)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 749.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 749.53 Tm (Be safe)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 733.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 733.53 Tm (Have the right outcomes, including clinical outcomes)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 717.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 717.53 Tm (Be a good experience for the people that use it)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 701.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 701.53 Tm (Help prevent illness, and promote healthy, independent living)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 685.53 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 685.53 Tm (Be available to those who need it when they need it.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 651.03 Tm (The first part of the review gives the overall quality rating for the )Tj ET /F2 12 Tf BT 1 0 0 1 427.6 651.03 Tm (care home:)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 631.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 631.04 Tm (3 stars - excellent)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 615.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 615.04 Tm (2 stars - good)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 599.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 599.04 Tm (1 star - adequate)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 583.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 583.04 Tm (0 star - poor)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 551.04 Tm (There is also a bar chart that gives a quick way of seeing the quality of care that the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 534.04 Tm (home provides under key areas that matter to people.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 500.04 Tm (There is a summary of what we think this service does well, what they have improved )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 483.04 Tm (on and, where it applies, what they need to do better.)Tj ET /F2 12 Tf BT 1 0 0 1 364.74 483.04 Tm (We use the national minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 466.04 Tm (standards to describe the outcomes that people should experience.)Tj ET /F2 12 Tf BT 1 0 0 1 443.2 466.04 Tm (National minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 449.04 Tm (standards are written by the Department of Health for each type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 409.54 Tm (After the summary there is more detail about our findings. The following table explains )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 392.05 Tm (what you will see under each outcome area.)Tj ET [] 0 d 0.5 w 0 0 0 RG 22.69 383.86 m 572.15 383.86 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.69 50.22 m 572.15 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 22.7 383.86 m 22.7 50.22 l S 0.001 w [] 0 d [] 0 d 0.5 w 572.15 383.86 m 572.15 50.22 l S 0.001 w [] 0 d /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 370.56 Tm (Outcome area \(for example )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 173.59 370.56 Tm (Choice of home\))Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 340.26 Tm (These are the outcomes that people )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 216.34 340.26 Tm (staying in care homes should experience.)Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 435.79 340.26 Tm (They reflect the things )Tj ET 0 0 0 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 328.11 Tm (that people have said are important to them:)Tj ET 0 0 0 RG 0.001 w 0 Tr 1 0.9451 0.76078 RG 82.23 w 30.6 263.37 m 562.45 263.37 l S 0.001 w 0.95294 0.95294 0.95294 RG 39.99 w 29.47 285.61 m 563.57 285.61 l S 0.001 w 1 1 1 RG 39.99 w 29.47 243.37 m 563.57 243.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 306.73 m 565.77 306.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 264.49 m 565.77 264.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 222.25 m 565.77 222.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 307.81 m 28.35 221.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 307.81 m 564.7 221.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 291.05 Tm (This box tells you the outcomes that we will always inspect against when we do a key )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 273.55 Tm (inspection)Tj ET /F2 10 Tf BT 1 0 0 1 95.78 273.55 Tm (.)Tj ET /F2 12 Tf BT 1 0 0 1 34.87 248.81 Tm (This box tells you any additional outcomes that we may inspect against when we do a )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 231.31 Tm (key inspection.)Tj ET /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 191.8 Tm (This is what people )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 131.32 191.8 Tm (staying in this care home experience:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 154.64 Tm (Judgement:)Tj ET 1 0.9451 0.76078 RG 39.99 w 30.6 123.34 m 562.45 123.34 l S 0.001 w 1 1 1 RG 39.99 w 29.47 124.46 m 563.57 124.46 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 145.58 m 565.77 145.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 103.34 m 565.77 103.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 146.66 m 28.35 102.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 146.66 m 564.7 102.26 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 129.9 Tm (This box tells you our opinion of what we have looked at in this outcome area.)Tj ET /F2 12 Tf BT 1 0 0 1 517.79 129.9 Tm (We )Tj ET /F2 12 Tf BT 1 0 0 1 34.87 112.4 Tm (will say whether it is excellent, good, adequate or poor.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 86.53 Tm (Evidence:)Tj ET 1 0.9451 0.76078 RG 22.5 w 30.6 63.97 m 562.45 63.97 l S 0.001 w 1 1 1 RG 22.5 w 29.47 65.1 m 563.57 65.1 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 27.27 77.47 m 565.77 77.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.27 52.72 m 565.77 52.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.35 78.55 m 28.35 51.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.7 78.55 m 564.7 51.65 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.87 61.78 Tm (This box describes the information we used to come to our judgement.)Tj ET endstream endobj 11 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 12 0 obj<>>> endobj 13 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (3)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (38)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 28.35 779.1 Tm (We review the quality of the service against outcomes from the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 762.1 Tm (Standards \(NMS\).)Tj ET /F2 12 Tf BT 1 0 0 1 144.87 762.1 Tm (Those standards are written by the Department of Health for each )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 745.1 Tm (type of care service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 705.6 Tm (Copies of the)Tj ET /F2 12 Tf BT 1 0 0 1 111.71 705.6 Tm (National Minimum Standards )Tj ET /F2 12 Tf BT 1 0 0 1 290.49 705.6 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 302.34 705.6 Tm (Care Homes for Older People)Tj ET /F2 12 Tf BT 1 0 0 1 477.18 705.6 Tm ( can be found )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 688.11 Tm (at www.dh.gov.uk or bought from The Stationery Office \(TSO\) PO Box 29, St Crispins, )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 670.61 Tm (Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 653.11 Tm (Stationery Office is also available: )Tj ET /F2 12 Tf 0 0 1 rg BT 1 0 0 1 238.73 653.11 Tm (www.tso.co.uk/bookshop)Tj ET /F2 12 Tf 0 0 0 rg BT 1 0 0 1 28.35 613.12 Tm (The mission of the Care Quality Commission is to make care better for people by:)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 596.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 596.12 Tm (Regulating health and adult social care services to ensure quality and safety )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 580.12 Tm (standards, drive improvement and stamp out bad practice)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 564.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 564.12 Tm (Protecting the rights of people who use services, particularly the most )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 548.12 Tm (vulnerable and those detained under the Mental Health Act 1983)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 532.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 532.12 Tm (Providing accessible, trustworthy information on the quality of care and )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 516.12 Tm (services so people can make better decisions about their care and so that )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 500.12 Tm (commissioners and providers of services can improve services.)Tj ET /F4 12 Tf BT 1 0 0 1 85.05 484.12 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 100.35 484.12 Tm (Providing independent public accountability on how commissioners and )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 468.12 Tm (providers of services are improving the quality of care and providing value )Tj ET /F2 12 Tf BT 1 0 0 1 99.25 452.12 Tm (for money.)Tj ET /F1 14 Tf BT 1 0 0 1 28.35 390.28 Tm (5HDGHU,QIRUPDWLRQ)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 28.35 368.85 m 224.05 368.85 l S 0.001 w 1 1 1 RG 20.58 w 226.3 368.85 m 567 368.85 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 346.02 m 224.05 346.02 l S 0.001 w 1 1 1 RG 20.58 w 226.3 346.02 m 567 346.02 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 323.19 m 224.05 323.19 l S 0.001 w 1 1 1 RG 20.58 w 226.3 323.19 m 567 323.19 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 300.36 m 224.05 300.36 l S 0.001 w 1 1 1 RG 20.58 w 226.3 300.36 m 567 300.36 l S 0.001 w 0.95294 0.95294 0.95294 RG 137.22 w 28.35 219.21 m 224.05 219.21 l S 0.001 w 1 1 1 RG 137.22 w 226.3 219.21 m 567 219.21 l S 0.001 w 0.95294 0.95294 0.95294 RG 38.16 w 28.35 129.27 m 224.05 129.27 l S 0.001 w 1 1 1 RG 38.16 w 226.3 129.27 m 567 129.27 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 149.47 m 569.2 149.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 380.26 m 569.2 380.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 357.43 m 569.2 357.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 334.6 m 569.2 334.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 311.77 m 569.2 311.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 288.94 m 569.2 288.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 149.47 m 569.2 149.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 109.06 m 569.2 109.06 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 381.34 m 27.22 107.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 225.17 381.34 m 225.17 107.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 568.12 381.34 m 568.12 107.99 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 31.2 364.08 Tm (Document Purpose)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 364.08 Tm (Inspection report)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 341.25 Tm (Author)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 341.25 Tm (Care Quality Commission)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 318.42 Tm (Audience)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 318.42 Tm (General public)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 295.59 Tm (Further copies from)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 295.59 Tm (0870 240 7535 \(telephone order line\))Tj ET /F2 12 Tf BT 1 0 0 1 31.2 272.76 Tm (Copyright)Tj ET /F2 12 Tf BT 1 0 0 1 229.15 272.76 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 258.18 Tm (This publication may be reproduced in whole or in part, )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 243.6 Tm (free of charge, in any format or medium provided that )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 229.02 Tm (it is not used for commercial gain. This consent is )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 214.44 Tm (subject to the material being reproduced accurately )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 199.86 Tm (and on proviso that it is not used in a derogatory )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 185.28 Tm (manner or misleading context. The material should be )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 170.7 Tm (acknowledged as CQC copyright, with the title and date )Tj ET /F2 12 Tf BT 1 0 0 1 229.15 156.12 Tm (of publication of the document specified.)Tj ET /F2 12 Tf BT 1 0 0 1 31.2 133.29 Tm (Internet address)Tj ET /F2 12 Tf 1 0 0 rg BT 1 0 0 1 229.15 133.29 Tm (www.cqc.org.uk)Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 15 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (4)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (38)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm 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646.82 m 567.85 646.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 623.99 m 567.85 623.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 601.16 m 567.85 601.16 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 28.99 669.65 m 567.85 669.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 646.82 m 567.85 646.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 623.99 m 567.85 623.99 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 601.16 m 567.85 601.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 578.33 m 567.85 578.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 786.71 m 30.07 577.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 269.07 786.71 m 269.07 577.26 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.77 786.71 m 566.77 577.26 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 (Ellerslie)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 (108 Albert Road )Tj ET /F2 12 Tf BT 1 0 0 1 273.05 729.04 Tm (Pittville)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 711.46 Tm (Cheltenham)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 693.88 Tm (Glos)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 676.3 Tm (GL52 3JB)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 653.47 Tm (Telephone number:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 653.47 Tm (01242514384)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 630.64 Tm (Fax number:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 630.64 Tm (01242255804)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 607.81 Tm (Email address:)Tj ET /F2 12 Tf BT 1 0 0 1 273.05 607.81 Tm (manager.ellerslie@osjctglos.co.uk)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 584.98 Tm (Provider web address:)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 566.03 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 111.9 w 32.32 499.76 m 564.77 499.76 l S 0.001 w 1 1 1 RG 20.58 w 355.5 546.54 m 565.9 546.54 l S 0.001 w 20.58 w 31.2 500.88 m 565.9 500.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 478.05 m 353.25 478.05 l S 0.001 w 1 1 1 RG 20.58 w 355.5 478.05 m 565.9 478.05 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 455.22 m 353.25 455.22 l S 0.001 w 1 1 1 RG 20.58 w 355.5 455.22 m 565.9 455.22 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 535.13 m 568.1 535.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 512.3 m 567.8 512.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 489.47 m 568.1 489.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 559.03 m 354.37 534.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 466.64 m 568.1 466.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 557.96 m 568.1 557.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 535.13 m 567.8 535.13 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 512.3 m 568.1 512.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 489.47 m 568.1 489.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 466.64 m 568.1 466.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 443.81 m 568.1 443.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 559.03 m 30.07 442.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 490.54 m 354.37 442.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 559.03 m 567.02 442.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 541.77 Tm (Name of registered provider\(s\):)Tj ET /F2 12 Tf BT 1 0 0 1 355.5 541.77 Tm (The Orders of St John Care Trust)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 518.94 Tm (Name of registered manager \(if applicable\))Tj ET /F2 12 Tf BT 1 0 0 1 34.05 496.11 Tm (Mrs )Tj ET /F2 12 Tf BT 1 0 0 1 59.76 496.11 Tm (Karen )Tj ET /F2 12 Tf BT 1 0 0 1 99.39 496.11 Tm (Cummings)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 473.28 Tm (Type of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 473.28 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 450.45 Tm (Number of places registered:)Tj ET /F2 12 Tf BT 1 0 0 1 358.35 450.45 Tm (31)Tj ET /F2 10 Tf BT 1 0 0 1 28.35 431.51 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 28.35 414.51 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 63.99 w 32.32 372.19 m 564.47 372.19 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 383.6 m 567.8 383.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 406.43 m 567.8 406.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 383.6 m 567.8 383.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 340.19 m 567.8 340.19 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 407.51 m 30.07 339.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 384.68 m 298.32 339.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 407.51 m 566.72 339.11 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 390.25 Tm (Conditions of registration:)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 367.42 Tm (Category\(ies\) :)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 367.42 Tm (Number of places \(if applicable\):)Tj ET /F2 12 Tf BT 1 0 0 1 302.3 346.84 Tm (Under 65)Tj ET /F2 12 Tf BT 1 0 0 1 435.37 346.84 Tm (Over 65)Tj ET 1 1 1 RG 35.16 w 31.2 318.11 m 297.3 318.11 l S 0.001 w 35.16 w 299.55 318.11 m 431.45 318.11 l S 0.001 w 35.16 w 433.7 318.11 m 565.6 318.11 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 287.99 m 565.6 287.99 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 299.41 m 567.8 299.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 336.82 m 567.8 336.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 299.41 m 567.8 299.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 276.58 m 567.8 276.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 337.89 m 30.07 275.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.42 337.89 m 298.42 298.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.57 337.89 m 432.57 298.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 337.89 m 566.72 275.5 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 320.63 Tm (old age, not falling within any other )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 306.05 Tm (category)Tj ET /F2 12 Tf BT 1 0 0 1 302.4 320.63 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 436.55 320.63 Tm (31)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 283.22 Tm (Additional conditions: )Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 261.79 m 315.25 261.79 l S 0.001 w 1 1 1 RG 20.58 w 317.5 261.79 m 346.55 261.79 l S 0.001 w 20.58 w 348.8 261.79 m 377.9 261.79 l S 0.001 w 20.58 w 380.15 261.79 m 409.2 261.79 l S 0.001 w 20.58 w 411.45 261.79 m 440.55 261.79 l S 0.001 w 20.58 w 442.8 261.79 m 471.9 261.79 l S 0.001 w 20.58 w 474.15 261.79 m 503.2 261.79 l S 0.001 w 20.58 w 505.45 261.79 m 534.55 261.79 l S 0.001 w 20.58 w 536.8 261.79 m 565.9 261.79 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 273.2 m 568.1 273.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 250.37 m 568.1 250.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 274.28 m 30.07 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 274.28 m 316.37 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 274.28 m 347.67 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 274.28 m 379.02 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 274.28 m 410.32 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 274.28 m 441.67 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 274.28 m 473.02 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 274.28 m 504.32 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 274.28 m 535.67 249.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 274.28 m 567.02 249.29 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 257.02 Tm (Date of last inspection)Tj ET /F2 12 Tf BT 1 0 0 1 328.2 257.02 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 359.53 257.02 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 390.86 257.02 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 422.18 257.02 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 453.53 257.02 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 484.86 257.02 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 516.18 257.02 Tm (0)Tj ET /F2 12 Tf BT 1 0 0 1 547.53 257.02 Tm (8)Tj ET 0.95294 0.95294 0.95294 RG 17 w 31.2 238.5 m 565.9 238.5 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 228.87 m 568.1 228.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 229.95 m 30.07 39.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 229.95 m 567.02 39.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 248.12 m 568.1 248.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 228.87 m 568.1 228.87 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 40.22 m 568.1 40.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 249.2 m 30.07 227.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 249.2 m 567.02 227.79 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 234.94 Tm (Brief description of the )Tj ET /F2 12 Tf BT 1 0 0 1 177.31 234.94 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 215.69 Tm (Ellerslie is a large three-storey building, which has been converted and extended to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 198.69 Tm (provide accommodation for up to 31 people who require nursing and personal care. It )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 181.69 Tm (is situated close to Cheltenham town centre, a short walk from Pittville Pump Rooms )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 164.69 Tm (and the racecourse. The Care Home is equipped with shaft lifts to assist those unable )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 147.69 Tm (to manage the stairs. In addition, a variety of aids and adaptations have been provided )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 130.69 Tm (throughout the property to help people who use the service. With the exception of two )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 113.69 Tm (spacious double rooms, all the bedrooms are for single occupation. Only two rooms )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 96.69 Tm (have en suite facilities but assisted bathrooms and toilets have been installed )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 79.69 Tm (throughout the property. The communal facilities consist of three well-appointed )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 62.69 Tm (lounges and a dining room. A Day Centre has been developed within the property; this )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 45.69 Tm (is in use 4 days a week but may also be used by people at weekends. The private )Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 17 0 obj <>stream 0 J 0.8 0.8 0.8 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 485.42 30.79 Tm (Page)Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 515.95 30.79 Tm (5)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 523.58 30.79 Tm ( of )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 541.88 30.79 Tm (38)Tj ET 0.8 0.8 0.8 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 804.03 m 565.9 804.03 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 794.4 m 568.1 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 795.48 m 30.07 655.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 795.48 m 567.02 655.08 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 28.99 656.15 m 568.1 656.15 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 (gardens are easily accessible and may be enjoyed by people in warm weather; they )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 766.47 Tm (are well protected from the busy main road by tall mature trees. Adequate parking is )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 749.47 Tm (provided for staff and visitors. The provider supplies information about the home, )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 732.47 Tm (including our most recent report in a file at the entrance of Ellerslie. The fee ranges for )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 715.47 Tm (this home are from 395 pounds to 816.14 pounds per week. Information about how )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 698.47 Tm (the home manages the Funded Nursing Care Contribution \(FNC\) is )Tj ET /F2 12 Tf BT 1 0 0 1 440.14 698.47 Tm (available.)Tj ET /F2 12 Tf BT 1 0 0 1 497.74 698.47 Tm ( )Tj ET /F2 12 Tf BT 1 0 0 1 33.25 681.47 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 33.25 664.47 Tm ()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 533/Matrix [1 0 0 1 0 0]>>stream xMo0>e񌿏 J8T@U,|ثd*Ҿy;`k|Lap$%=`9~#}o{re,?ϒfrvB5 )U=0Ģ9<Z׃c$u=>jaКݚӋfW6.[5 k8%J"6qIt5_{uaQdSQ'2dBl4BhSdUQ9:B=i{;F8({lvn06vʬ3ʆh3.;󁷵k-*3u7εK\c̪:Pk5{]Ћ[͊Ej˱[wrߍÛ1oƇ4onp5.{#%IU-_}].3ƅ5uX< SY]# b3M_ ~4-&G\Vi{ZLe> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 1 0 0 1 28.35 795.65 Tm (6XPPDU\\)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 774.7 Tm (This is an overview of what we found during the inspection.)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 754.22 m 381.05 754.22 l S 0.001 w 1 1 1 RG 20.58 w 383.3 754.22 m 566.2 754.22 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 765.64 m 568.4 765.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 742.81 m 568.4 742.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 766.71 m 30.07 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 382.17 766.71 m 382.17 741.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 766.71 m 567.32 741.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 34.05 749.45 Tm (The quality rating for this )Tj ET /F2 12 Tf BT 1 0 0 1 191.92 749.45 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 255.59 749.45 Tm ( is:)Tj ET /F2 12 Tf BT 1 0 0 1 398 749.45 Tm (one star adequate service)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 717.31 Tm (2XUMXGJHPHQWIRUHDFKRXWFRPH)Tj ET /F2 10 Tf BT 1 0 0 1 212.29 641.27 Tm (Choice of home)Tj ET /F2 10 Tf BT 1 0 0 1 164.41 601.02 Tm (Health and personal care)Tj ET /F2 10 Tf BT 1 0 0 1 145.18 560.77 Tm (Daily life and social activities)Tj ET /F2 10 Tf BT 1 0 0 1 157.95 520.52 Tm (Complaints and protection)Tj ET /F2 10 Tf BT 1 0 0 1 226.36 480.27 Tm (Environment)Tj ET /F2 10 Tf BT 1 0 0 1 251.17 440.02 Tm (Staffing)Tj ET /F2 10 Tf BT 1 0 0 1 127.47 399.77 Tm (Management and administration)Tj ET q 0.75227 0 0 0.75161 305.05 334.32 cm /Xf1 Do Q 1 1 1 RG 20.58 w 31.2 283.08 m 567.85 283.08 l S 0.001 w 206.51 w 32.32 167.28 m 566.72 167.28 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 271.66 m 567.85 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 271.66 m 568.92 271.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 62.9 m 568.92 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 272.74 m 31.2 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 272.74 m 567.85 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 278.3 Tm (How we did our inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 35.17 255.48 Tm (This inspection was carried out by two inspectors over a two day period in December )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 240.9 Tm (2009. One of the inspectors was a Pharmacist and his role was to look at the )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 226.32 Tm (arrangements the home has in place for the management of peoples medications.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 211.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 197.15 Tm (We received the homes Annual Quality Assurance Assessment \(AQAA\) on time and it )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 182.57 Tm (contained details about what the service feels they do well and areas they are looking )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 167.99 Tm (to improve. The AQAA also contained Dataset information which is numerical )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 153.41 Tm (information about the service. We looked at other information we have received from )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 138.84 Tm (or about the service from other stakeholders. This should include where the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 124.25 Tm (notifies us of any incidents that affects the well being of people who use the service. )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 109.68 Tm (We also sent surveys to the home for people who use the service, their )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 95.1 Tm (relative/carers/advocates and staff. We received 8 from people who use the service, 4 )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 80.51 Tm (from relatives/carers/advocates and 3 from staff. The feedback from these has been )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 65.93 Tm (used in the report. We spoke to people where able to gauge their views on the service )Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 595 842]>> endobj 23 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 119.64 w 32.32 752.71 m 566.72 752.71 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.12 813.65 m 568.92 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 691.76 m 568.92 691.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 814.73 m 31.2 690.69 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 814.73 m 567.85 690.69 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 32.92 802.72 Tm (provided. We also spoke to staff and observed interactions between them and people )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 788.14 Tm (who use the service. The outcome from this has also been used in the report.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 773.56 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 758.98 Tm (We looked at a number of systems the service has in place to include care records, )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 744.4 Tm (activities, medication, food provision, complaints, staff training and supervision.)Tj ET /F2 12 Tf BT 1 0 0 1 32.92 729.82 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 32.92 715.24 Tm (Prior to this key inspection we undertook a random inspection in September 2009 and )Tj ET /F2 12 Tf BT 1 0 0 1 32.92 700.66 Tm (the results of this have been used in this report.)Tj ET endstream endobj 24 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 25 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 20.58 w 31.2 786.36 m 567.85 786.36 l S 0.001 w 297.6 w 32.32 625.02 m 566.72 625.02 l S 0.001 w 20.58 w 32.7 463.68 m 569.35 463.68 l S 0.001 w 93.48 w 33.82 404.4 m 568.22 404.4 l S 0.001 w 20.58 w 33.45 345.12 m 570.1 345.12 l S 0.001 w 268.56 w 34.57 198.3 m 568.97 198.3 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.2 774.95 m 567.85 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 774.95 m 568.92 774.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.12 475.1 m 568.92 475.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 776.03 m 31.2 474.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.2 475.1 m 569.35 475.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 452.27 m 569.35 452.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 452.27 m 570.42 452.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.62 356.54 m 570.42 356.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 333.71 m 570.1 333.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 356.54 m 570.1 356.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 333.71 m 571.17 333.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 62.9 m 571.17 62.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.7 453.35 m 32.7 355.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 334.79 m 33.45 61.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.85 776.03 m 567.85 474.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 569.35 453.35 m 569.35 355.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 334.79 m 570.1 61.82 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 781.59 Tm (What the )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 90.52 781.59 Tm (care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 154.2 781.59 Tm ( does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 567.85 784.25 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.76 Tm (The home ensures that an assessment of needs is obtained prior to any new people )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.18 Tm (moving into the home to make sure the home can meet their needs.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 729.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 715.02 Tm (People are offered choices at each mealtime and they are also able to request )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 700.44 Tm (alternatives if they do not like the choices offered. People are offered a variety of food )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 685.86 Tm (and they are able to have input into the menus.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 671.28 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 656.7 Tm (The home's kitchen has been rated as 4 stars by the local Environmental Health )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 642.12 Tm (Department \(EHO\) which is excellent.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 627.54 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 612.96 Tm (The home has a designated member of staff to organise a range of activities. People )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 598.38 Tm (are provided with information each week about what activities are due to take place. A )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 583.8 Tm (range of photographs are on display showing people and staff taking part.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 569.22 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 554.64 Tm (The home exceeds the recommended 50 per cent of care staff with an NVQ 2 or above )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 540.06 Tm (in health and social care which is excellent.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 525.48 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 510.9 Tm (The feedback we received both at the inspection and from the surveys is that people )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 496.32 Tm (and their relatives/carers/advocates are happy with the standard of care the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 481.74 Tm (provides.)Tj ET /F2 10 Tf BT 1 0 0 1 568.97 623.47 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 461.57 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 32.7 458.91 Tm (What has improved since the last inspection?)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 569.35 462.13 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 402.85 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 436.08 Tm (The home has introduced a staff supervision system and they are on the way to )Tj ET /F2 12 Tf BT 1 0 0 1 36.67 421.5 Tm (meeting the recommended six sessions per year for care staff.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 406.92 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 392.34 Tm (Some improvements have been made with the medication systems used.)Tj ET /F2 12 Tf BT 1 0 0 1 36.67 377.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.67 363.18 Tm (The home continues to improve the environment.)Tj ET /F2 10 Tf BT 1 0 0 1 570.47 402.85 Tm ()Tj ET /F2 10 Tf BT 1 0 0 1 31.2 343.57 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 33.45 340.35 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 31.2 196.76 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 317.52 Tm (We raised concerns about the high levels of care and nursing needs that people have )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 302.94 Tm (and the staffing levels in place to meet these. The Registered Provider has put actions )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 288.36 Tm (in place to address this, however it is the responsibility of the Registered Person to )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 273.78 Tm (make sure the staffing numbers remain at an appropriate level to meet people's )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 259.2 Tm (assessed needs. The feedback we received from people who use the service, their )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 244.62 Tm (relatives/carers/advocates and staff is that more staff are needed.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 230.04 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 215.46 Tm (We found that some care plans are very personalised, contain people's choices and )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 200.88 Tm (clear instructions for staff to follow but this was not the case for the vast majority. This )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 186.3 Tm (is an area that the home is aware they need to improve on. The use of fluid, food, )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 171.72 Tm (personal care and turn charts needs to be reviewed as they are not always being )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 157.14 Tm (completed and it was difficult to assess because dates were not always clear. In )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 142.56 Tm (relation to the food and fluid charts evidence needs to be provided that a senior )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 127.98 Tm (member of staff is checking these and acting upon the information.)Tj ET /F2 12 Tf BT 1 0 0 1 37.42 113.4 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 37.42 98.82 Tm (Wound care documentation was not very clear. It was difficult to identify when people )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 84.24 Tm (required their dressing to be renewed and the instructions on the care plans were not )Tj ET /F2 12 Tf BT 1 0 0 1 37.42 69.66 Tm (being followed. Some people's wounds had healed but care plans had not been )Tj ET endstream endobj 26 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 27 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 515.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 533.49 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 75.9 w 34.57 774.58 m 568.97 774.58 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 32.37 813.65 m 571.17 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.37 735.5 m 571.17 735.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 33.45 814.73 m 33.45 734.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 570.1 814.73 m 570.1 734.43 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.17 802.72 Tm (updated to reflect this.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 788.14 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.17 773.56 Tm (Recruitment practices must improve to make sure all the required checks take place )Tj ET /F2 12 Tf BT 1 0 0 1 35.17 758.98 Tm (before a new member of staff commences employment at the home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.17 744.4 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 720.94 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 700.95 Tm (If you want to know what action the person responsible for this )Tj ET /F2 12 Tf BT 1 0 0 1 416.37 700.95 Tm (care home)Tj ET /F2 12 Tf BT 1 0 0 1 480.04 700.95 Tm ( is taking )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 683.45 Tm (following this report, you can contact them using the details on page 4.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 663.46 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 643.46 Tm (The report of this inspection is available from our website )Tj ET /F2 12 Tf BT 1 0 0 1 380.85 643.46 Tm (www.cqc.org.uk.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 623.46 Tm (You can get printed copies from )Tj ET /F2 12 Tf BT 1 0 0 1 225.22 623.46 Tm (enquiries@cqc.org.uk or by telephoning our)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 603.47 Tm (order line 0870 240 7535.)Tj ET endstream endobj 28 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 29 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 777.09 Tm (Details of our findings)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 26 w 31.2 744.15 m 565.9 744.15 l S 0.001 w /F1 12 Tf BT 1 0 0 1 34.05 741.14 Tm (&RQWHQWV)Tj ET 1 1 1 RG 16 w 28.35 700.15 m 566.93 700.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 696.09 Tm (Choice of home \(standards 1 - 6\))Tj ET 16 w 28.35 678.15 m 566.93 678.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 674.09 Tm (Health and personal care \(standards 7 - 11\))Tj ET 16 w 28.35 656.15 m 566.93 656.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 652.09 Tm (Daily life and social activities \(standards 12 - 15\))Tj ET 16 w 28.35 634.15 m 566.93 634.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 630.09 Tm (Complaints and protection \(standards 16 - 18\))Tj ET 16 w 28.35 612.15 m 566.93 612.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 608.09 Tm (Environment \(standards 19 - 26\))Tj ET 16 w 28.35 590.15 m 566.93 590.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 586.09 Tm (Staffing \(standards 27 - 30\))Tj ET 16 w 28.35 568.15 m 566.93 568.15 l S 0.001 w /F2 12 Tf BT 1 0 0 1 28.35 564.09 Tm (Management and administration \(standards 31 - 38\))Tj ET /F2 12 Tf BT 1 0 0 1 28.35 544.09 Tm (Outstanding statutory requirements)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 522.22 Tm (Requirements and recommendations from this inspection)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 33 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (11)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Choice of home )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 206.25 w 32.32 610.38 m 562.53 610.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 119 w 31.2 567.88 m 563.65 567.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 507.25 m 565.85 507.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 506.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 506.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People are confident that the care home can support them. This is because there is an )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (accurate assessment of their needs that they, or people close to them, have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (involved in. This tells the home all about them and the support they need. People who )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (stay at the home only for intermediate care, have a clear assessment that includes a )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (plan on what they hope for and want to achieve when they return home.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People can decide whether the care home can meet their support and accommodation )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (needs. This is because they, or people close to them, have been able to visit the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and have got full, clear, accurate and up to date information about the home. If they )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (decide to stay in the home they know about their rights and responsibilities because )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (there is an easy to understand contract or statement of terms and conditions between )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (them and the care home that includes how much they will pay and what the home )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 513.32 Tm (provides for the money.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 489 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 467 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 467 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 444.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 141.85 w 34.6 369.25 m 562.54 369.25 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 119.35 w 33.47 358 m 563.66 358 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 418.8 m 565.87 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 419.88 m 32.35 296.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 419.88 m 564.79 296.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 418.8 m 564.79 418.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 297.2 m 565.87 297.2 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 427.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 403.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 403.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 403.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 385.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.75 Tm (People are not admitted to the home without a detailed assessment of their needs. )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 341.25 Tm (However the needs of all people need to be taken into account when admitting a new )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 323.76 Tm (person into the home, to make sure the staffing arrangements can meet all people's )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 306.26 Tm (assessed needs.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 281.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.3 w 34.6 176.68 m 562.54 176.68 l S 0.001 w 1 1 1 RG 22.5 w 32.35 262.33 m 564.79 262.33 l S 0.001 w 167.93 w 33.47 164.87 m 563.66 164.87 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 249.96 m 565.87 249.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 251.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 251.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 249.96 m 564.79 249.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 259.02 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 234.27 Tm (The pre admission assessment of a person who was recently admitted to the home )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.78 Tm (was examined. The Registered Manager had undertook this assessment prior to this )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 199.28 Tm (person moving into the home. The pre admission assessment contained detailed )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.79 Tm (information about this person's care needs and a list of their medications. However it )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 164.29 Tm (was not recorded that this person is a diabetic and requires insulin and tablets. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.79 Tm (list of medications contained details about this. The Registered Manager said she was )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 129.3 Tm (not informed about this person being a diabetic until she was leaving the hospital and )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.8 Tm (had recorded it on another piece of paper.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 94.31 Tm ()Tj ET endstream endobj 35 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 36 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (12)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 231.32 w 34.6 695.74 m 562.54 695.74 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 209.95 w 33.47 683.93 m 563.66 683.93 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 576.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 576.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 577.83 m 565.87 577.83 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (At this inspection we were concerned about the dependency levels of people who use )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (the service and the staffing ratio to meet peoples needs. We received the homes' )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (Annual Quality Assurance Assessment \(AQAA\) prior to this inspection and it was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (completed in October 2009. In this it listed that 23 of the 27 people in the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (required 2 members of care staff to meet their personal care needs.)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 (This person was admitted to the home with nursing care needs in November 2009 )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (whilst the care needs of people already living at the home were very high. As )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (previously mentioned we raised concerns about the staffing levels and this is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (discussed further in the Health and Personal Care and Staffing outcome groups.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (Intermediate care is not provided at Ellerslie.)Tj ET endstream endobj 37 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 38 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Health and personal care )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 172.25 w 32.32 627.38 m 562.53 627.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 102 w 31.2 663.63 m 563.65 663.63 l S 0.001 w 1 1 1 RG 68 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 611.5 m 565.85 611.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 541.25 m 565.85 541.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 540.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 540.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Peoples health, personal and social care needs are met. The home has a plan of care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (that the person, or someone close to them, has been involved in making. If they take )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (medicine, they manage it themselves if they can. If they cannot manage their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (medicine, the care home supports them with it, in a safe way. Peoples right to privacy )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (is respected and the support they get from staff is given in a way that maintains their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (dignity.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (If people are approaching the end of their life, the care home will respect their choices )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (and help them feel comfortable and secure. They, and people close to them, are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (reassured that their death will be handled with sensitivity, dignity and respect, and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (take account of their spiritual and cultural wishes. )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 523 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 501 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 501 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 478.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 264.32 w 34.6 342.01 m 562.54 342.01 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 241.82 w 33.47 330.77 m 563.66 330.77 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 452.8 m 565.87 452.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 453.88 m 32.35 207.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 453.88 m 564.79 207.65 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 31.27 208.73 m 565.87 208.73 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 461.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 437.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 437.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 437.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 419.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 392.75 Tm (People who use the service receive care based on their assessed care and nursing )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.25 Tm (needs. However care records do not always reflect this. Due to the high levels of care )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 357.76 Tm (needs care staff are not always available to meet people's needs in a timely manner or )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 340.26 Tm (make sure their privacy and dignity is always respected.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 322.77 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.62 305.27 Tm (Conclusion about medication:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 287.77 Tm (The inspection showed there were generally suitable arrangements in place for )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 270.28 Tm (managing medicines but despite this an unusually large number of medicine errors )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 252.78 Tm (continue to occur. It is essential that attention is continually given to make sure that )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 235.29 Tm (actions taken do in fact reduce the risk and numbers of errors when administering )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 217.79 Tm (medicines.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 193.04 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 100.83 w 34.6 132.44 m 562.54 132.44 l S 0.001 w 1 1 1 RG 22.5 w 32.35 173.86 m 564.79 173.86 l S 0.001 w 79.46 w 33.47 120.63 m 563.66 120.63 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 161.49 m 565.87 161.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 162.56 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 162.56 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 161.49 m 564.79 161.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 170.55 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 145.8 Tm (We undertook a case tracking exercise on two people and this involves examining care )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.31 Tm (records, speaking to the person if able and staff. We also followed up on two other )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 110.81 Tm (people's care records that were examined in detail at a random inspection in )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.31 Tm (September 2009. A number of other people's care plans were examined at this key )Tj ET endstream endobj 39 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 40 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (14)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (inspection. We found that care plans are in place for all people's assessed needs, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (however the contents were variable depending on which member of staff had written )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (it. Some care plans were very detailed and personalised and linked to other care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (plans. Others were more task orientated and at times contradicted instructions written )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (in other care plans. The terminology in some care plans also needs to be reviewed for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (example "functions of mattress should be checked at all time" and the word 'regular' is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (used for toileting of people and in relation to providing people with fluids. More specific )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (details are needed based on people's assessed needs and their choices. We also found )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (that some care plans were illegible and these must be re-written. At the present time )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (the home is relying on a large number of agency qualified staff as they have been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (unable to recruit suitably qualified and experienced nurses to work at the home. This )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (makes care planning and reviews difficult as these nurses are not able to update or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (write care plans as they do not know the people who use the service well enough. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (However if some of the care plans do not contain enough detailed information for the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (agency staff to follow then it makes it difficult when they come to care for people as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (they have to rely solely on handovers from other staff.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (For some people we found care plans were in place where they didn't have an )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (assessed need. We were told that this is a direction from the Registered Provider, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (however this takes away valuable time when staff could be reviewing and updating )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (other more important care plans. We also found that in the case of two people they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (had two care plans in place for one assessed need.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (Risk assessments were in place for falls, pressure areas, nutrition and moving and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (handling. A new fire assessment for each person is going to be introduced shortly. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (found that people had assessments in place for pain but for one person who was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (receiving frequent pain relief medication this had not been reviewed since August )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (2009.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (People who were assessed as being nutritionally at risk had evidence of weekly or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (monthly monitoring of their weights dependent on their assessment and any weight )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (loss. We found that a number of people have been prescribed supplements by their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (GP. One person was prescribed a 2 week trial of supplements in October 2009 but no )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (update for this had been documented in their care plan.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (We looked at the wound care records of three people who have developed pressure )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (sores. A care plan and wound assessment sheet was in place. However it was difficult )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (in all three cases to work out when the next dressing changes were due. The recorded )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (dates of changes of dressing did not follow the instructions on people's care plans and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (we were told for one person their pressure sore had healed and a dressing was applied )Tj ET endstream endobj 41 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 42 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (for protection, but this was not documented in their care plan.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (We found that a large number of people had the same instructions in place for the use )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (of perscribed creams to prevent sore skin. The instruction stated that the cream that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (had been prescribed needed to be applied at least twice a day or after every )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (incontinence pad change. This is not personalised care and the creams should only be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (used if there is a clinical need.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (We found that on the whole the vast majority of care plans and risk assessments we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (examined except for the one mentioned in relation to pain were reviewed monthly or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (sooner if required.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (We examined a number of charts in people's room and these included food and fluid, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (turning and personal care records. We found that in the case of the food and fluid )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (charts and personal care records they were not always completed. These charts were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (also confusing to read as staff had not always added the date. We found with the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (turning charts that the majority of people were being turned as per their care plans )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (but again at times these were confusing as staff had not always documented the date. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (We could also not find any evidence that these charts are checked by a senior )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (member of staff or the qualified nurses, especially in relation to the food and fluid )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (intake of people. The records indicated that one person was fed whilst they were on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (their left side and this is not good practice. If people are assessed as needing these )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (charts then they must be completed.)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 (As previously mentioned the homes AQAA stated that 23 of the 27 people in the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (need two members of care staff to meet their personal care needs. On the first day of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (the inspection we expressed our concerns about the high number of people who )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (require two members of care staff to meet their needs. There was no supervision of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (the communal areas during the morning and two people who have pressure mats in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (place were not positioned on these, therefore if they had tried to mobilise then the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (care staff would not be aware of this. We observed one person shouting in a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (distressed state in one of the corridors as no care staff were available. A member of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (the care staff did come to their assistance but they were also attending to another )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (person.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (We observed care staff speaking to people in a respectful manner but as they were )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (very busy we did observe that in one person's room their night clothing and a bed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (sheet were left in a heap on their armchair. We also observed another person waiting )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (for a member of staff to help them get dressed at lunchtime on the first day of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (inspection and their breakfast tray was left in their room. We received the following )Tj ET endstream endobj 43 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 44 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (comment from a relative in the surveys we sent to them via the home, "More care is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (needed with the choice of garments when dressing the residents as randomly chosen )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (giving resdients an uncared for appearance. More notice should be given to hair and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (nails, this is about giving residents some dignity despite their disabilities".)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 (People we spoke with during the inspection were happy with the care they receive. In )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (the surveys we sent to people who use the service we asked them, do you receive the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (care and support you need, 3 people said 'always' 3 people said 'usually' and 1 person )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (said 'sometimes'.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (We also received the following comments from people who use the service; " The staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (are all very good and do an excellent job, we get on very well with all of them" and "It )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (would be appreciated if the staff could occasionally clean people's spectacles they are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (often smudged and difficult to see through".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (We asked relatives/carers/advocates in the surveys we sent them do you feel the care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (service meets the needs of your friend/relative who gave you this form, 2 people said )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm ('always' and 2 people said 'usually'. We received the following comments; "A small )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (friendly home which tries its best for the residents, all staff introduce themselves and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (are approachable" and "More staff are needed so that they could respond quicker to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (residents needs and also have time to talk to them. More staff would also enable them )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (to make sure all residents drink regularly as quite often drinks are left as no one to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (help".)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 (We saw evidence in people's care records that they have access to external health and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (social care professionals. Records are maintained of any visits. People who use the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (service confirmed they have access to external health and social care professionals )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (verbally and in the surveys we sent them.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (Pharmacist inspector's report about arrangements for the handling of medicines that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (were inspected on 02 December 2009 as part of the key inspection.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (As part of this key inspection, one of our \(the Care Quality Commission\) pharmacist )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (inspectors looked at some of the arrangements for the management of medicines. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (This included looking at some stocks and storage arrangements for medicines and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (various records about medication. We saw how staff administered some medicines to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (people living in the home. The pharmacist spoke to the registered manager, deputy )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (manager, two nurses and visited some bedrooms and communal areas of the home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (We gave full feedback after the inspection to the registered manager and area )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (operations manager. This part of the inspection took place over a seven hour period )Tj ET endstream endobj 45 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 46 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (17)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (on a Wednesday.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (The registered manager has taken action to meet the statutory requirements relating )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (to the arrangements for handling medicines included in the report following the last )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (key inspection in December 2008. For example there were new records in place about )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (using creams and ointments for people living here. We pointed out some examples )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (where the directions could be clearer or less ambiguous. We also found that where )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (medicines were prescribed to use 'as required' there were written protocols to give )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (guidance to staff about how or when to use such medicines to meet that person's )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (needs. The registered manager explained to us about problems when the medicine )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (directions change each month when new supplies arrived. We pointed out examples )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (where the directions stated 'as required' but the medicines \(including a number of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (sleeping tablets\) were given regularly but there was no protocol giving guidance about )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (use. Staff told us that these were all intended for regular use and that the directions )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (had changed with a recent delivery. We strongly recommend that the registered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (manager takes more control of the reordering of medicines each month by sending the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (medicine requests directly to the surgery and then checking the prescriptions before )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (sending these to the pharmacy. In this way any discrepancies can be taken up directly )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (with the surgery to make really sure the medicine directions are up to date.)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 (Registered nurses administered most medicines \(except for certain moisturising and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (barrier skin products that carers applied\). The home has a system to check the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (competence with medicines of their own permanent nurses. We were also told that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (Trust are changing to a computer based medicine training programme but no nurse )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (we spoke to had yet completed it. This may only fulfil some training needs as such a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (programme will lack the one to one support provided by an experienced tutor. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (Because the registered manager is unable to recruit suitably qualified nurses to work )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (permanently in the home they rely heavily on different agency nurses who therefore )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (do not go through this training and assessment process. The lack of permanent nurses )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (means continuity is lacking and is possibly some of the reason for the number of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (medicine errors reported.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (At the time of the inspection no person living in the home was assessed as able to self )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (administer and look after their medicines. The medicine policy indicated this could )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (happen if a risk assessment showed this would be safe for everyone in the home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (People living in the home were therefore totally dependent on the staff for this part of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (their care. The deputy manager told us there were no cultural, equality or diversity )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (issues related to medicines for anyone living in the home at the moment. During the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (inspection we saw staff administering medicines to some people in the home following )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (safe procedures. We were concerned that the nurse finished administering some )Tj ET endstream endobj 47 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 48 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (18)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (medicines due at 8am by 12.30pm. We were aware that the inspection may cause )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (some delay and that due to illness there was one carer short. Even so this was very )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (late to complete giving these medicines. The registered manager told us that normally )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (this task would be finished by 10.30am and we have seen this at previous inspections. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (Some people needed a lot of support to take their medicines and we saw that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (nurse provided this. By far the greatest number of medicines were given in the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (morning so this was a lot of work for just the one nurse to carry out as well as all the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (other duties they may have to do. We saw that at 1pm another nurse began to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (administer the medicines due at lunch time. The nurses we spoke to were aware to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (make sure that there was a suitable interval between medicine doses and we saw that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (the medicines being given at lunchtime had either previously been given early that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (morning around 7am or there was only one dose a day so there was not a risk to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (people in the home.)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 (There were arrangements for keeping records about medicines received, administered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (and leaving the home or disposed of \(as no longer needed\) for each person. Accurate, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (clear and complete records about medicines are very important in a care home to help )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (reduce risks from mistakes with medicines as during any week a number of different )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (staff will be involved in handling these. Records also make sure there is a full account )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (of the medicines the home is responsible for on behalf of the people living here. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (commented that the way the dates were indicated on the medicine charts may not be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (very clear about the actual date and was not how we would normally see the date )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (printed. We also noted that extra important directions \(take one hour before food for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (example\) were not included on the charts. This was on the labels on the medicine )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (packs but the medicine chart is more obvious and where we generally see these )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (directions. Many medicines were also packed in special bubble packs intended to help )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (see what medicine was due on what day and time. We noted that the days were not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (clearly indicated on these packs \(Monday, Tuesday for example\) as we generally see )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (with this type of system. We pointed out that these types of issues could be confusing )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (to nurses \(particularly if they are not regularly working in the home\) and should be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (discussed with the supplying pharmacy to seek improvements.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (The sample of medicine records we looked at generally appeared to be order so that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (there were clear records about the medicines people living here need and had taken. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (We pointed out three gaps on the administration records we looked at. In one case )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (another record indicated that the dose had in fact been taken. We could not find out )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (for the other two what had happened. The deputy manager described the action taken )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (if they find a gap in a medicine record to try and make sure person involved does not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (suffer harm.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm ()Tj ET endstream endobj 49 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 50 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (19)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (We saw that directions for giving two medicines for one person were to put on the top )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (of the food. There was a care plan in place about this but the registered manager )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (needs to arrange to write a proper best interests plan about this including significant )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (people involved in this person's care. We also discussed the arrangements for giving )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (medicines to another person on the food. The nurse was not able to find anything )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (about this in the care plan during the inspection but was sure that this had been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (included in the care plans. In both these cases the registered manager must be able )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (to demonstrate that the provisions of the Mental Capacity Act 2005 have been fully )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (taken into account.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (The registered manager must make sure that some records about the administration )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (of prescribed feeds are improved. There were arrangements for recording this sort of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (care but we found some records were incomplete or inaccurate. This meant that it was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (not always possible to know if people have received the correct nutrition and so could )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (be a risk to their health.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (Since March 2009 the registered manager has regularly notified us of a higher number )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (of medicine errors than we would expect. It is good that there is an open culture )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (about reporting these so that lessons can be learnt as a result. By highlighting this we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (do not want to discourage reporting as this could be more of a risk to people living )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (here. We are also aware that perhaps other homes may not be so diligent about )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (reporting but from our experience we are concerned about the number of reports we )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (receive. The registered manager told us about actions taken and changes put in place )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (as a result of investigations into the reasons for these. There are also monthly audit )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (checks of some of the arrangements for handling medicines which have helped )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (identify that errors have happened but are not be suitable in most cases to pick up )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (unintended omissions of medicine doses. The registered manager and deputy manager )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (have clearly worked hard to put in place all the standard arrangements we would )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (expect to see for the safe handling of medicines and we found this to be the case at )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (this inspection. It is essential that the medicine arrangements are safe and do in fact )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (reduce the risk and occurrence of errors to an absolute minimum. In view of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (number of errors the registered manager needs to consider other issues such as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (looking critically at the medicine policy and procedures to be sure that staff do )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (understand and follow these properly. A review of the policy may also be needed )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (specifically to see if any changes are necessary to promote safer systems and if the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (appropriate checks and audits are made at the right time. Other questions to consider )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (are issues such as is the medicine training and assessment of competence sufficient )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (and suitable? Are all nurses actually competent with handling medicines? Are there too )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (many distractions for nurses when administering medicines? Are there always enough )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (nurses and other staff on duty to allow the nurse to give the necessary time and )Tj ET endstream endobj 51 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 52 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (20)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 668.72 w 34.6 477.04 m 562.54 477.04 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 647.35 w 33.47 465.23 m 563.66 465.23 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 139.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 139.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 140.43 m 565.87 140.43 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (attention to this important task? What is the impact of having to rely on so many )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (different agency nurses to cover the shifts? Are the medicine records clear for all staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (as often the errors seem to be in part the result of failure to read or understand the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (records properly?)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 (There were suitable arrangements to store medicines safely and at the right )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (temperature. Sample checks showed that the medicines needed were all available. An )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (insulin syringe that was in use was wrongly stored in the fridge despite the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (manufacturer labelling this as not to be kept in fridge when in use. The syringe that is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (in use must be identified with the person's name and the date taken out of fridge to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (make sure this is used within the right period to be sure of the right potency of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (insulin. The registered manager must make sure that arrangements are in place to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (store all medicines correctly in accordance with the manufacturers' directions.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (We found that attention was needed to repair one of the fixing bolts on one medicine )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (cupboard. We had pointed this out at the last inspection and were told this would be )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (dealt with so we were disappointed to still find this. The registered manager must )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (make sure that the work is completed so that medicines are stored safely and in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (accordance with the law. The lead inspector reported that this was repaired on the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (following day. We otherwise found there were suitable arrangements in place for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (handling controlled drugs. We looked in the latest record book. We found that regular )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (checks of these medicines were recorded and audits we made on a sample of records )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (appeared to be in order. We pointed out to the deputy manager that they needed to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (note in the old record book what stock balance of medicines was transferred to the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (new book as the records here appeared to show some medicines were missing.)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 (Nurses were taking regular blood tests from the finger tip for one person so as to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (measure a blood glucose level. It is not good practice to use just the lancet that they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (were using. When staff take blood the lancing device used must be safe to use in a )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (care home environment as described in Medical Device Alert MDA.2006.066 issued by )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (MHRA in December 2006. This is to reduce the risk to people living in the home and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (staff of cross infection linked with the use of the wrong sort of lancing device. There )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (was a care plan written for this person's condition. We advised the nurses to also )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (include the ideal range of blood glucose levels for this person.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (The Trust's standard medicine policy and procedures were available so that all staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (should be aware of how the Trust expected medicines to be handled in a safe way. )Tj ET endstream endobj 53 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 54 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (21)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Daily life and social activities )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 138.25 w 32.32 644.38 m 562.53 644.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 119 w 31.2 655.13 m 563.65 655.13 l S 0.001 w 1 1 1 RG 17 w 31.2 584.88 m 563.65 584.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 594.5 m 565.85 594.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 575.25 m 565.85 575.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 574.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 574.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (Each person is treated as an individual and the care home is responsive to his or her )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (race, culture, religion, age, disability, gender and sexual orientation. They are part of )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (their local community. The care home supports people to follow personal interests and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (activities. People are able to keep in touch with family, friends and representatives. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (They are as independent as they can be, lead their chosen lifestyle and have the )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 617.57 Tm (opportunity to make the most of their abilities. People have nutritious and attractive )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 600.57 Tm (meals and snacks, at a time and place to suit them.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 557 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 535 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 535 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 512.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 141.85 w 34.6 437.25 m 562.54 437.25 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 119.35 w 33.47 426 m 563.66 426 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 486.8 m 565.87 486.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 487.88 m 32.35 364.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 487.88 m 564.79 364.12 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 31.27 365.2 m 565.87 365.2 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 0.75294 0.75294 0.75294 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 have access to an activities programme based on their preferences and abilities )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 409.25 Tm (and people are able to make decisions about their daily lives. Menu choices are )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 391.76 Tm (available and people are offered a variety of foods, however at times people may have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 374.26 Tm (to wait to receive their meals due to the staffing levels.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 349.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 257.3 w 34.6 210.68 m 562.54 210.68 l S 0.001 w 1 1 1 RG 22.5 w 32.35 330.33 m 564.79 330.33 l S 0.001 w 235.93 w 33.47 198.87 m 563.66 198.87 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 317.96 m 565.87 317.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 319.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 319.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 317.96 m 564.79 317.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 327.02 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 302.27 Tm (The home has a member of staff designated to provide activities for people who use )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 284.78 Tm (the service. In the corridor by the main entrance is a number of photographs of people )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 267.28 Tm (and staff taking part in activities. Also on display is a poster advertising the weeks )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 249.79 Tm (activities, minutes of the last residents meeting and a copy of the homes newsletters. )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 232.29 Tm (The activities coordinator said she is able to provide one to one and group activities. )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 214.79 Tm (On the second day of the inspection a coffee morning was taking place. People spoken )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 197.3 Tm (with said they are able to choose if they take part in activities as some people said )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 179.8 Tm (they prefer to make their own farrangements but know they can join if they change )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 162.31 Tm (their mind. The home has planned a number of activities to celebrate Christmas. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 144.81 Tm (arrangements the home has in place to meet people's spiritualist needs were not )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 127.31 Tm (examined at this inspection.)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 asked people who use the service in the surveys we sent them does the home )Tj ET endstream endobj 56 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 57 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (22)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (arrange activities that you can take part in if you want, 2 people said 'always', 3 )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (people said 'usually', 1 person said 'sometimes', 1 person said 'don't know' and 1 )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (person had not answered the question.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (We received the following comments from relatives, "The activities coordinator works )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (hard to organise activities that are appropriate" and "Recently there has been more )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (effort put into special events and entertainment, with relatives invited to attend most )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (of them and be more involved".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (Visiting to the home is not restricted and this was confirmed by the Registered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (Manager. One relative had commented in their survey that "It can take a long time for )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (a member of staff to respond to the doorbell. Since the appointment of the new )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (manager and activities coordinator visitors are made more welcome and often offered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (tea or coffee which is nice".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (During the tour of the home we saw that people are able to have their personal )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (belongings on display in their bedrooms. A number of people had pictures and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (photographs of family and friends on display. We asked people we spoke with are they )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (able to make choices about their ldaily life and people said yes. We observed staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (offering people choices of drinks, snacks and if they wish to take part in activities. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (People also confirmed they can choose where they have their meals.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (We asked people in the surveys we sent them do the staff listen to you and act on )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (what you say, 2 people said 'always', 4 people said 'usually' and 2 people said )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm ('sometimes'.)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 (We spoke with the cook about how menus are devised and they said people's choices )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (are included. The homes AQAA states that changes have been made to the menus )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (based on people's preferences. The AQAA also states that people are visually offered )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (choices at meal times and the cook also confirmed this. We did not witness this taking )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (place during the inspection during the lunchtime meal we observed. The cook said )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (they are aware which people require a special or therapeutic diet and they also know )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (people's likes and dislikes.)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 saw records to prove health and safety checks are taking place. The cook was not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (able to find records relating to the evening meal where sandwich filings are recorded. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (A Menu board is on display in the dining room listing the meal choices for the day. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (cook also said that alternatives are also provided as one person had soup which was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (not on the menu. For people who require soft or liquidised meal each component of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (the meal is liquidised separately for presentation.)Tj ET endstream endobj 58 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 59 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (23)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 353.8 w 34.6 634.51 m 562.54 634.51 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 332.42 w 33.47 622.7 m 563.66 622.7 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 454.28 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 454.28 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 31.27 455.36 m 565.87 455.36 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (On the first day of the inspection the lunchtime meal was late being served and people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (in the dining room did not start eating their meals until 13.15 and we observed people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (finishing off their meals at 14.15. We were concerned about how long people had to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (wait for their meal and that they receive their evening meal around 17.00 -17.30. On )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (the second day of the inspection lunchtime was observed to be starting at 12.30pm in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (the dining room as additional care staff were on duty on this day. The AQAA stated )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (that 17 people required some form of assistance from care staff with eating and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (drinking and a number of people require assistance in their rooms. This is a high )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (number and the home must make sure that the staffing levels ensure people's needs )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (are met.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (The home has started to offer people home made milkshakes once a day to help with )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (their nutritional needs. The cook confirmed that people are offered home made cakes )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (with their afternoon hot drink and snacks are also offered in the morning and evening.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (One relative commented in a survey "The range of food on the menu has also )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (improved in the past year, as has the presentation of the dining room with table )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (clothes and flowers etc".)Tj ET endstream endobj 60 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 61 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (24)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Complaints and protection )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 87.25 w 32.32 669.88 m 562.53 669.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 68 w 31.2 680.63 m 563.65 680.63 l S 0.001 w 1 1 1 RG 17 w 31.2 635.88 m 563.65 635.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 645.5 m 565.85 645.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 626.25 m 565.85 626.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 625.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 625.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (If people have concerns with their care, they or people close to them know how to )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (complain. Any concern is looked into and action taken to put things right. The care )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (home safeguards people from abuse and neglect and takes action to follow up any )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (allegations.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (Peoples legal rights are protected, including being able to vote in elections.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 608 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 586 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 586 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 563.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 141.85 w 34.6 488.25 m 562.54 488.25 l S 0.001 w 1 1 1 RG 22.5 w 32.35 550.17 m 564.79 550.17 l S 0.001 w 119.35 w 33.47 477 m 563.66 477 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 537.8 m 565.87 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 538.88 m 32.35 415.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 538.88 m 564.79 415.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 537.8 m 564.79 537.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 416.2 m 565.87 416.2 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 546.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 522.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 522.12 Tm (good)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 292.92 522.12 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 who use the service are able to express their concerns and have access to an )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.25 Tm (effective complaints procedure. Systems are in place to protect people from possible )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 442.76 Tm (abuse. The home should look at ways of improving these and making sure people's )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 425.26 Tm (rights are protected.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 400.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 308.3 w 34.6 236.18 m 562.54 236.18 l S 0.001 w 1 1 1 RG 22.5 w 32.35 381.33 m 564.79 381.33 l S 0.001 w 286.93 w 33.47 224.37 m 563.66 224.37 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 368.96 m 565.87 368.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 370.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 370.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 368.96 m 564.79 368.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 378.02 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.27 Tm (The homes AQAA stated they have received 8 complaints in the last 12 months and 5 )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 335.78 Tm (of these have been upheld. The Registered Manager was able to provide records of all )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.28 Tm (the investigation findings and any correspondence. All complaints are audited by the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 300.79 Tm (Registered Provider. A copy of the homes complaints procedure is on display by the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.29 Tm (main entrance.)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 asked people who use the service in the surveys we sent them is there someone )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 230.8 Tm (you can speak to informally if you are not happy, 7 people said 'yes and 1 person did )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.31 Tm (not answer the question. We also asked do you know how to make a formal )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 195.81 Tm (complaint, 4 people said 'yes', 3 people said 'no' and 1 person did not answer the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.31 Tm (question. One person spoken with at the inspection said they have no complaints )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 160.82 Tm (about the service. One person commented in their survey " If I have any concerns I )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.32 Tm (can talk to the staff about them".)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 125.83 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.33 Tm (We asked relatives/carers/advocates in the surveys we sent them do you know how to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 90.83 Tm (make a complaint about the care provided by the care service if you need to, all 4 )Tj ET endstream endobj 62 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 63 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (25)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 546.25 w 34.6 538.28 m 562.54 538.28 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 524.88 w 33.47 526.47 m 563.66 526.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 261.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 261.83 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 31.27 262.9 m 565.87 262.9 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 (people said 'yes'. We also asked has the care service responded appropriately if you or )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (the person using the service raised any concerns, 2 people said 'always', 1 person said )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm ('usually and 1 person said 'sometimes'.)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 (Comments we received include "I do not feel inhibited in raising any concerns that I )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (may have from time to time" and "When I have raised any concerns these have been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (understood and addressed as much as possible. The general level of communication )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (has improved".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (All staff receive in house training in relation to abuse from a member of staff who is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (appropriately trained to provide this. They also use a DVD as part of this training. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (senior care leader who provides this training said they have plans for staff to attend )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (the 'Alerters' guide training by the local County Council. We would strongly )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (recommend that all staff attend this training. The Registered Manager has attend the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm ('Alerters' guide training and is planning to attend the 'Enhanced' training also provided )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (by the local County Council. She was able to discuss the actions she would take if an )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (allegation of abuse was made. The home has had one safeguarding referral made to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (the local Adult Protection Unit and this has been investigated.)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 has policies and procedures in place in relation to safeguarding people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (however the policy for managing challenging behaviour could not be found during the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (inspection. The home's AQAA confirmed they have a policy in place for this.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (We asked staff in the surveys we sent them, do you know what to do if someone has )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (concerns about the home, all three staff replied 'yes'.)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 Registered Manager has attend Mental Capacity Act and Deprivation of Liberty )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (training provided by the local County Council and we would strongly recommend that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (all care staff also attend this training.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm ()Tj ET endstream endobj 64 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 65 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (26)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Environment )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 34 w 31.2 697.63 m 563.65 697.63 l S 0.001 w 1 1 1 RG 68 w 31.2 644.38 m 563.65 644.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 679.5 m 565.85 679.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People stay in a safe and well-maintained home that is homely, clean, pleasant and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (hygienic. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 666.32 Tm (People stay in a home that has enough space and facilities for them to lead the life )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 649.32 Tm (they choose and to meet their needs. The home makes sure they have the right )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 632.32 Tm (specialist equipment that encourages and promotes their independence. Their room )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (feels like their own, it is comfortable and they feel safe when they use it.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 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 0.75294 0.75294 0.75294 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 433.12 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 0.75294 0.75294 0.75294 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 (Ellerslie is not a purpose built nursing home but people who use the service live in a )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm (safe and comfortable environment.)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 0.75294 0.75294 0.75294 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 (We toured parts of the environment and we viewed a number of room belonging to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 353.77 Tm (people who use the service with their consent.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.27 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.78 Tm (Ellerslie is not a purpose built nursing home however aids have been added to assist )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm (the care staff to care for people who use the service. These include assisted bathing )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (facilities, shaft lift and hoists.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm (The AQAA lists the improvements that have taken place since the last key inspection )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (and these are;)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm (Bedrooms are redecorated when they become vacant, Carpets in all communal )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm (corridors have been replaced as have 2 bedrooms and one lounge, New curtains in the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm (dining room, hall and windows on the stairs have been fitted, and lower ground floor )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm (corridor and dining room have all had improvements made to the lighting.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm (During the tour of the home we did not find any unpleasant odours which is excellent )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (and the standard of cleanliness was good. However in room 9 we found that the )Tj ET endstream endobj 66 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 67 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (27)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 371.29 w 34.6 625.76 m 562.54 625.76 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 349.92 w 33.47 613.95 m 563.66 613.95 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 436.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 436.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 437.86 m 565.87 437.86 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (wallpaper was looking tired and was marked in places and stains were visible on the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (carpet. The domestic explained to us that they are unable to remove these stains. The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (home should consider replacing this carpet but we aware this could prove difficult as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (this person spends all day in their bedroom due to their medical condition.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (We asked a number of people if they were warm enough and they all said yes. We )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (also asked if they were happy with their bedrooms and the cleanliness of their rooms )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (again all replied yes.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (We did not examine the laundry area in detail but the laundry assistant said they have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (a procedure in place for managing soiled linen. We observed staff wearing protective )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (clothing when required and tabards at mealtimes when serving and assisting people.)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 (We asked people in the surveys we sent them is the home fresh and clean, 5 people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (said 'always' and 3 people said 'usually. We received the following comments "The )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (home is clean and feels really homely" and "A nice extra would be room freshness in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (individual rooms and cleaning of rooms \(furniture polish\) could be better")Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (We also received the following comment from a relative in one of the surveys, "There )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (continues to be a problem with clothing going missing/going to the wrong person".)Tj ET endstream endobj 68 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 69 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (28)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Staffing )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 104.25 w 32.32 661.38 m 562.53 661.38 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 17 w 31.2 618.88 m 563.65 618.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.25 m 565.85 609.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 608.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 608.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have safe and appropriate support as there are enough competent staff on duty )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (at all times. They have confidence in the staff at the home because checks have been )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (done to make sure that they are suitable to care for them. Their needs are met and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (they are cared for by staff who get the relevant training and support from their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (managers.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (There are no additional outcomes.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 591 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 569 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 569 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 546.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 141.85 w 34.6 471.25 m 562.54 471.25 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 119.35 w 33.47 460 m 563.66 460 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 520.8 m 565.87 520.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 521.88 m 32.35 398.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 521.88 m 564.79 398.12 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 31.27 399.2 m 565.87 399.2 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 529.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 505.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 505.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 505.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 487.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 460.75 Tm (Staff in the home receive training to make sure they are skilled, however at times )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 443.25 Tm (they are not in sufficient numbers to support people who use the service. )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 425.76 Tm (Improvements are needed with the recruitment of new staff to make sure people are )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 408.26 Tm (not placed at unnecessary risk.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 383.52 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 291.3 w 34.6 227.68 m 562.54 227.68 l S 0.001 w 1 1 1 RG 22.5 w 32.35 364.33 m 564.79 364.33 l S 0.001 w 269.93 w 33.47 215.87 m 563.66 215.87 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 351.96 m 565.87 351.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 353.04 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 353.04 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 351.96 m 564.79 351.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 361.02 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 336.27 Tm (We discussed the staffing duty rotas with the Registered Manager and shared our )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 318.78 Tm (concerns about the care/nursing staffing levels on the first day of the inspection. As )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 301.28 Tm (mentioned in previous outcome groups we identified that there was no supervision of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 283.79 Tm (communal areas and in corridors where people stayed in their bedrooms. We )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 266.29 Tm (witnessed one person in the corridor who was very distressed trying to call for a )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 248.79 Tm (member of staff. Lunchtime was very late on the first day of the inspection as care )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 231.3 Tm (staff were very busy trying to meet people's needs and people were still receiving )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 213.8 Tm (personal care up to lunchtime. The Registered Provider increased the number of care )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 196.31 Tm (staff on duty the next day and put other actions in place to make sure people's needs )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 178.81 Tm (will be met in a timely manner. On the second day of the inspection with the increased )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 161.31 Tm (staffing number lunchtime started at 12.30 which is much improved.)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 143.82 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 36.57 126.32 Tm (The Registered Provider and Manager must maintain staffing levels that meet people's )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 108.83 Tm (needs and we will expect the higher staffing number to remain in place until the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 91.33 Tm (dependency levels of people have reduced.)Tj ET endstream endobj 70 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 71 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (29)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 728.25 w 34.6 447.28 m 562.54 447.28 l S 0.001 w 1 1 1 RG 22.5 w 32.35 802.41 m 564.79 802.41 l S 0.001 w 706.88 w 33.47 435.47 m 563.66 435.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 79.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 80.9 m 565.87 80.9 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (People spoken with at the inspection said the staff are very good and kind. Staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (spoken with said they enjoy working at the home but it is very busy. We asked people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (who use the service in the surveys we sent them, are the staff available when you )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (need them, 1 person said 'always', 5 people said 'usually' and 1 person said )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm ('sometimes'. Comments we received include "The staff do their best to make mum as )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (comfortable as possible" and "I am very satisfied with the standard of care".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (We received the following comments in the surveys completed by )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (relatives/carers/advocates, "For the most part, the staff are kindly and caring in their )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (dealings with the residents", "A small friendly home which tries its best for its )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (residents" and "Looking after patients well." "More staff are needed so that they could )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (respond quicker to residents needs and also have time to talk to them" and "More )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (staff on duty at all times as often there is no staff member visible when one is visiting, )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (the impression is that staff all take their breaks at the same time".)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (We asked the staff in the surveys we sent them, are there enough staff to meet the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (individual needs of all people who use the service, 2 staff said 'usually' and 1 said )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm ('never'. We received the following comments, "Everybody is trying to improve and do )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm (things better", "The home is relaxed and friendly warm environment for our residents )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (and the home is very sensitive to every each individual residents needs" and "We care )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (for all the residents and we are all well trained". The staff also said that the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (needs more staff so they can provide more one to one and quality time so that people )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (do not have to wait along time for staff to answer the bells. The home is having to use )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (agency staff to cover shifts and the AQAA stated that in the last 3 months they have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (used 90 nursing shifts and 85 care shifts. As mentioned the home is having difficulties )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (recruiting trained nurses.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (The number of care staff with an NVQ 2 or above in health and social care exceeds the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (recommended 50 percent, which is excellent.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (We examined the recruitment records of four staff who have started work at the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (since the last key inspection. All four staff had the required recruitment checks in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (place except two members of staff did not have a full employment history in place and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (they also had different employment dates on their application forms to what was )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (written on the references. The Registered Manager said she did follow up on one of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 149.24 Tm (these with the referee. The Care Home Regulations 2001 state that new staff must not )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 131.75 Tm (commence employment until two written references are received. One member of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 114.25 Tm (staff only had one written reference in place when they started work at the home. All )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 96.75 Tm (four staff did not commence employment until the home had received a full Criminal )Tj ET endstream endobj 72 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 73 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (30)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 651.23 w 34.6 485.79 m 562.54 485.79 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 629.86 w 33.47 473.98 m 563.66 473.98 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 156.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 156.85 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 31.27 157.93 m 565.87 157.93 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 799.09 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 779.1 Tm (Records Bureau Disclosure \(CRB\) which is good practice and the home had also )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm (applied for POVAfirst checks. Improvements are needed with the recruitment of new )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (staff to make sure people who use the service are safeguarded. Since the 12 October )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (2009 changes have been made to the pre employment checks as POVAfirst checks no )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (longer exist and the Registered Manager said she is aware of the Independent )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (Safeguarding Authority \(ISA\) and vetting and barring scheme. As no staff have been )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (appointed since this date no ISA Adult first checks have been requested.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (We examined the system the home has in place for induction of new staff. Each new )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (member of staff receives an induction booklet based on the Common Induction )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm (Standards. We saw evidence of staff completing this induction. The senior care leader )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (who is responsible for this training said that new staff are allocated an experienced )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (member of staff as their supervisor but no records are maintained of this. New staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm (are supernumerary for a number of shifts. The senior care leader said as part of the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (induction of new staff they receive training in a number of health and safety subjects )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (to include moving and handling and fire. We were not able to find evidence on the four )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (staff files we examined that they had undertaken this training. The senior care leader )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (assured us they had done this training but the records we were examined were not up )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (to date.)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 (We asked staff in the surveys we sent them did your induction cover everything you )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (needed to know to do the job when you started and all 3 staff said 'yes'.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (The senior care leader is also responsible for monitoring and keeping staff up to date )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (with training. She is a qualified train the trainer. A training matrix is in place and staff )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (now have an individual training record sheet. All the health and safety training is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (provided and this includes infection control, food hygiene and first aid. A number of )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (these subjects are completed in house with the exception of first aid. Staff have )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (access to DVD's and 'e-learning'. Other topics that staff have received training on is )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (dementia, nutrition and continence care. Some of these were with external trainers. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (The senior care leader said they have met with the local County Council re training )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (requirements and we encourage that staff attend any training sessions pertinent to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 219.23 Tm (the home and meeting people's needs.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 201.73 Tm (The feedback we received from staff is that training is provided and they feel they are )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (kept up to date with new ways of working.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 166.74 Tm (Qualified nurses have the opportunity to attend a development day each year.)Tj ET endstream endobj 74 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 75 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (31)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 1 1 1 RG 13.6 w 29.55 794.85 m 566.93 794.85 l S 0.001 w /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 785.57 Tm (Management and administration )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 10 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 29.55 766 Tm ()Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 747.89 Tm (These are the outcomes that people )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 250.51 747.89 Tm (staying in care homes)Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 383.43 747.89 Tm ( should experience. They )Tj ET 1 1 1 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 730.4 Tm (reflect the things that people have said are important to them:)Tj ET 1 1 1 RG 0.001 w 0 Tr /F6 5 Tf BT 1 0 0 1 28.35 717.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 189.25 w 32.32 618.88 m 562.53 618.88 l S 0.001 w 0.95294 0.95294 0.95294 RG 85 w 31.2 672.13 m 563.65 672.13 l S 0.001 w 1 1 1 RG 102 w 31.2 576.38 m 563.65 576.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 715.75 m 565.85 715.75 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 628.5 m 565.85 628.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 524.25 m 565.85 524.25 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 716.83 m 30.07 523.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.78 716.83 m 564.78 523.17 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 702.57 Tm (People have confidence in the care home because it is led and managed appropriately. )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 685.57 Tm (People control their own money and choose how they spend it. If they or someone )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 668.57 Tm (close to them cannot manage their money, it is managed by the care home in their )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 651.57 Tm (best interests. The environment is safe for people and staff because appropriate health )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 634.57 Tm (and safety practices are carried out.)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 615.32 Tm (People get the right support from the care home because the manager runs it )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 598.32 Tm (appropriately with an open approach that makes them feel valued and respected. The )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 581.32 Tm (people staying at the home are safeguarded because it follows clear financial and )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 564.32 Tm (accounting procedures, keeps records appropriately and ensures their staff understand )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 547.32 Tm (the way things should be done. They get the right care because the staff are )Tj ET /F2 12 Tf BT 1 0 0 1 35.5 530.32 Tm (supervised and supported by their managers.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 506 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 484 Tm (7KLVLVZKDWSHRSOHVWD\\LQJLQWKLVFDUHKRPHH[SHULHQFH)Tj ET /F1 12 Tf BT 1 0 0 1 369.04 484 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 28.35 461.94 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 124.35 w 34.6 395 m 562.54 395 l S 0.001 w 1 1 1 RG 22.5 w 32.35 448.17 m 564.79 448.17 l S 0.001 w 101.85 w 33.47 383.75 m 563.66 383.75 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 435.8 m 565.87 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 436.88 m 32.35 330.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 436.88 m 564.79 330.62 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 435.8 m 564.79 435.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 331.7 m 565.87 331.7 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 444.86 Tm (Judgement:)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 420.12 Tm (People using this service experience )Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 259.17 420.12 Tm (adequate)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 319.4 420.12 Tm (quality outcomes in this area. We have )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 402.62 Tm (made this judgement using a range of evidence, including a visit to this service.)Tj ET /F2 12 Tf BT 1 0 0 1 36.62 375.75 Tm (The management and administration of this home is based on openness and respect, )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 358.25 Tm (however some improvements to the service overall are required to make sure it is run )Tj ET /F2 12 Tf BT 1 0 0 1 36.62 340.76 Tm (in the best interests of the people who use the service.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 316.01 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 223.8 w 34.6 193.93 m 562.54 193.93 l S 0.001 w 1 1 1 RG 22.5 w 32.35 296.83 m 564.79 296.83 l S 0.001 w 202.43 w 33.47 182.12 m 563.66 182.12 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 284.45 m 565.87 284.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 285.53 m 32.35 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 285.53 m 564.79 78.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 284.45 m 564.79 284.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 79.78 m 565.87 79.78 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 35.5 293.52 Tm (Evidence:)Tj ET /F2 12 Tf BT 1 0 0 1 36.57 268.77 Tm (Since the last key inspection the Manager has been registered with us. She is a )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 251.27 Tm (qualified nurse who has a number of years experience caring for older people. The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 233.78 Tm (Registered Manager has undertaken a management course and attends training )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 216.28 Tm (relevant to her role. The home also has a deputy manager in post. We received )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 198.79 Tm (positive comments about the Registered Manager and deputy manager in the survey )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 181.29 Tm (we received. These included, "The management are efficient and helpful" and "The )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 163.79 Tm (deputy manager is particular efficient, friendly and very professional". We )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 146.3 Tm (acknowledge that the Registered Manager is working hard to make improvements to )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 128.8 Tm (the service but we are concerned about the high levels of care and nursing needs of )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 111.31 Tm (people who use the service and the staffing levels. It is the responsibility of the )Tj ET /F2 12 Tf BT 1 0 0 1 36.57 93.81 Tm (Registered Person's to maintain staffing levels that make sure people's needs are met )Tj ET endstream endobj 77 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 78 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 56.81 m 566.93 56.81 l S 0.001 w /F2 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 53.04 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 456.46 52.04 Tm ()Tj ET /F2 11 Tf BT 1 0 0 1 477.68 53.04 Tm (Page )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 53.04 Tm (32)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 53.04 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 53.04 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F5 10 Tf BT 1 0 0 1 28.35 37.61 Tm ()Tj ET 0.99608 0.9451 0.76078 RG 633.73 w 34.6 494.54 m 562.54 494.54 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 612.36 w 33.47 482.73 m 563.66 482.73 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 31.27 790.03 m 565.87 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 791.11 m 32.35 174.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 564.79 791.11 m 564.79 174.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 32.35 790.03 m 564.79 790.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 31.27 175.42 m 565.87 175.42 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 (and that people are supervised whilst in the communal areas and their own rooms.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 761.6 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 744.11 Tm (We received the home's Annual Quality Assurance Assessment \(AQAA\) on time. It )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 726.61 Tm (contained details about what the service does well and the areas the home is looking )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 709.11 Tm (to improve. It also contained Dataset information which is numerical details about the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 691.62 Tm (service. The Registered Provider has a comprehensive quality assurance system in )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 674.12 Tm (place and we were shown evidence of internal audits done by the staff in the home )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 656.63 Tm (and ones by a representative from the Registered Provider. Regulation 26 visits take )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 639.13 Tm (place and we saw records of these. We saw minutes of residents and relatives )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 621.63 Tm (meetings and a list of staff meetings.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 604.14 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 586.64 Tm (The home has a safe system in place for the management of people's monies and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 569.15 Tm (valuables.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 551.65 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 534.15 Tm (We looked at the system the home has in place for staff supervision. All staff receive )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 516.66 Tm (supervision and from the randomly selected care staff records the home is on target to )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 499.16 Tm (meet the recommended six sessions per year. We asked staff in the surveys we sent )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 481.67 Tm (to the home does your manager give you enough support and meet you to discuss )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 464.17 Tm (how you are working, 2 staff said 'regularly' and 1 said 'sometimes'.)Tj ET /F2 12 Tf BT 1 0 0 1 34.32 446.67 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 34.32 429.18 Tm (The Registered Provider has a health and safety policy in place. Health and safety )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 411.68 Tm (training is discussed in the Staffing outcome group. The AQAA contained information )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 394.19 Tm (about servicing of services and some larger items of equipment. We saw records that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 376.69 Tm (water checks are undertaken to minimise the risks of Legionella and monthly hot )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 359.19 Tm (water temperature checks to make sure it is within safe limits. A fire risk assessment )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 341.7 Tm (is in place and an evacuation procedure but this was not examined at this inspection. )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 324.2 Tm (We saw evidence that fire drills and checks are undertaken. We were told that the )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 306.71 Tm (care staff check wheelchairs to make sure they are safe to use. We recommend that )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 289.21 Tm (checks on window restrictors are undertaken to make sure they are still safe. A )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 271.71 Tm (number of people have bed rails in place and we saw evidence of an assessment and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 254.22 Tm (consent, however we recommend that the home checks on the Health and Safety )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 236.72 Tm (Executive website that they are meeting the required Regulations.)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 Environmental Health Department \(EHO\) visited the home in January 2009 and )Tj ET /F2 12 Tf BT 1 0 0 1 34.32 184.23 Tm (rated the kitchen 4 stars which is excellent.)Tj ET endstream endobj 79 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 81 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (33)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.99216 0.9451 0.76078 RG 36.25 w 29.47 793.28 m 564.97 793.28 l S 0.001 w 0.95294 0.95294 0.95294 RG 17 w 28.35 804.03 m 566.1 804.03 l S 0.001 w 17 w 28.35 784.78 m 422.1 784.78 l S 0.001 w 17 w 424.35 784.78 m 467.1 784.78 l S 0.001 w 1 1 1 RG 17 w 469.35 784.78 m 494.1 784.78 l S 0.001 w 0.95294 0.95294 0.95294 RG 17 w 496.35 784.78 m 539.1 784.78 l S 0.001 w 1 1 1 RG 17 w 541.35 784.78 m 566.1 784.78 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 794.4 m 568.3 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 813.65 m 568.3 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 794.4 m 568.3 794.4 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 775.15 m 568.3 775.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 814.73 m 27.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 423.22 795.48 m 423.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 468.22 795.48 m 468.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 495.22 795.48 m 495.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 540.22 795.48 m 540.22 774.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 814.73 m 567.22 774.08 l S 0.001 w [] 0 d /F2 12 Tf BT 1 0 0 1 33.75 800.47 Tm (Are there any outstanding requirements from the last inspection?)Tj ET /F2 12 Tf BT 1 0 0 1 429.75 781.22 Tm (Yes)Tj ET /F7 12 Tf BT 1 0 0 1 476.37 783.16 Tm (5)Tj ET /F2 12 Tf BT 1 0 0 1 501.75 781.22 Tm (No)Tj ET /F7 12 Tf BT 1 0 0 1 546.75 783.16 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 517.89 w 32.32 458.46 m 564.97 458.46 l S 0.001 w 1 1 1 RG 213.12 w 31.2 507.99 m 91.05 507.99 l S 0.001 w 213.12 w 93.3 507.99 m 197.4 507.99 l S 0.001 w 213.12 w 199.65 507.99 m 289.45 507.99 l S 0.001 w 213.12 w 291.7 507.99 m 473.8 507.99 l S 0.001 w 213.12 w 476.05 507.99 m 566.1 507.99 l S 0.001 w 198.54 w 31.2 299.91 m 91.05 299.91 l S 0.001 w 198.54 w 93.3 299.91 m 197.4 299.91 l S 0.001 w 198.54 w 199.65 299.91 m 289.45 299.91 l S 0.001 w 198.54 w 291.7 299.91 m 473.8 299.91 l S 0.001 w 198.54 w 476.05 299.91 m 566.1 299.91 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 400.3 m 568.3 400.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 616.75 m 30.07 198.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 616.75 m 567.22 198.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 648.22 m 568.4 648.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 615.67 m 568.3 615.67 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 616.75 m 92.17 198.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 616.75 m 198.52 198.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 616.75 m 290.57 198.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 616.75 m 474.92 198.44 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 28.99 400.3 m 568.3 400.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 199.51 m 568.3 199.51 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 0.75294 0.75294 0.75294 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 (1)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 599.49 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 599.49 Tm (15)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 599.49 Tm (The registered persons must )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 584.91 Tm (make sure that peoples care )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 570.33 Tm (plans are kept up to date )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 555.75 Tm (with their current care needs )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 541.17 Tm (and provide staff with clear )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 526.59 Tm (direction on how to meet )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 512.01 Tm (peoples needs.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 497.43 Tm (This requirement remains )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 482.85 Tm (outstanding.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 465.27 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 450.69 Tm (This will help to make sure )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 436.11 Tm (staff are provided with clear )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 421.53 Tm (directions on how to meet )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 406.95 Tm (peoples assessed needs.)Tj ET /F2 12 Tf BT 1 0 0 1 478.9 599.49 Tm (30/11/2009)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 387.12 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 384.12 Tm (29)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 384.12 Tm (19)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 384.12 Tm (The home must make sure )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 369.54 Tm (that all the required )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 354.96 Tm (recruitment checks are )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 340.38 Tm (undertaken as listed in this )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 325.8 Tm (Regulation prior to the new )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 311.22 Tm (worker starting work at the )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 296.64 Tm (home.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 282.06 Tm (This requirement remains )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 267.48 Tm (outstanding.)Tj ET /F2 12 Tf BT 1 0 0 1 294.55 249.9 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 235.32 Tm (This will help to reduce any )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 220.74 Tm (risks to people who use the )Tj ET /F2 12 Tf BT 1 0 0 1 294.55 206.16 Tm (service.)Tj ET /F2 12 Tf BT 1 0 0 1 478.9 384.12 Tm (05/03/2009)Tj ET endstream endobj 82 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 83 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (34)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 797.57 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 782.15 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 108.12 w 32.32 719.78 m 564.97 719.78 l S 0.001 w 1 1 1 RG 20.58 w 31.2 677.13 m 91.05 677.13 l S 0.001 w 20.58 w 93.3 677.13 m 197.4 677.13 l S 0.001 w 20.58 w 199.65 677.13 m 289.45 677.13 l S 0.001 w 20.58 w 291.7 677.13 m 473.8 677.13 l S 0.001 w 20.58 w 476.05 677.13 m 566.1 677.13 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 689.63 m 30.07 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 689.63 m 567.22 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.3 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 689.63 m 92.17 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 689.63 m 198.52 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 689.63 m 290.57 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 689.63 m 474.92 664.64 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 776.09 m 568.4 776.09 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 721.1 m 568.4 721.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 688.55 m 568.4 688.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 665.72 m 568.3 665.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 777.17 m 30.07 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 722.18 m 92.12 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 722.18 m 198.52 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 722.18 m 290.62 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 722.18 m 475.02 687.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 777.17 m 567.32 687.47 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 759.9 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 742.32 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 727.74 Tm (The registered person had to meet these within 48 hours.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 709.92 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 706.92 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 706.92 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 706.92 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 706.92 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 694.77 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 675.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 96.15 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 202.5 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 294.55 672.36 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 478.9 672.36 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 543.54 w 32.32 355.45 m 564.97 355.45 l S 0.001 w 1 1 1 RG 272 w 31.2 390.8 m 91.05 390.8 l S 0.001 w 272 w 93.3 390.8 m 197.4 390.8 l S 0.001 w 272 w 199.65 390.8 m 289.45 390.8 l S 0.001 w 272 w 291.7 390.8 m 473.8 390.8 l S 0.001 w 272 w 476.05 390.8 m 566.1 390.8 l S 0.001 w 170 w 31.2 167.55 m 91.05 167.55 l S 0.001 w 170 w 93.3 167.55 m 197.4 167.55 l S 0.001 w 170 w 199.65 167.55 m 289.45 167.55 l S 0.001 w 170 w 291.7 167.55 m 473.8 167.55 l S 0.001 w 170 w 476.05 167.55 m 566.1 167.55 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 253.68 m 568.3 253.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 529.01 m 30.07 80.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 529.01 m 567.22 80.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.48 m 568.4 560.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 527.93 m 568.3 527.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 529.01 m 92.17 80.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 529.01 m 198.52 80.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 529.01 m 290.57 80.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 529.01 m 474.92 80.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 629.47 m 568.4 629.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 560.48 m 568.4 560.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 527.93 m 568.4 527.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 253.68 m 568.3 253.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 81.43 m 568.3 81.43 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 630.55 m 30.07 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 561.56 m 92.12 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 561.56 m 198.52 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 561.56 m 290.62 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 561.56 m 475.02 526.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 630.55 m 567.32 526.85 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 616.28 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 596.28 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 581.7 Tm (Standards Act 2000, Care Homes)Tj ET /F2 12 Tf BT 1 0 0 1 239.77 581.7 Tm (Regulations 2001 and the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 567.12 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 549.3 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 546.3 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 546.3 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 546.3 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 546.3 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 534.15 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 514.74 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 514.74 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 514.74 Tm (15)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 514.74 Tm (The registered persons must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 497.74 Tm (make sure that peoples care )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 480.74 Tm (plan are kept up to date )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 463.74 Tm (with their current care needs )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 446.74 Tm (and provide staff with clear )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 429.74 Tm (directions on how to meet )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 412.74 Tm (peoples needs.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 395.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 378.74 Tm (This will help to make sure )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 361.74 Tm (staff are provided with clear )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 344.74 Tm (directions on how to meet )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 327.74 Tm (peoples assessed needs.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 310.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 293.74 Tm (The home has started to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 276.74 Tm (address this requirement but )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 259.74 Tm (it is not as yet met in full.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 514.74 Tm (31/03/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 514.74 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 240.49 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 240.49 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 240.49 Tm (17)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 240.49 Tm (The registered persons must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 223.49 Tm (make sure that any )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 206.49 Tm (recording charts that are )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 189.49 Tm (assessed as being required )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 172.49 Tm (must be completed in full )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 155.49 Tm (and be clear to understand.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 138.49 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 121.49 Tm (This will help to make sure )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 104.49 Tm (that peoples health needs )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 87.49 Tm (are being monitored.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 240.49 Tm (29/01/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 240.49 Tm ()Tj ET endstream endobj 84 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 85 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (35)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 31.8 Tm ( of )Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 540.49 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 713.54 w 32.32 454.63 m 564.97 454.63 l S 0.001 w 1 1 1 RG 255 w 31.2 583.49 m 91.05 583.49 l S 0.001 w 255 w 93.3 583.49 m 197.4 583.49 l S 0.001 w 255 w 199.65 583.49 m 289.45 583.49 l S 0.001 w 255 w 291.7 583.49 m 473.8 583.49 l S 0.001 w 255 w 476.05 583.49 m 566.1 583.49 l S 0.001 w 357 w 31.2 275.24 m 91.05 275.24 l S 0.001 w 357 w 93.3 275.24 m 197.4 275.24 l S 0.001 w 357 w 199.65 275.24 m 289.45 275.24 l S 0.001 w 357 w 291.7 275.24 m 473.8 275.24 l S 0.001 w 357 w 476.05 275.24 m 566.1 275.24 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 454.86 m 568.3 454.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 713.19 m 30.07 94.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 713.19 m 567.22 94.54 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 94.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 713.19 m 198.52 94.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 713.19 m 290.57 94.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 713.19 m 474.92 94.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 813.65 m 568.4 813.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 744.66 m 568.4 744.66 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 712.11 m 568.4 712.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 454.86 m 568.3 454.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 95.61 m 568.3 95.61 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 814.73 m 30.07 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 745.74 m 92.12 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 745.74 m 198.52 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 745.74 m 290.62 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 745.74 m 475.02 711.04 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 814.73 m 567.32 711.04 l S 0.001 w [] 0 d /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 800.47 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 34.05 780.47 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 765.89 Tm (Standards Act 2000, Care Homes)Tj ET /F2 12 Tf BT 1 0 0 1 239.77 765.89 Tm (Regulations 2001 and the National Minimum )Tj ET /F2 12 Tf BT 1 0 0 1 34.05 751.31 Tm (Standards. The registered person\(s\) must do this within the timescales we have set.)Tj ET /F2 10 Tf BT 1 0 0 1 31.2 733.49 Tm (No.)Tj ET /F2 10 Tf BT 1 0 0 1 96.1 730.49 Tm (Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.5 730.49 Tm (Regulation)Tj ET /F2 10 Tf BT 1 0 0 1 294.6 730.49 Tm (Requirement)Tj ET /F2 10 Tf BT 1 0 0 1 479 730.49 Tm (Timescale for )Tj ET /F2 10 Tf BT 1 0 0 1 479 718.34 Tm (action)Tj ET /F2 12 Tf BT 1 0 0 1 35.5 698.93 Tm (3)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 698.93 Tm (8)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 698.93 Tm (12)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 698.93 Tm (The registered persons must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 681.93 Tm (make sure that a clear )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 664.93 Tm (system is in place to monitor )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 647.93 Tm (peoples wounds and )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 630.93 Tm (pressures areas. This will )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 613.93 Tm (include clear directions for )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 596.93 Tm (staff to follow in care plans )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 579.93 Tm (and these are updated with )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 562.93 Tm (any changes.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 545.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 528.93 Tm (This will help to make sure )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 511.93 Tm (that peoples wounds and )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 494.93 Tm (pressure areas are kept )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 477.93 Tm (under review and that )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 460.93 Tm (records are current.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 698.93 Tm (29/01/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 698.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 441.68 Tm (4)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 441.68 Tm (9)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 441.68 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 441.68 Tm (Conduct a thorough review )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 424.68 Tm (of all arrangements for )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 407.68 Tm (handling medicines )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 390.68 Tm (\(including staff levels, )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 373.68 Tm (deployment and training\) )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 356.68 Tm (and put into place any )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 339.68 Tm (changes found necessary to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 322.68 Tm (make sure that there is )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 305.68 Tm (always safe administration )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 288.68 Tm (of medicines. \(This is )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 271.68 Tm (specifically to address the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 254.68 Tm (issue of the high number of )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 237.68 Tm (medicine errors reported.\) )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 220.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 203.68 Tm (This is needed to help make )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 186.68 Tm (sure that people living in the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 169.68 Tm (home always receive the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 152.68 Tm (correct medicines as )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 135.68 Tm (prescribed and the risk of )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 118.68 Tm (errors is reduced to a )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 101.68 Tm (minimum. )Tj ET /F2 12 Tf BT 1 0 0 1 482.1 441.68 Tm (31/01/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 441.68 Tm ()Tj ET endstream endobj 86 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 87 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (36)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 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()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 579.93 Tm (This is to make sure that the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 562.93 Tm (assessed needs of people )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 545.93 Tm (are met.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 698.93 Tm (14/01/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 698.93 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 526.68 Tm (6)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 526.68 Tm (29)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 526.68 Tm (19)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 526.68 Tm (The registered persons must )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 509.68 Tm (make sure that all the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 492.68 Tm (required recruitment check )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 475.68 Tm (are in place prior to a new )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 458.68 Tm (member of staff )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 441.68 Tm (commencing employment at )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 424.68 Tm (the home.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 407.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 298.05 390.68 Tm (This will help to make sure )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 373.68 Tm (people are safeguarded )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 356.68 Tm (against possible risk of )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 339.68 Tm (abuse or harm.)Tj ET /F2 12 Tf BT 1 0 0 1 482.1 526.68 Tm (29/01/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 526.68 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 35.5 320.43 Tm (7)Tj ET /F2 12 Tf BT 1 0 0 1 99.3 320.43 Tm (38)Tj ET /F2 12 Tf BT 1 0 0 1 201.55 320.43 Tm (13)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 320.43 Tm (When staff take blood )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 303.43 Tm (samples for blood glucose )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 286.43 Tm (monitoring for people living )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 269.43 Tm (in the home the lancing )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 252.43 Tm (device used must be safe to )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 235.43 Tm (use in a care home )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 218.43 Tm (environment as described in )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 201.43 Tm (Medical Device Alert )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 184.43 Tm (MDA/2006/066. )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 167.43 Tm (This is to reduce the known )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 150.43 Tm (risk to people living in the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 133.43 Tm (home of cross infection )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 116.43 Tm (linked with the use of the )Tj ET /F2 12 Tf BT 1 0 0 1 298.05 99.43 Tm (wrong sort of lancing device.)Tj ET /F2 12 Tf BT 1 0 0 1 298.05 82.43 Tm ()Tj ET /F2 12 Tf BT 1 0 0 1 482.1 320.43 Tm (31/01/2010)Tj ET /F2 12 Tf BT 1 0 0 1 554.05 320.43 Tm ()Tj ET endstream endobj 88 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 89 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm 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(improving their service.)Tj ET /F2 10 Tf BT 1 0 0 1 34.05 711.78 Tm (No)Tj ET /F2 10 Tf BT 1 0 0 1 96.15 711.78 Tm (Refer to Standard)Tj ET /F2 10 Tf BT 1 0 0 1 202.45 711.78 Tm (Good Practice Recommendations)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 690.5 Tm (1)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 690.5 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 690.5 Tm (The home should make sure that all staff attend the )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 675.92 Tm ('Alerters' guide training so they are aware of the local )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 661.34 Tm (reporting procedures.)Tj ET /F2 12 Tf BT 1 0 0 1 34.05 638.51 Tm (2)Tj ET /F2 12 Tf BT 1 0 0 1 96.15 638.51 Tm (18)Tj ET /F2 12 Tf BT 1 0 0 1 202.5 638.51 Tm (The home should make sure that all care staff attend )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 623.93 Tm (training on Mental Capacity Act and Deprivation of Liberty )Tj ET /F2 12 Tf BT 1 0 0 1 202.5 609.35 Tm (provided by the local County Council.)Tj ET endstream endobj 90 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 595 842]>> endobj 91 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 20.58 w 28.35 35.56 m 566.93 35.56 l S 0.001 w /F2 12 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 30.79 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 477.68 31.8 Tm (Page)Tj ET /F2 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 508.21 31.8 Tm (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 11 Tf BT 1 0 0 1 522.2 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 (38)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 22.5 w 22.95 802.41 m 560.45 802.41 l S 0.001 w /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 799.09 Tm (Helpline:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 10 Tf BT 1 0 0 1 28.35 781.11 Tm ()Tj ET /F2 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 759.6 Tm (Telephone:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F2 12 Tf BT 1 0 0 1 95.88 759.6 Tm ( 03000 616161)Tj ET /F2 12 Tf BT 0 0 0 RG 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If you would like a summary in a )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 662.12 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F2 12 Tf BT 1 0 0 1 28.35 622.62 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 605.13 Tm (reproduced in whole or in part, free of charge, in any format or medium provided that it )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 587.63 Tm (is not used for commercial gain. This consent is subject to the material being )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 570.13 Tm (reproduced accurately and on proviso that it is not used in a derogatory manner or )Tj ET /F2 12 Tf BT 1 0 0 1 28.35 552.64 Tm (misleading context. 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/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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LF}M ߞ %E'W?n}$lg1HBs }ٕ,),rqB-AHCrf!]vx.H x"n,6\O)FG=oNXLϤ$oǤ5xiP6 cXr,xW6A1I/?@ѵ}|6DMk7\8 Li$hu/,ZPpEo_I4 0B#\Gnnqk+5SHĺfo$؉qb;~l+0vi^v(< ;nҖx hHC~3xJa昐 X[[,D|14^^NH@Z{Ӌ2QiPT0%mujB1c!>73V zeKo7VWBlL<|d`{ܮē0jQyܒصȍOptNp@eSb= nvO 3Dv`Ogfi?FujH2#F@9P  N:.J4[4#(%$mXgY@~d`ñ}V$pбSa&vѠ\U@-$L:&,GZr!aʝʹg3PVT0?+m:~تo\xkx Жj\\3>Zl ӥz :S`F G(O{ աˡ3HJBrEu70pCzOd#H6+#T<֋T4Ks^C٨CAeB"C=)?0Sge!X(><+Eg4pr\ƌz_H^zR5IcF$уUhfzo}YBӎEM^ :"% E~$6$|B^t\:T&Y]7(ou&rzOU$`.@ŪÌ#1dEi!8 uXؗvA{o o쭺8*IϿcʒ,F[bdW3PI!:$-p31/_7v2dsoF2f6-HCaj>_lU4HqFa="QT, ?|Vbd j;[&̢ %[rU_Qpܥ^&@8k%^+#IzsFK~7GϽBAnxO4D]$y;0?[")X NFʼn(5FׁK%!k6BD"c&z#aoAb( +qt.B!#`>cD>LZZP%8,b"N7PȲ:ƚo0J zvAj[ԉ8dog7XxtփmMw*έLފӲV`E*V-Ữ  /&.SQ`q2ɸxAM gV>5~"ceLMDCRBϯ/k*cqX;vD=oD4]IU%qJ> ¥7s#1Ur*)ӆaØ׻$ CocfYzalS~]E3k+vQ]2B`DoB":6V?N  l ڊӌoIcWn'tj?*:NCCI}:DrL2w!8uqI 6jw)I VrjSuX d 3h\m0 r_cσAg彜.5?A Uz4VbɎݪj@r$'bC0plDS-ȱRyvJ2v,oHAaYin~]FZvae2c'T?9 ڧ}jk5ݕ (NJ7>B\&PupȺ=΁~ Cfv By1^lbN^yϚ|nNi7C<,ɓ0P%,q94BrByÄ` 0KzG;Tz𲀶) ߧ#jShfHn tS͋!\ #[<<$9A-)kGho$D?,E]b aEiI9 ;Al^ofrׯ'`\D o FQӟ>M3`ouKhHk]bn N:7f!&Tm$cGmr_v$McnvS;$۩4Ŀov엂 VƟq>#P}#[fCE~ȕ h?Y=cZcgiGz(S'h 1B2p#{ 42h,{WUaeao¤i<͑( | K>aHc?/} MZʚ|*yNaql!oIcp87`HZyb~>@l$ʁsb1B38b P%2Pov|2ؔqeflkǨ>Am=n/rЧYע>k}+v(b .|(bz؉Z3+:@ D 3TOA %L-TiȱmpvZjfarüY8#?/}!23Gp>kwOu]Rܻ56k$9Vv𧌰y"J^#MAОXېɅq o &d҂JșZw7x6.'S7JGTBʶjj_`휱<_;жBƏ0)[ό۲ZuW2^/woC㛟'ޙ]EusN(?yn)#X],'Tִ3#" }~#k]u`WKfT7~a8o#h ׈>M9ݐ1ӌ *~q(pӎQLٔLhD H@5Aٺ4{SdZ-jhZWM7MLr#fVML8*9Dx}ȃYpK=/Vj.l:(Tt#vW3#lЁ8wǫihm&Z(pB<# pۯ߂I˝ؾQ*HJͽiPG\#r+Z/L5h/*#a<8 G(<Ң0_(K׳8f*N3p<0+s-]1"}^ZuP; 6rgbPqwb 釞 W.]J~ ;=/![_j J26U\I4m6BG`Tnhr3[[-2ffy9Ew$ Y} "KaEB `m/ 1;>H՝u NV=apnYxFoܼħdž̀u_5*\ů_cމGCg3Vk@ncEtK4TS=ZdSL<ߗx2A`l6`eRhGFߦjVCov?ѵKRNQfF>DxH!#s%trY\i)Zpd|y!' ^?C4@(=r hCarS#ɹ 20&\VaBo6 )6S Q iIE LhI:+"HzI Yq={6 kCD))jBdfjPcwW!ret2?Z;Y@J8H8r(H?RRfTG1E6+J!^HqG_Oa߅} }5W1~L\_dԭ]CHƲ b|uae6> 7D(BD{v-d'kA}shzĆh9.S^ֳ.LX92sBÔUO?)Cڰ}'UݾqsK^N􀘊#1 C,&h[X|K[19v`oYI]Ηbf?Bm=d]#wBI6=Ϭx(yJNH'-PMMHXZ%RNV|v){z!6Gp.`a{t.0*a9+wS+)ϐV63Ew` eliV}qԥvWIu@ʔ h%kNːv-cLz{z68vΝ^u<}EZBݨV$GK93Fj˅G¦~#F#?J|6hU3m6@O CVw߼H$$2s6k=G ߈rAg`Xb=Om<̭(6~"H4w30VJ\IǫkK~D$Y8?N*@ "E4tgejDۚ<~i*EX{+w8RL%hV]o)@5Hgt\Aw"cJb0rXa28zb++j `#9Kr.S)cfU)iF,^'+Am1Sjt$}^N_a󒠀s5H㘠!chwI!c26Z_#13uHW'sbS M./9inɥd|mŊ? s6x+p]^@i%_OE ۞ ȔVTu.bH ͕fF+}kOOb5ʹk}|f,1Yݔ,GuaoL%Ob4 n` {_dhA!rgmﱨJxu`%faLwqr"95[M`^#߄8u PY:&''9{5k9eP>SSUZoXtMÛpGF PpGn|˓_`?G[~\s.\A4f)$@x9Fp}#H&יYBbwx4,`њy' +Dj&!uTfzsSlĢbbba/kTjb WI;{$7{ǝ70/:`U5Zp *M%5(:)Mh|J~^ߣ5dqoۜ>KRi9mfM=uC,TftDΩTswh.xϾxW1ې'y#|/T(}M/&xR`R`1Qd1T/ \){V(WɝEh]3XRgp7RKa@Ev06S 0d{)xb*tׯ•:\`h#lCjsUqۺ5vX\!C{o u7: }" w$>{y+f>5a*Rthq #p?Ùܜ/q&Nє{p$9 *1*;rhr>kF 1l呑m!Y]%Gr $` Ӳs9%8ãNZW#P7Xup .sg\_JyYȎ0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 0000000000000000000000000000000000000000000000000000000000000000 cleartomark endstream endobj 95 0 obj<> endobj 9 0 obj<> endobj 96 0 obj <>stream  cvt xefpgm:`headҗ 6hhea 8$hmtx7 \loca*$maxp pI prep^.cJy|]xdY'v}f| sBB99I?Zo7zLLto\S} `^B/``Y}LfK}qqLuu1=b{9ZZpqqh@=T;:9876543210/.-,+*)('&%$#"!  ,CX+!!!Y-,CX+!!!Y-,CX%!!!!Y-,CX+!!!Y-,CX+!!!Y-,CX+!!!Y-,CX+!!!Y-,NF#CD%F!M-,CXEdj#EiCd``F#D# F/!!!!Y-, C#Ce -, C#C -,F#pF>F#pFE: -,+%E%Ej@`%#D!!!-,+%E%Ej`%#D!!!-,+!!!-,+!!!-,CCe -, i@a ,b`+ d#da\XaY-,%EhTX%E%E`h %#D%#D% Eh #D%Eh`%#DY-,% Eh #D%Eh`%#D-, CX!CXE+G#DGzEi G#D QX+G#DGz!GzYYY-, E#Eh`D-,EjB-,/-,!!-,%E%Ed`j%Eja %Ej e%#D%#D!!-,Eh#Eia%Eja %Ej e%#D%#D!!-,Ed#EdadB-,%C@T%CTZX% E@aDY%CT%C@TZX% E@`DY!!!!-,KRXC%E#aD!!Y-,KRXC%E#`D!!Y-,KRXED!!Y-, %#I@` c RX#%8#%e8c8!!!!!Y-,KPXED!!Y-,%# `#-,%# a#-,%-,F#F`F# F`ab# #KKpE` PXaFY`h:-, E%FRX?!Y-, E%FPX?!Y-,CC -,KRX%%I%%Ia TX! 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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 97 0 obj<> endobj 98 0 obj<>/Subtype/CIDFontType2/Type/Font/W [3[312]]/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 <0003><0003> endcodespacerange 1 beginbfrange <0003><0003><00a0> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 5 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 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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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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 109 0 obj<> endobj 110 0 obj<>/Subtype/CIDFontType2/Type/Font/W [3[292]29[363]38[667]44[483]46[696]50[770]53[726 633 612]68[598 631 527 629 593 382 629 640 301 362]79[301 953 640 617 629]85[433 514 415 640]90[889 604 575]]/CIDToGIDMap/Identity/DW 1000>> endobj 111 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0003><005c> endcodespacerange 31 beginbfrange <0003><0003><0020> <001d><001d><003a> <0026><0026><0043> <002c><002c><0049> <002e><002e><004b> <0032><0032><004f> <0035><0035><0052> <0036><0036><0053> <0037><0037><0054> <0044><0044><0061> <0045><0045><0062> <0046><0046><0063> <0047><0047><0064> <0048><0048><0065> <0049><0049><0066> <004a><004a><0067> <004b><004b><0068> <004c><004c><0069> <004d><004d><006a> <004f><004f><006c> <0050><0050><006d> <0051><0051><006e> <0052><0052><006f> <0053><0053><0070> <0055><0055><0072> <0056><0056><0073> <0057><0057><0074> <0058><0058><0075> <005a><005a><0077> <005b><005b><0078> <005c><005c><0079> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 3 0 obj<> endobj 112 0 obj <>stream %!PS-AdobeFont-1.0: TimesNewRomanPSMT Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved %%CreationDate: Fri Oct 10 11:48:26 2008 % Converted from TrueType font 'TIMES.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.76) readonly def /Notice (Typeface The Monotype Corporation plc. Data The Monotype Corporation plc/Type Solutions Inc. 1990-1992. All Rights Reserved) readonly def /FullName (Times New Roman) readonly def /FamilyName (Times New Roman) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -109 def /UnderlineThickness 49 def end readonly def /FontName /TimesNewRomanPSMT def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-77 -216 1009 877} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /periodcentered put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B TcJ6*]h[zeKq)ƷW0jlBIf14%B[tnqNOדe{fC;1I^7^r5=[ySwF 5ZUͧ@;J7{Phx ғ*⿅΅V1lCd3Dk9+ ~Iic*x 2YC.eKgt_"t!Ztb$~iS[xdw +P7)%g9/-awT=JK/{ Q'y!kA,7 Α$?H}Om"s*5aks*HRUufn6i?kɝ=-0X%lϧQ4ݡ`rџ~D&#&:t]=.ok &DZђԺŠRq [j@3a*42K]sjϖjG_n 4Ϛ5. *Ly^w`ܮ64r/:!?u:};ߜ`dӤJY2R'wbTCI2CRNY2uD-.Y9y:2Cʸ`ͻq5dBpQŰ: TimM;f ]+ozY0,(Fh^ GirY E W| -R̵vVP ce޾'zH+1= PU~}fIa 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