%PDF-1.4 % 1 0 obj <>stream JFIF``ExifII*C    $.' ",#(7),01444'9=82<.342C  2!!22222222222222222222222222222222222222222222222222S" }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz w!1AQaq"2B #3Rbr $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ?gBGBkQQ(((((((((((((((((((((((((((((((XRA5,˛rSGQGiy >d-\EXeN(!g!T OJl2𤱜 \޷4hQ6? lz0Bv,(((((((((|?x:(tEZu[J{U*(((((((((((((((((((((((((((((((((U'Oα R$b;8((((((((((?gUN|J((((((((((((((((((((((((((((((((((((((((((((|?x:(tEOw?ZJUh((((((((((((((((((((((((((((((((((((((((((((?6!ΫUFQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEGtQΊB?տQ@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@Q@tEP endstream endobj 3 0 obj <>stream JFIFC     C   rc" }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz w!1AQaq"2B #3Rbr $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ?㟈3[/a}5>UHA q%}0WG#J'sZL58QSVI /4j]UFI51.χOq myr=鶖캕QW%x-0x"K[v^khQܓls^Fђ#4&)VY^(QEQEQEQEQEQEQV,4V+[+io.`v'rM{|j\Y=cڟRin*ץCQi-Ezd {S~i-B>Q|s^K,oe( 9&tRJJKmQL((((RW{g u魥@ʖlU8m-ٕJ[I/Wcme̓Hrx3R~,uv7y͂j2Xm ֧M9%~(o-+m! X\*f ((Kg{F7~Z RbYgPa|Џ~o Mᮽqi6w/cKd`9U͏UR=ҿmO|>mL^lQH t0=WcjF<1wgN^Oz/CWzh-߇|C.|KnۜNSt5_쉢/ iXKv?W-1~铵aqͼ7F [_/[8#JV2\i6z B|w~gӕKtע~ϟdgDݭۗb?u R+QVhH]j.oo%vE\c1ဩ1GGT›_ i?>ҡ$,5],'2w)S8_Q_G¿ ;axzmՊȉ>WGR\TĬ."'5>º/$x oHJGHﭒeC 085Ϗgo!L4l[xóJ0psu9]^%ծdM(ciYLn]+aocFgl!BѶ既ɑJ?q*'9M.ѤsC ,V&ߖ£)vdsR~<tt{S\:NmObm$wwION kLk ~ HndLlˏlQ{Z*Ρjnmu-:n!ou$˭ϱRRW[nx/i^ѠN\-t'I:? e }o㦯\(siN>첺xjdSg?<5JW>e~>_K_Q>m9v<וH6v6麗Z)%Xmf5-yt:fWqA*P+2ygLshoMG_(ot~XGnSz*ʧA'h?|9}z /ǖљa/ϕ(W 9Րe9vOZ;O[\,Bf;2~J<4g? f M+ٯtilebF pAC^rx:~3@w1ߢѬ3džx_Zdm.7gm2żvu,:k]TWmOº0})ƿR|-5 :y1JRqU)reG.mR+(s amY%[k8V$\T־c_AJ4OkZ KK>C0İrL96ʉYu\~T k\gxOm!i4p@*0v>>~ҞL٩ډ5*"M˕pan=EO}Q>"}@>i襯/xz xUk2[9qrHT{|$ KJC: w!i^'19']Ww_)/¯96ea%Դ8LQ2.%_&%daG8گ_ <gƗm"^9aFFCd'UxXVrz~^.4Ix=F 9dO$g ~C|#\t(@Y;էOZ|?}z孮C/ud]z9x?Gi΍kX68ʸt ȹÕ jj\{ZߦwVJ0})FHWOs8g?߆[^-gRRmB9]<ߙ, S`ǮkIKLΞYITݒ?(U|qx㇊5Oa6V@Db>b ʪQN3jQE3S%ѭ^m?ګ¢%\)?h`H%ѭT#}C^'ҵ&smi)uo'>W ~捾~~~_#RZ11#9q+nt~ c;u+#[V%`'\-+G.kz}֍3VvxꬮYIn|6ARˣS|;5}αZw2ăRkҾ"~o/RC^|zcʏ_Ꮝ,|_RUӜOai})%O!qW~_Mڎit۽0 L6;tScuիa1SOw?߈>(<9a6^ =II$5)״{E!mLFXp29ž*w5Vћ^gR<6{}(g߉hx^[ZHڦg1Y.lldo wq3汖iWX`S_z~_?  v߁?T<_` `"y0$JiXib(vU/ -^gM/X_?ɸn?B-4:XmllT"\$vS?9ZHu 붦8t*{k  ߀x|-#KAvѴhX|fxia+잉_πy 2lzj_ sNuwskQܖg5O Z\uY(-ڿf}po? ti/s?xPg5=sUϩjOws# nwb3__Ii?Yv) >dqai.#Ro& efOk7D(?|g?' ?ǷfM"K.+ )5O.!O '_A}ZoXOJň0sNrRI# 6#Qm=5ϱ/z脫߳7UK֍,5G45F%}P{fFq c<߳Y:WE-x^xIi  C?@6ҽc3*~YTRz[8|4/>!GF'a|6;c-3ᮅii0z|Jҫ c3u~Ox.⿈o+󵫫kyrŹ{c ~ݫ}4ORWðtW]|>ѯ|K`啌tSXx?~iQ>/U<e>/!HAڛ>WH<-Yg5)N:G9+X($C?kW9]ď(~'j*c:_};⟅zׄPQȝv}"cf>5T [}pg|K]xŐtO jڼd= |Ë>& ?S>%/m/>ԑM|>;׮ujw:tۦ7O@:T } oz)!~+a0xL2 _3_ž,| sCLլe[[3Gb }*׏--o 蚽 җ $g_QCb\e+I|L+|It둨[~w:vHuX2ǵl|H|B]gz|*fnmnE # #ex%jK/ٮꚷ,۝F[JO" +E"hſ^'Ӵ{f\2ǻۻv?qqw7x,;. u |k_\pdïW E=R*jgGVHt+ېiXC]ז|k&en4VZHVWO,G\H)+QV{EPy㏍ jΒCMOʷNdgW~x"ռ-'hL徣yWT71o4~yk7E= ۥǸ~? j?x"|%X(} ׭K k7p$7B(nX{T8Bݎ ]:~٨m^~eFDڄ^f#F{.{jn=CA$sTgWRIPta2rchgh_NJ5m)_Ӯ>C:כ$%$].KbwM<&\ F8q_7G$WCeAӍ%gju}zRHђ w=^GCkMaEsd䈤R 9xuj:`hp[.>G6IkZ7qX9۟5|,T[_+i%k׾{z9;ܡT~\2{q_1K+:j1Y>5A񆭧inzϏKT(|3g+I|Q4+M* o[#=F:_#YiZMSc; B @D}ݤE@O"QٛU+F5b=7SKխZkyuK)5?িYWB*s4!HX7g_"MFX|SAIo!Gm:iZƓxF"W `o ᏾=5-ŊaQAI#i/i6Ƒzl%Vrl1A 9g?.K+n)is!zڹ Rm[#.#GG֋)_4si98?Z{GW-8 ?2we굽?ƾ0o [z6Msq'Usǀ=H-xψ72rLǦbH8wE__O<+ ne+SP8WTSg/u04VӲAEVQ@ď(~'jp>G?NFz?m(>$~^ /!Y\FqipGpJ'h'rJhaYmG߱xo>/&YkWzy18Fk>&~mCYYQɧoʤw9.Ϟ2/j-$_0R5k,l4m&KJueAG4KmGok|m< cRQ>00lS{%?+hK/߲Lj5?Fll<wr*ۋ}kj&Ɨi_xZ\Awl,VeQۿbs؃Qu<GQRA>ipj|5_B&-煲7J&Y>'~ G}KL𷅬UsӷA; |^Eдlu SקnGB5xKh;ZU9ؿ</:+kZK'r+Bk/x\𶩷MHXF58~e#޳+ZKkP]|QS[4.!xjrs8-y?0>-~" WN\iͼ$fS#ruC?TLFp|~梑bL>]J=ےVKv~PQ_z&xTB-CcTz}xoE>OZdmww^XF]-F T.. *^m̴?8MWS,3H|ۗH"PZIz;_op|%k{;]6rXDu?f{p}SN}j5~mG8ҒrKV~D_~Oi^5~ijW _־Nb[Z|2lyV]Vzs8焪&sas55HJJ<Ꮔmi)aqxh‚J I5sF|h5N]HX-Bt:ƾ~sm :TZƒ}ĦfeRӕ P/:. zV 1hWb:¥}Sb?7~ k~ Yx[yA\Vo@r@_ E:F ֯ .}n>?Uj'glT? h]3NtFH$cva`_~؟o.5os ƞXn a݀A#9ITMٜL N.{)u>?7FE`x"{YXm  yFi RIuJ I7+1uל`O8|xЬ?#h dXo"z\ y}+LsVQ>=k>҇|G[vfTRNW=}DRm[~WAN( (:?POa;NmJO4_…?W|H ֣ǎ/BFWivz6Ӓ،k;^(]nַ,n# ¿+'+vn5'r&.qƿ3>.7(/7)]=<_oum:$꽄?}:Vp[xXHO $y5u2Em$2X¶|U_x~!е 81j `3_pO/?|W"I.=&U;~ʨ _R4jڬOc]Dn]ݟ]M}ׯ8apU/Ozo OI'&-LΑevq_RN% )hE̖ghh 2dtJ;Oϊv h:MVeY4gs>|jE?mOIpnTa)mrG<;;Y,%eATYr;t^o,>%𾿬xfo!_L+mozu?eϏ._:9n&PVx\w98ӟO5t$gZ+p ZQ-o_G}{h4mGoدOk_|)񗈵kg AnK#jf=L2gZhN/VZqcųytQWȟ? Hiv&/庄̭M{MҺ y}&K]OJ;T}}h]i6s$!<{Rp˱beZY7/N~w_W_U7\WʿL9O!_UV߼=c$?MqToNw ;;o~1INu(=2fvJ*Z^xDKe|,7þ@ֺO%/[ )|S Ʉr`p&=7Cd|^42SU d3Hی▊z)=eo?6 M[4wYjz|4Rq<_cSᔶk {J4N3.-%[ƶZ׆5 hI(kCT ~`ܳz+#3:[}md)$QߞO*ǵoAqJXE xfRtg $MoC/yi%? 5},[#iӟįkK:FZ)V2Z]<24sG ut8`A_.t4䓎:}X>Im]\\-Ckj:j: Q@ď(~'j+ҿh߇Z/+Y-|HɄr"ךF%ҌG|q>R_xSS#:uﵸA|1ik$O .}:Yzt}2k~N ~/)ceZ}~x Ӻ6]jיD>'^+yujW6Ƥm:G ?SqTPV+`_5Y" *Dlqԭj:/n@zm)nubpt1$~j-57j{a?|E~~:mrb<08tlMGvfyA#d $*~kxG][Z>>+v68_|Gs_ ¸:Ο5'B}nsJ-YىعƥxmZg ?+#qH|ݻ M?J-cV"-p*x-wkh'x7į_Qoorwgp+}k 5 i?i{_;w;7!M?=kbՙ#-#ZPWݟQۙ} t>|6߅Óce/ؠns>54/EC~M>5%05f7n-8q m=,g ioob1ZSV'TkF].އ}c_gGb+ljbg_T#­g º:=Z}k^Wcvϳ>58g_-iBX^1]en^lO| \q Ɵtk]Ś\~3"k|{ެk*(qOB6.ZKo/鬟Vo 7E=U1Z Wߴ__χllnx=vIp>_e=+*T"80 5R=VmfExO\4{ٴNQ= B } zlV6ZN}ݣ*TJjEKsq,D/oGviVtj78R"LUW?gs_BuL-|=DAoryv>l.MRww7ogo˵i>|scLW~՟?4?8-58O;*m&?g9ӚNU{U25\DqS{]bV/&+IVX.0A*=>+/boб9tOE|#E"~x ե7rޑXPW?h~^ ]G: ud{$^y"0e8< BϾ=ŏQeleO؄O"ݞ{+[wAg1JuSqMݛR7vw}5aYO}V 'KH|ݻM?+T ^_(Domkht;?6*@(iyc~״ I.|eR3t8=z+?i $[5~~|O uNե$֑r>`v{lȵ_MW/Sr/5}oZ/&)B-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏4¾ Z?EE-B֏5_x6H鰰ϯ+Eb?/C[DT*xQEHn[ endstream endobj 4 0 obj <>stream 0 J q 546 0 0 62.25 28.35 0 cm /img0 Do Q 0.75294 0.75294 0.75294 RG 94.4 w 22.95 722.15 m 561.53 722.15 l S 0.001 w /F1 10 Tf 0 0 0 rg BT 1 0 0 1 28.35 759.3 Tm ()Tj ET q 170.25 0 0 54.75 28.35 697.6 cm /img1 Do Q /F1 36 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 638.77 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 36 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 72.25 595.03 Tm (Random )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 36 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 233.68 595.03 Tm (inspection report)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 17 w 22.95 549.81 m 580.6 549.81 l S 0.001 w /F1 24 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 514.69 Tm (Care homes for older people)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 96.15 w 32.32 449.87 m 579.13 449.87 l S 0.001 w 1 1 1 RG 20.58 w 166.71 488.78 m 580.25 488.78 l S 0.001 w 73.32 w 166.71 439.58 m 580.25 439.58 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 477.36 m 582.46 477.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 500.19 m 582.46 500.19 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 477.36 m 582.46 477.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 401.79 m 582.46 401.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 501.27 m 30.07 400.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 165.58 501.27 m 165.58 400.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 501.27 m 581.38 400.72 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 484.01 Tm (Name:)Tj ET /F1 12 Tf BT 1 0 0 1 169.56 484.01 Tm (Winterbourne)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 461.18 Tm (Address:)Tj ET /F1 12 Tf BT 1 0 0 1 169.56 461.18 Tm (Winterbourne )Tj ET /F1 12 Tf BT 1 0 0 1 255.76 461.18 Tm (London Road)Tj ET /F1 12 Tf BT 1 0 0 1 169.56 443.6 Tm (Salisbury)Tj ET /F1 12 Tf BT 1 0 0 1 169.56 426.02 Tm (Wiltshire)Tj ET /F1 12 Tf BT 1 0 0 1 169.56 408.44 Tm (SP1 3YU)Tj ET /F1 8 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 391.5 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 31.2 370 m 391.05 370 l S 0.001 w 1 1 1 RG 20.58 w 393.3 370 m 580.25 370 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 347.17 m 391.05 347.17 l S 0.001 w 1 1 1 RG 20.58 w 393.3 347.17 m 580.25 347.17 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 358.59 m 582.46 358.59 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 381.42 m 582.46 381.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 358.59 m 582.46 358.59 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 335.76 m 582.46 335.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 382.49 m 30.07 334.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 392.17 382.49 m 392.17 334.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 382.49 m 581.38 334.68 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 365.23 Tm (The quality rating for this care home is:)Tj ET /F1 12 Tf BT 1 0 0 1 396.14 365.23 Tm (two star good service)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 342.4 Tm (The rating was made on:)Tj ET /F1 12 Tf BT 1 0 0 1 396.14 342.4 Tm (30/06/2009)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 304.45 Tm (A quality rating is our assessment of how well a care home, agency or scheme is meeting )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 287.45 Tm (the needs of the people who use it. We give a quality rating following a full review of the )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 270.45 Tm (service. We call this review a key inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 236.45 Tm (This is a report of a )Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 150.58 236.45 Tm (random)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 200.47 236.45 Tm (inspection)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 261.38 236.45 Tm ( of this care home. A )Tj ET /F1 12 Tf BT 1 0 0 1 392.12 236.45 Tm (random inspection is a short, )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 219.45 Tm (focussed review of the service. Details of how to get other inspection reports for this care )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 202.45 Tm (home, including the last key inspection report, can be found on the last page of this report.)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 167.97 m 315.25 167.97 l S 0.001 w 20.58 w 317.5 167.97 m 565.9 167.97 l S 0.001 w 1 1 1 RG 20.58 w 317.5 145.14 m 346.55 145.14 l S 0.001 w 20.58 w 348.8 145.14 m 377.9 145.14 l S 0.001 w 20.58 w 380.15 145.14 m 409.2 145.14 l S 0.001 w 20.58 w 411.45 145.14 m 440.55 145.14 l S 0.001 w 20.58 w 442.8 145.14 m 471.9 145.14 l S 0.001 w 20.58 w 474.15 145.14 m 503.2 145.14 l S 0.001 w 20.58 w 505.45 145.14 m 534.55 145.14 l S 0.001 w 20.58 w 536.8 145.14 m 565.9 145.14 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 156.55 m 568.1 156.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 179.38 m 568.1 179.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 156.55 m 568.1 156.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 133.72 m 568.1 133.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 180.46 m 30.07 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 180.46 m 316.37 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 157.63 m 347.67 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 157.63 m 379.02 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 157.63 m 410.32 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 157.63 m 441.67 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 157.63 m 473.02 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 157.63 m 504.32 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 157.63 m 535.67 132.65 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 180.46 m 567.02 132.65 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 163.2 Tm (Lead inspector:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 320.35 163.2 Tm (Date:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 140.37 Tm (Susie Stratton)Tj ET /F1 12 Tf BT 1 0 0 1 329.63 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 360.95 140.37 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 392.28 140.37 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 423.61 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 454.95 140.37 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 486.28 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 517.6 140.37 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 548.96 140.37 Tm (9)Tj ET endstream endobj 6 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/XObject<>>>/MediaBox[0 0 612 792]>> endobj 7 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (2)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 768.28 Tm (Information about the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 31.2 746.8 m 274.61 746.8 l S 0.001 w 1 1 1 RG 20.58 w 276.86 746.8 m 580.25 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 73.32 w 31.2 697.6 m 274.61 697.6 l S 0.001 w 1 1 1 RG 73.32 w 276.86 697.6 m 580.25 697.6 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 648.4 m 274.61 648.4 l S 0.001 w 1 1 1 RG 20.58 w 276.86 648.4 m 580.25 648.4 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 625.57 m 274.61 625.57 l S 0.001 w 1 1 1 RG 20.58 w 276.86 625.57 m 580.25 625.57 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 602.74 m 274.61 602.74 l S 0.001 w 1 1 1 RG 20.58 w 276.86 602.74 m 580.25 602.74 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 579.91 m 274.61 579.91 l S 0.001 w 1 1 1 RG 20.58 w 276.86 579.91 m 580.25 579.91 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 758.22 m 582.46 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 568.49 m 582.46 568.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 759.29 m 30.07 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 275.73 759.29 m 275.73 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 759.29 m 581.38 567.42 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 742.03 Tm (Name of care home:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 742.03 Tm (Winterbourne)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 719.2 Tm (Address:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 719.2 Tm (Winterbourne )Tj ET /F1 12 Tf BT 1 0 0 1 365.92 719.2 Tm (London Road)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 701.62 Tm (Salisbury)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 684.04 Tm (Wiltshire)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 666.46 Tm (SP1 3YU)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 643.63 Tm (Telephone number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 643.63 Tm (01722428210)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 620.8 Tm (Fax number:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 597.97 Tm (Email address:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 575.14 Tm (Provider web address:)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 539.2 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 35.16 w 31.2 512.41 m 353.25 512.41 l S 0.001 w 1 1 1 RG 35.16 w 355.5 512.41 m 565.9 512.41 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 436.64 m 353.25 436.64 l S 0.001 w 1 1 1 RG 20.58 w 355.5 436.64 m 565.9 436.64 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 413.8 m 353.25 413.8 l S 0.001 w 1 1 1 RG 20.58 w 355.5 413.8 m 565.9 413.8 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 493.71 m 568.1 493.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 470.88 m 567.8 470.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 448.05 m 568.1 448.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 532.2 m 354.37 492.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 425.22 m 568.1 425.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 531.12 m 568.1 531.12 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 493.71 m 567.8 493.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 470.88 m 568.1 470.88 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 448.05 m 568.1 448.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 425.22 m 568.1 425.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 402.39 m 568.1 402.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 532.2 m 30.07 401.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 354.37 449.13 m 354.37 401.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 532.2 m 567.02 401.31 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 514.93 Tm (Name of registered provider\(s\):)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 514.93 Tm (Caring Homes Healthcare Group )Tj ET /F1 12 Tf BT 1 0 0 1 358.35 500.36 Tm (Limited)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 477.52 Tm (Name of registered manager \(if applicable\))Tj ET /F1 12 Tf BT 1 0 0 1 34.05 454.7 Tm (Ms )Tj ET /F1 12 Tf BT 1 0 0 1 54.64 454.7 Tm (Gillian )Tj ET /F1 12 Tf BT 1 0 0 1 96.12 454.7 Tm (Brinkley)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 431.86 Tm (Type of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 431.86 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 409.04 Tm (Number of places registered:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 409.04 Tm (80)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 390.09 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 346.64 m 564.47 346.64 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 359.18 m 567.8 359.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 336.36 m 567.8 336.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 382.02 m 567.8 382.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 359.18 m 567.8 359.18 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 336.36 m 567.8 336.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 313.52 m 567.8 313.52 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 383.09 m 30.07 312.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.32 360.26 m 298.32 312.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 432.52 337.43 m 432.52 312.45 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 383.09 m 566.72 312.45 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 365.83 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 343 Tm (Category\(ies\) :)Tj ET /F1 12 Tf BT 1 0 0 1 302.3 343 Tm (Number of places \(if applicable\):)Tj ET /F1 12 Tf BT 1 0 0 1 302.3 320.17 Tm (Under 65)Tj ET /F1 12 Tf BT 1 0 0 1 436.5 320.17 Tm (Over 65)Tj ET 1 1 1 RG 20.58 w 31.2 298.73 m 297.25 298.73 l S 0.001 w 20.58 w 299.5 298.73 m 429.25 298.73 l S 0.001 w 20.58 w 431.5 298.73 m 565.9 298.73 l S 0.001 w 35.16 w 31.2 268.61 m 297.25 268.61 l S 0.001 w 35.16 w 299.5 268.61 m 429.25 268.61 l S 0.001 w 35.16 w 431.5 268.61 m 565.9 268.61 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 287.32 m 568.1 287.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 310.15 m 568.1 310.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 287.32 m 568.1 287.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 249.91 m 568.1 249.91 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 311.23 m 30.07 248.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 298.37 311.23 m 298.37 248.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 430.37 311.23 m 430.37 248.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 311.23 m 567.02 248.83 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 293.96 Tm (dementia)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 293.96 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 293.96 Tm (41)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 271.14 Tm (old age, not falling within any other )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 256.55 Tm (category)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 271.14 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 271.14 Tm (80)Tj ET 0.95294 0.95294 0.95294 RG 161.97 w 32.32 146.3 m 564.77 146.3 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 206.71 m 567.8 206.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 169.29 m 568.1 169.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 146.46 m 568.1 146.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 229.54 m 567.8 229.54 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 206.71 m 568.1 206.71 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 169.29 m 568.1 169.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 146.46 m 568.1 146.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 65.32 m 568.1 65.32 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 230.61 m 30.07 64.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 230.61 m 566.72 64.24 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 213.35 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 190.52 Tm (Service users whose primary care needs on admission to the home relate to their )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 175.94 Tm (dementia may only be accommodated to receive personal care and nursing care.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 153.11 Tm (The maximum number of services users who can be accommodated in 80.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 130.28 Tm (The registered person may provider the following category of service only: Care home )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 115.7 Tm (with nursing - Code N to service users of either gender whose primary care needs on )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 101.12 Tm (admission to the home are within the following categories Old age, not falling within )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 86.54 Tm (any other category \(Code OP\) - maximum of 80 places Dementia \(Code DE\) - )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 71.96 Tm (maximum of 41 places)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 50.53 m 315.25 50.53 l S 0.001 w 1 1 1 RG 20.58 w 317.5 50.53 m 346.55 50.53 l S 0.001 w 20.58 w 348.8 50.53 m 377.9 50.53 l S 0.001 w 20.58 w 380.15 50.53 m 409.2 50.53 l S 0.001 w 20.58 w 411.45 50.53 m 440.55 50.53 l S 0.001 w 20.58 w 442.8 50.53 m 471.9 50.53 l S 0.001 w 20.58 w 474.15 50.53 m 503.2 50.53 l S 0.001 w 20.58 w 505.45 50.53 m 534.55 50.53 l S 0.001 w 20.58 w 536.8 50.53 m 565.9 50.53 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 61.94 m 568.1 61.94 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 39.11 m 568.1 39.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 63.02 m 30.07 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 63.02 m 316.37 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 63.02 m 347.67 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 63.02 m 379.02 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 63.02 m 410.32 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 63.02 m 441.67 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 63.02 m 473.02 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 63.02 m 504.32 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 63.02 m 535.67 38.03 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 63.02 m 567.02 38.03 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 45.76 Tm (Date of last inspection)Tj ET /F1 12 Tf BT 1 0 0 1 328.2 45.76 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 359.53 45.76 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 390.86 45.76 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 422.18 45.76 Tm (6)Tj ET /F1 12 Tf BT 1 0 0 1 453.53 45.76 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 484.86 45.76 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 516.18 45.76 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 547.53 45.76 Tm (9)Tj ET endstream endobj 8 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 9 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (3)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 776.72 m 565.9 776.72 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 768.18 m 30.07 542.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 768.18 m 567.02 542.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.1 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 543.85 m 568.1 543.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 766.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 787.43 m 567.02 766.02 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 773.16 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 773.16 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 753.91 Tm (The Winterbourne Care Centre is registered to provide nursing and personal care for )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 736.91 Tm (up to 80 people. It was purpose-built and first registered on 5th February 2009. )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 719.91 Tm (Accommodation is provided over three floors. The home is divided into six units. At the )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 702.91 Tm (time of this inspection, four units were opened. One unit on the ground floor to the )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 685.91 Tm (right of the entrance area provided personal care to elderly people, the unit above this )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 668.91 Tm (on the first floor provided nursing care to people who were medically frail. The two )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 651.91 Tm (units to the left of the entrance area on the ground and first floor provided dementia )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 634.91 Tm (care. The home is owned by Caring Homes Healthcare, a national provider of care. The )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 617.91 Tm (registered manager's post is currently vacant, but there is an experienced manager )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 600.91 Tm (acting into the role. This person leads a team of registered nurses, carers and anciliary )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 583.91 Tm (staff. The home is on the London Road, leading into the city of Salisbury. There is )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 566.91 Tm (ample car parking on site, a bus stop close by and a train station about 10 minutes )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 549.91 Tm (away by bus or car. )Tj ET endstream endobj 10 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 11 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (4)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 745.27 Tm (What we found:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 691.53 w 31.2 389.44 m 580.26 389.44 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 736.33 m 582.46 736.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 737.41 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 737.41 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 720.15 Tm (This random inspection took place on Friday 9th October 2009 between 9:25am and 3:05 )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 705.57 Tm (pm. It was carried out by two regulatory inspectors. We reviewed a range of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 690.98 Tm (documentary information and discussed issues with different members of staff, including )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 676.41 Tm (the head of care. We concentrated mainly on standards of care in the nursing unit as we )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 661.83 Tm (had received information about standards of care on this unit. At the end of our visit, we )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 647.24 Tm (fed back to the acting manager.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 632.66 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 618.09 Tm (We looked at pre-admission assessments of residents on the nursing wing. We found that )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 603.51 Tm (until the new head of care had come into post, assessments of need for people admitted )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 588.92 Tm (for nursing care had been performed a senior carer, not a registered nurse. This meant )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 574.34 Tm (that not all factors relating to nursing care had been adequately considered. This )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 559.77 Tm (included, among other areas, information relating to catheter care and tissue viability. In )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 545.18 Tm (two of the cases reviewed, the residents should not have been admitted to the home, as )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 530.6 Tm (not all the registered nurses on the unit had the clinical skills to meet certain of their )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 516.03 Tm (complex nursing care needs. This had not been considered prior to the person's )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 501.45 Tm (admission. Now that the head of care is in post, this situation has been addressed and all )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 486.86 Tm (people to be admitted to for nursing care will have an assessment performed by a person )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 472.29 Tm (qualified to do so. The pre-admission assessment documentation will also be revised to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 457.7 Tm (expand assessments relating to people needing nursing care.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 443.13 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 428.55 Tm (We met with six people who needed nursing care and reviewed documentation in detail )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 413.96 Tm (relating to four people who needed nursing care and discussed their needs with the head )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 399.39 Tm (of care. The head of care reported that when they came in post, they found that junior )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 384.8 Tm (carers were not given a report regularly on residents' conditions. They had now set up )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 370.23 Tm (systems to ensure that carers did receive regular reports on residents' conditions and was )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 355.64 Tm (further developing documentary systems relating to this. They also reported that they )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 341.07 Tm (had identified that some carers needed further training in how to support residents. They )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 326.48 Tm (had set up supervisory systems to carers to address this.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 311.9 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 297.33 Tm (We found a variability in assessments and care plans. Some people had full assessments )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 282.74 Tm (and care plans, so that staff could know what a person's needs were and how they were )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 268.17 Tm (to be met. One person had a detailed assessment relating to their manual handling needs )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 253.59 Tm (and a clear care plan to direct staff on how the person's needs were to be met and risk )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.01 Tm (reduced. Another person had a care plan promptly put in place when they developed a )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 224.43 Tm (fungal infection. However other people's care plans were not clear. One person's care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 209.85 Tm (plan stated that their urinary catheter bag was to be emptied "regularly" with no )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 195.26 Tm (description of how often "regularly" was. Another person had a care plan about topical )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 180.68 Tm (applications to be used for them but they also had additional used topical applications in )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 166.1 Tm (their en-suite and it was not clear if and when they were to be used. Some people had )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 151.52 Tm (care plans which were only partially completed. One person had a care plan about a )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 136.95 Tm (urinary catheter; it did not include information on meeting the person's personal care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 122.36 Tm (needs in relation to cleanliness in the light of this catheter and did not document how )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 107.79 Tm (often the catheter bag was to be changed. Another person had a care plan about their )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 93.21 Tm (breathing, they had a clear care plan about the administration of Oxygen via a )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 78.63 Tm (concentrator but the care plan did not document how often the nasal canulae needed to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 64.04 Tm (be cleaned or how often any tubing needed to be changed. The person also had a )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 49.47 Tm (nebuliser in their room, which the resident reported they were given three times a day )Tj ET endstream endobj 12 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 13 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (5)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (but their care plan did not mention the use of the nebuliser or its effects on the resident. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (Some care plans which should have been drawn up were not in place. One person )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (experienced pain in a range of different parts of their body and was prescribed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (medication both regularly and on an as required basis about this. Medicines records )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (showed that the person was being administered these medicines and when and daily )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (records showed that the person did experience pain, however no care plans had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (drawn up about this person's pain or interventions to be taken by staff to ensure that the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (person did not experience pain. Another person had particular needs relating to their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (meals, which they told us about but they reported that some staff met these needs but )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (others did not. This need was not documented in their care plan.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (There was limited evidence that staff were meeting individual care needs. One person )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (was assessed as being both at high risk of pressure ulceration and needing to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (encouraged to take in fluids. They had monitoring charts which had not been completed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (for two days before the inspection, so it was not possible to assess if the person had had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (their position changed two to three hourly, as directed in their records or had taken in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (adequate fluids during the 24 hour period. This was not an isolated occurrence and was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (repeated across all residents in the nursing unit. This is of concern as all of the people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (visited were frail and were at risk of pressure ulceration and could have been at risk of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (dehydration if they were not given adequate fluids. This matter was identified at the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (previous ubspection and the requirement has not been addressed within timescales. None )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (of the fluid charts were observed to have been totalled every 24 hours as was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (recommended at the previous inspection. Where a resident had a catheter, there was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (limited documentary evidence of changes of catheter bags and the clinical indicator for )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (use of the catheter was not documented as was recommended at the previous inspection. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (This was discussed with the head of care, who reported that they were trying to establish )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (routines to ensure that residents' needs were met, for example they had delegated the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (role of ensuring that all residents were weighed at least monthly to one of the care staff.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (We observed that all residents on the nursing wing had been left with access to their call )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (bell. One person reported that staff "usually comes" when they rang their bell and that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (staff speed of attendance was variable. Another person reported "Oh yes, they come if I )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (ring my bell" and another that staff come "nice and quick" when they rang their bell.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (One resident reported that they tended to slide down their bed and become )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (uncomfortable. We asked them how staff met their needs when this happened. They )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (reported that carers would put their arms under their arms and "yank up" the bed. The )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (person did have a slide sheet in their en-suite. A second person reported to us that it )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (took two carers to move them up the bed, they described how some carers put their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (hands under their arms and pulled them up the bed. This person also had a slide sheet in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (their en-suite. Manually pulling a person up the bed is not appropriate practice as it can )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (put the resident and member of staff at risk of injury. It can also put the resident at risk )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (of a sheering injury. Appropriate manual handling aids must always be used.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (We discussed how relatives and other people could raise complaints and issues of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (concern, with the head of care. They were able to describe how they had listened to one )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (person who felt their relative's nursing care could be improved and showed us how they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (had documented this in the person's record. The record was clear and reflected what the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (head of care told us. They also reported that they had discussed the matter with the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (acting manager and had advised the persons involved to meet with the acting manager.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm ()Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 15 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (The environment of the home remained at a high standard, with equipment to meet )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (residents' needs. Standards of cleanliness were also high and there was clearly a ready )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (supply of disposable gloves and aprons. Some rubbish bins contained stuck-on debris )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (which needed removing. Equipment to meet disability was largely available. However )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (people who were assessed as having a high risk of pressure ulceration sat out of bed on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (cushions which were consistent with a medium risk of pressure ulceration, but their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (records did not clarify why this was indicated for the resident. Risk of pressure ulceration )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (does not reduce when a person is cared for out of bed. Several of the people who had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (topical applications in their room did not have these named or dated, as was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (recommended at the previous inspection. This is recommended to reduce risks of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (communal use of such creams and prevent them from being used for extended periods )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (after they are opened.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (As part of the inspection process we sampled the off duty staffing rota for the nursing )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (unit, over a period of one month. The rota does not currently clearly identify which staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (are working on specific units within the home. We suggested that the rota would be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (clearer if the nursing unit was separated from the rest of the units. The acting manager )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (immediately put this into action.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (The rota demonstrated that there is always a registered nurse, \(sometimes two\) on duty. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (They are now supported on the nursing wing by two carers. This was not the case until )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (recently. Previously there was one registered nurse and one carer on the nursing unit. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (The home has experienced some difficulties in recruiting permanent staff, however the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (acting manager reported that this has improved with regard to the nursing unit and they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (are almost in the position where they have an "established" team working on the nursing )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (unit. Several appointments have been made and the acting manager reported that they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (were waiting for several newly appointed members of staff to complete notice periods in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (their previous posts. The head of care reported that if the registered nurse had to leave )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (the nursing unit to support the residential units, that they and their nurses now always )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (complete an incident form so that the extent of supports required by the other units can )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (be monitored.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (We discussed the use of agency staff and were informed that the home generally use the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (same agencies to ensure that the carers have a good knowledge of the unit and the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (residents. This provides a consistent approach. The head of care reported that the agency )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (staff they currently had were "very good" and liked coming to the nursing unit. One )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (permanent member of staff commented "all of the agency staff that I have worked with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (all know what to do but will ask if they are unsure. We use agency but they do not work )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (alone, there is always a registered nurse with them".)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (One agency worker we met with told us that they were currently working an average of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (four or five shifts a week. They confirmed that they had received an induction into the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (home. We asked the agency worker to explain how they obtain information about )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (peoples' needs when they come on duty. They told us "everyday I look at the care plans )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (and keep up to date. The registered nurse and the full time carers will also pass )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (information on to me". They told us about the daily recording they complete to pass on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (information to the next shift. There are currently four separate daily records to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (completed by staff. We suggested that this be reduced to incorporate all information on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (fewer records. The head of care confirmed that they and their staff are piloting improved )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (systems in relation to this.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm ()Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 17 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 673.68 w 31.2 448.39 m 580.26 448.39 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 110.42 m 582.46 110.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 109.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 109.34 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (We spoke to the two care staff on duty during our visit. Both confirmed that they felt )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (there were sufficient staff on duty with the current numbers of people accommodated on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (the nursing unit. Both carers told us that they had time to chat to individuals while they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (deliver personal care. One person commented " the residents always look for me as they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (like me to chat with them".)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (We looked at staff induction and training on the nursing unit. One member of staff told us )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (that they had worked at the home since January 2009. They told us that they had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (previously worked in retail and had no previous experience of working within a care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (home. They added that they "love it and it was the best decision they had made". We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (asked them to explain about the induction process and if they felt competent to carry out )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (their duties. They reported that their induction had consisted of training in all mandatory )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (subjects such as, manual handling, safeguarding, first aid, basic food hygiene and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (catheter care. They added that they have also attended training in pain relief and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (palliative care at Salisbury hospital. They confirmed that they felt competent and by )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (working alongside a registered nurse they could always ask if they need advice.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (The carer told us that there were two permanent staff on the unit who were half way )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (through completing their National Vocational Qualification \(NVQ\) level 2. The agency staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (we spoke to confirmed that they held an NVQ level 2 also.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (The acting manager introduced us to a member of staff who works on the dementia unit. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (They are a qualified manual handling trainer. They told us that they are planning to start )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (training throughout the home in the near future and were intending to "work alongside )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (lesser qualified staff until they were deemed competent". We discussed residents' reports )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (of inappropriate manual handling with the head of care and acting manager and stated )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (that they must ensure that staff always use safe practice when performing manual )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (handling.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (The home currently hold profiles for all the agency staff used at the home. We looked at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (the profiles and saw that their qualifications are listed and proof of a check being carried )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (out with the Criminal Records Bureau \(CRB\). Letters are kept on file from the agencies to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (confirm that all of their staff meet CQC minimum standards and a copy of their Statement )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (of Purpose. The acting manager confirmed that they will not use an agency that does not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (provide the relevant information when requested.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (On the 14/5/09 records demonstrated that thirteen staff attended safeguarding training. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (On 30/6/09 three staff attended manual handling training. Some training is provided by E )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (learning. This is where staff members complete workbooks on line and are presented with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (a certificate when successfully completed. Subjects were E learning is used include, the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (principles of care, fire awareness and health and safety.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (The acting manager explained that the Primary Care Trust \(PCT\) provide training in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (subjects such as catheter care and continence care. They added that if, during an initial )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (assessment specific training needs were identified, they would arrange for this to take )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (place.)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 92.35 Tm (What the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 175.95 92.35 Tm (does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 38.61 w 31.2 62.98 m 580.26 62.98 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 83.41 m 582.46 83.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 84.49 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 84.49 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 67.22 Tm (The Winterbourne provides a modern, comfortable home environment. There are a wide )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 52.65 Tm (range of different communal rooms for residents to use if they wish. Residents' bedrooms )Tj ET endstream endobj 18 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 19 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 411.24 w 31.2 579.6 m 580.26 579.6 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 372.86 m 582.46 372.86 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 371.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 371.78 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (are large and residents can bring in items of their own. One person had brought in their )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (own recliner chair. One resident described the home as "gorgeous". We met with one )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (recently admitted resident who had been supported in bringing in a range of their own )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (items, this gave their room a highly personal appearance, reflecting their likes and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (preferences. Residents can choose to eat their meal in their own room or the dining room )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (on their floor or other areas of the home. Safe facillities for residents who wish to smoke )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (have been provided.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (High standards of nursing equipment are provided, including profiling beds and a range of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (equipment to meet their manual handling needs. One person described how )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm ("comfortable" their bed was. Air mattresses are readily available. Where residents needed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (safety rails, assessments of need were consistently made and regularly reviewed.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (We met with a resident who had been recently admitted to the home from another care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (home with nursing. They reported that their family had come and seen their room on )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (their behalf before they were admitted. They reported that the home provided much )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (improved supports in comparison with their previous placement and that they particularly )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (liked the size of their room, reporting that it was "much bigger than my last home". The )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (head of care reported on how this person's condition had improved since they had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (admitted and that they were now sitting out of bed more and taking more of an interest )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (in their surroundings and the home life.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (One person reported that they appreciated being able to have a shower every day if they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (wanted it. Another person reported that they were "not a bath person" and they they )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (appreciated staff not trying to pressurise them into having a bath if they did not want )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (one. A resident who had an existing condition relating to their leg reported "they look )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (after my leg properly". Another person who was assessed as being at high risk of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (pressure ulceration reported "they do turn me at night".)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 354.79 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 301.05 w 31.2 194.2 m 580.26 194.2 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 345.85 m 582.46 345.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 346.93 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 346.93 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 329.67 Tm (When assessing a person for admission, assessments should consider if the home can )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 315.08 Tm (meet all of the person's nursing care needs. These assessments should include )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 300.51 Tm (consideration of if the current registered nurses employed by the home have the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 285.92 Tm (technical skills to meet all of a residents' specific nursing needs.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 271.35 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 256.77 Tm (Care plans must be in place for all of a resident's nursing and care needs. Care plans )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 242.18 Tm (need to be specific and precisely describe how a person's needs are to be met. Plans )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 227.6 Tm (need to include details of care such as how catheters are to be cared for by carers and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 213.02 Tm (when tubing for such items as Oxygen needs changing. There must be full written )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 198.45 Tm (evidence that care is being provided to people in accordance with their care plans. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 183.87 Tm (Monitoring records must be completed at the time care is given. Staff must always )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 169.29 Tm (perform manual handling in a safe manner in accordance with care plans and good )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 154.71 Tm (practice guidelines.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 140.13 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 125.54 Tm (Where a resident is prescribed a medicine on an "as required" basis, there must always )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 110.96 Tm (be a care plan or protocol to direct registered nurses on when the person is to be given )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 96.39 Tm (such medication. Where a person is prescribed a medication which can affect their daily )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 81.81 Tm (lives, such as a nebuliser, this must be included in their care plan and the nebuliser )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 67.22 Tm (chamber must always be left clean and dry, to prevent risk of re-infection.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 52.65 Tm ()Tj ET endstream endobj 20 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 21 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 192.54 w 31.2 688.96 m 580.26 688.96 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.56 m 582.46 591.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 590.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 590.48 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (Management needs to take prompt action to ensure that our requirements and good )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (practice recommendations are acted upon. This inspection shows that one of the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (requirements at the last inspection relating to accurate monitoring records had not been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (addressed within timescales. Parts of two other requirements, one relating to care )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (planning and the other to "as required" medication care plans/protocols had also not been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (addressed within timescales. Also three recommendations had not been addressed. We )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (are aware that the home have experienced difficulties with the recruitment of staff and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (the acting manager reported that they anticipated that action would be taken to ensure )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (residents' needs were met, now they had established staff in post. The acting manager )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (was advised that if this inspection had been a key inspection, outcome areas relating to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (health and personal care would have been considered to be adequate, not good as at the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (previous inspection. We will perform a random inspection before the home's annual )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (service review, to ensure that standards have improved.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 575.5 Tm (If you want to know what action the person responsible for this care home)Tj ET /F1 12 Tf BT 1 0 0 1 483.55 575.5 Tm (is taking )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 559.5 Tm (following this report, you can contact them using the details set out on page 2.)Tj ET endstream endobj 22 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 24 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 36.25 w 29.47 752.7 m 564.97 752.7 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 753.83 m 568.3 753.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 773.08 m 568.3 773.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 753.83 m 568.3 753.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 734.58 m 568.3 734.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 774.15 m 27.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 423.22 754.9 m 423.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 468.22 754.9 m 468.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 495.22 754.9 m 495.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 540.22 754.9 m 540.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 774.15 m 567.22 733.5 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 33.75 759.89 Tm (Are there any outstanding requirements from the last inspection?)Tj ET /F1 12 Tf BT 1 0 0 1 429.75 740.64 Tm (Yes)Tj ET /F2 12 Tf BT 1 0 0 1 476.37 742.58 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 501.75 740.64 Tm (No)Tj ET /F2 12 Tf BT 1 0 0 1 546.75 742.58 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 635.4 w 32.32 361.38 m 564.97 361.38 l S 0.001 w 1 1 1 RG 329.76 w 31.2 411.34 m 91.05 411.34 l S 0.001 w 329.76 w 93.3 411.34 m 197.4 411.34 l S 0.001 w 329.76 w 199.65 411.34 m 289.45 411.34 l S 0.001 w 329.76 w 291.7 411.34 m 473.8 411.34 l S 0.001 w 329.76 w 476.05 411.34 m 566.1 411.34 l S 0.001 w 201.66 w 31.2 143.38 m 91.05 143.38 l S 0.001 w 201.66 w 93.3 143.38 m 197.4 143.38 l S 0.001 w 201.66 w 199.65 143.38 m 289.45 143.38 l S 0.001 w 201.66 w 291.7 143.38 m 473.8 143.38 l S 0.001 w 201.66 w 476.05 143.38 m 566.1 143.38 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 245.34 m 568.3 245.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 578.42 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 578.42 m 567.22 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.9 m 568.4 609.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 577.34 m 568.3 577.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 578.42 m 92.17 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 578.42 m 198.52 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 578.42 m 290.57 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 578.42 m 474.92 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 681.33 m 568.4 681.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 609.9 m 568.4 609.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 577.34 m 568.4 577.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 245.34 m 568.3 245.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 568.3 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 682.4 m 30.07 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 610.97 m 92.12 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 610.97 m 198.52 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 610.97 m 290.62 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 610.97 m 475.02 576.27 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 682.4 m 567.32 576.27 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 664.12 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 645.7 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 631.12 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 631.12 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 631.12 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 616.54 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 616.54 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 598.72 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 595.72 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 595.72 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 595.72 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 595.72 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 583.57 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 561.16 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 561.16 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 561.16 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 561.16 Tm (Where a person is unable to )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 546.58 Tm (change their position or give )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 532 Tm (themselves fluids or meals, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 517.42 Tm (monitoring records must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 502.84 Tm (show that care has been )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 488.26 Tm (given in accordance with )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 473.68 Tm (care plans. Monitoring )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 459.1 Tm (records must be fully )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 444.52 Tm (completed at the time care )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 429.94 Tm (was given.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 415.36 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 400.78 Tm (This requirement was )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 386.2 Tm (identified at the previous )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 371.62 Tm (inspection. It has not been )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 357.04 Tm (met within timescales.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 339.46 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 324.88 Tm (Monitoring records are )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 310.3 Tm (needed, so that staff can )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 295.72 Tm (assess if a person's needs )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 281.14 Tm (have been met and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 266.56 Tm (managers can monitor )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 251.98 Tm (effectiveness of care plans.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 561.16 Tm (31/07/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 229.15 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 229.15 Tm (26)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 229.15 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 229.15 Tm (The home must ensure safe )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 214.57 Tm (practice in the laundry, )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 199.99 Tm (including the correct )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 185.41 Tm (handling of items for )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 170.83 Tm (laundering, the availability of )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 156.25 Tm (disposable gloves, aprons )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 141.67 Tm (and rubbish bins and the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 127.09 Tm (marking of residents' own )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 112.51 Tm (items.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 97.93 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 83.35 Tm (This requirement was not )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 68.77 Tm (reviewed at this inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 51.19 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 478.9 229.15 Tm (31/07/2009)Tj ET endstream endobj 25 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 26 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (11)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 148.47 w 32.32 709.86 m 564.97 709.86 l S 0.001 w 1 1 1 RG 46.74 w 31.2 657.88 m 91.05 657.88 l S 0.001 w 46.74 w 93.3 657.88 m 197.4 657.88 l S 0.001 w 46.74 w 199.65 657.88 m 289.45 657.88 l S 0.001 w 46.74 w 291.7 657.88 m 473.8 657.88 l S 0.001 w 46.74 w 476.05 657.88 m 566.1 657.88 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 683.45 m 30.07 632.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 683.45 m 567.22 632.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.3 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 683.45 m 92.17 632.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 683.45 m 198.52 632.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 683.45 m 290.57 632.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 683.45 m 474.92 632.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 714.92 m 568.4 714.92 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 682.37 m 568.4 682.37 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 633.38 m 568.3 633.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 716 m 92.12 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 716 m 198.52 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 716 m 290.62 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 716 m 475.02 681.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 681.29 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 769.15 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 750.72 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 736.15 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 736.15 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 736.15 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 721.57 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 721.57 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 703.74 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 700.74 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 700.74 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 700.74 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 700.74 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 688.59 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 671.43 Tm (If there are not safe systems )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 656.85 Tm (in the laundry, there will be a )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 642.28 Tm (risk of cross infection.)Tj ET endstream endobj 28 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 29 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (12)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 770.27 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 754.85 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 32.32 692.47 m 564.97 692.47 l S 0.001 w 1 1 1 RG 20.58 w 31.2 649.83 m 91.05 649.83 l S 0.001 w 20.58 w 93.3 649.83 m 197.4 649.83 l S 0.001 w 20.58 w 199.65 649.83 m 289.45 649.83 l S 0.001 w 20.58 w 291.7 649.83 m 473.8 649.83 l S 0.001 w 20.58 w 476.05 649.83 m 566.1 649.83 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 662.32 m 30.07 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 662.32 m 567.22 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.3 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 662.32 m 92.17 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 662.32 m 198.52 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 662.32 m 290.57 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 662.32 m 474.92 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 748.78 m 568.4 748.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.4 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 638.41 m 568.3 638.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 749.86 m 30.07 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 694.87 m 92.12 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 694.87 m 198.52 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 694.87 m 290.62 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 694.87 m 475.02 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 749.86 m 567.32 660.17 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 732.6 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 715.02 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 700.44 Tm (The registered person had to meet these within 48 hours.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 682.62 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 679.62 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 679.62 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 679.62 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 679.62 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 667.47 Tm (action)Tj ET 0.95294 0.95294 0.95294 RG 556.24 w 32.32 321.8 m 564.97 321.8 l S 0.001 w 1 1 1 RG 242.28 w 31.2 378.36 m 91.05 378.36 l S 0.001 w 242.28 w 93.3 378.36 m 197.4 378.36 l S 0.001 w 242.28 w 199.65 378.36 m 289.45 378.36 l S 0.001 w 242.28 w 291.7 378.36 m 473.8 378.36 l S 0.001 w 242.28 w 476.05 378.36 m 566.1 378.36 l S 0.001 w 183.96 w 31.2 162.99 m 91.05 162.99 l S 0.001 w 183.96 w 93.3 162.99 m 197.4 162.99 l S 0.001 w 183.96 w 199.65 162.99 m 289.45 162.99 l S 0.001 w 183.96 w 291.7 162.99 m 473.8 162.99 l S 0.001 w 183.96 w 476.05 162.99 m 566.1 162.99 l S 0.001 w 26.21 w 31.2 55.65 m 91.05 55.65 l S 0.001 w 26.21 w 93.3 55.65 m 197.4 55.65 l S 0.001 w 26.21 w 199.65 55.65 m 289.45 55.65 l S 0.001 w 26.21 w 291.7 55.65 m 473.8 55.65 l S 0.001 w 26.21 w 476.05 55.65 m 566.1 55.65 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 256.1 m 568.3 256.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 69.89 m 568.3 69.89 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 501.7 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 501.7 m 567.22 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 533.17 m 568.4 533.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 500.63 m 568.3 500.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 501.7 m 92.17 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 501.7 m 198.52 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 501.7 m 290.57 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 501.7 m 474.92 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 602.16 m 568.4 602.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 533.17 m 568.4 533.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 500.63 m 568.4 500.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 256.1 m 568.3 256.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 69.89 m 568.3 69.89 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 568.3 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 603.24 m 30.07 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 534.25 m 92.12 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 534.25 m 198.52 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 534.25 m 290.62 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 534.25 m 475.02 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 603.24 m 567.32 499.55 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 588.98 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 568.98 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 554.4 Tm (Standards Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 166.31 554.4 Tm (Regulations 2001 and the National Minimum Standards. The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 539.82 Tm (registered person\(s\) must do this within the timescales we have set.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 522 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 519 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 519 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 519 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 519 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 506.85 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 484.44 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 484.44 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 484.44 Tm (15)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 484.44 Tm (All residents must have full )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 469.86 Tm (and detailed care plans put )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 455.28 Tm (in place for all of their care )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 440.7 Tm (needs.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 426.12 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 411.54 Tm (Parts of this requirement was )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 396.96 Tm (identified at the previous )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 382.38 Tm (inspection, with a timescale )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 367.8 Tm (of 31/07/09. This part has )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 353.22 Tm (not been addressed within )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 338.64 Tm (timescales by this inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 321.06 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 306.48 Tm (Care plans are needed so )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 291.9 Tm (that residents can have their )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 277.32 Tm (needs met in an appropriate )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 262.74 Tm (and consistent manner.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 484.44 Tm (30/10/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.91 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 239.91 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 239.91 Tm (23)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 239.91 Tm (If a person is assessed as )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 225.33 Tm (being at high risk of pressure )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 210.75 Tm (ulceration, pressure relieving )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 196.17 Tm (equipment which is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 181.59 Tm (consistent with this assessed )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 167.01 Tm (degree of risk must be )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 152.43 Tm (provided when the person is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 137.85 Tm (sitting out of bed. )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 120.27 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 105.69 Tm (Risks of pressure ulceration )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 91.11 Tm (do not reduce when a person )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 76.53 Tm (is sitting out of bed.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 239.91 Tm (30/11/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 53.7 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 53.7 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 53.7 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 53.7 Tm (Where a resident is )Tj ET /F1 12 Tf BT 1 0 0 1 478.9 53.7 Tm (30/10/2009)Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 31 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 699.41 w 32.32 434.39 m 564.97 434.39 l S 0.001 w 1 1 1 RG 256.86 w 31.2 555.26 m 91.05 555.26 l S 0.001 w 256.86 w 93.3 555.26 m 197.4 555.26 l S 0.001 w 256.86 w 199.65 555.26 m 289.45 555.26 l S 0.001 w 256.86 w 291.7 555.26 m 473.8 555.26 l S 0.001 w 256.86 w 476.05 555.26 m 566.1 555.26 l S 0.001 w 183.96 w 31.2 332.6 m 91.05 332.6 l S 0.001 w 183.96 w 93.3 332.6 m 197.4 332.6 l S 0.001 w 183.96 w 199.65 332.6 m 289.45 332.6 l S 0.001 w 183.96 w 291.7 332.6 m 473.8 332.6 l S 0.001 w 183.96 w 476.05 332.6 m 566.1 332.6 l S 0.001 w 154.8 w 31.2 160.96 m 91.05 160.96 l S 0.001 w 154.8 w 93.3 160.96 m 197.4 160.96 l S 0.001 w 154.8 w 199.65 160.96 m 289.45 160.96 l S 0.001 w 154.8 w 291.7 160.96 m 473.8 160.96 l S 0.001 w 154.8 w 476.05 160.96 m 566.1 160.96 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 425.7 m 568.3 425.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 239.49 m 568.3 239.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 685.89 m 30.07 81.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 685.89 m 567.22 81.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 717.36 m 568.4 717.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 684.81 m 568.3 684.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 685.89 m 92.17 81.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 685.89 m 198.52 81.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 685.89 m 290.57 81.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 685.89 m 474.92 81.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 717.36 m 568.4 717.36 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 684.81 m 568.4 684.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 425.7 m 568.3 425.7 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 239.49 m 568.3 239.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 82.44 m 568.3 82.44 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 718.44 m 92.12 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 718.44 m 198.52 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 718.44 m 290.62 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 718.44 m 475.02 683.73 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 683.73 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 773.16 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 753.16 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 738.59 Tm (Standards Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 166.31 738.59 Tm (Regulations 2001 and the National Minimum Standards. The )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 724.01 Tm (registered person\(s\) must do this within the timescales we have set.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 706.18 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 703.18 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 703.18 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 703.18 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 703.18 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 691.03 Tm (action)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 673.88 Tm (prescribed a medication on )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 659.29 Tm (an "as requred" basis, a care )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 644.72 Tm (plan or protocol must always )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 630.14 Tm (be put in place.)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 615.55 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 292.3 600.97 Tm (Parts of this requirement )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 586.4 Tm (were identified at the )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 571.82 Tm (previous inspection, with a )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 557.23 Tm (timescale of 31/07/09. This )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 542.66 Tm (part has not been addressed )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 528.08 Tm (within timescales by this )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 513.49 Tm (inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 292.3 492.92 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 292.3 478.33 Tm (Residents need to be given )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 463.76 Tm (their medications in a safe )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 449.17 Tm (and consistent manner by )Tj ET /F1 12 Tf BT 1 0 0 1 292.3 434.6 Tm (staff.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 409.52 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 409.52 Tm (26)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 409.52 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 409.52 Tm (Nebuliser reservoirs must )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 394.93 Tm (always be left clean and dry )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 380.36 Tm (after administration is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 365.77 Tm (completed.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 348.2 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 333.61 Tm (If a nebuliser reservoir is not )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 319.04 Tm (clean clean and dry, there is )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 304.45 Tm (a risk that micro-organisms )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 289.88 Tm (will grow in the reservoir and )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 275.3 Tm (the resident be at risk of )Tj ET /F1 12 Tf BT 1 0 0 1 447.98 275.3 Tm (re-)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 260.71 Tm (infection)Tj ET /F1 12 Tf BT 1 0 0 1 345.95 260.71 Tm ( when they use the )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 246.13 Tm (nebuliser.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 409.52 Tm (30/10/2009)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 223.3 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 223.3 Tm (38)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 223.3 Tm (13)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 223.3 Tm (Staff must always undertake )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 208.73 Tm (safe manual handling when )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 194.15 Tm (assisting residents to move )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 179.57 Tm (up their bed.)Tj ET /F1 12 Tf BT 1 0 0 1 294.55 161.99 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 294.55 147.4 Tm (Moving a person up the bed )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 132.82 Tm (by not using appropriate )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 118.25 Tm (manual handling aids can put )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 103.67 Tm (the resident and the member )Tj ET /F1 12 Tf BT 1 0 0 1 294.55 89.08 Tm (of staff at risk of injury.)Tj ET /F1 12 Tf BT 1 0 0 1 478.9 223.3 Tm (30/10/2009)Tj ET endstream endobj 32 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 33 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (14)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 720.09 w 32.32 424.05 m 564.97 424.05 l S 0.001 w 1 1 1 RG 49.74 w 31.2 670.39 m 91.05 670.39 l S 0.001 w 49.74 w 93.3 670.39 m 197.4 670.39 l S 0.001 w 49.74 w 199.65 670.39 m 566.1 670.39 l S 0.001 w 35.16 w 31.2 625.68 m 91.05 625.68 l S 0.001 w 35.16 w 93.3 625.68 m 197.4 625.68 l S 0.001 w 35.16 w 199.65 625.68 m 566.1 625.68 l S 0.001 w 78.9 w 31.2 566.41 m 91.05 566.41 l S 0.001 w 78.9 w 93.3 566.41 m 197.4 566.41 l S 0.001 w 78.9 w 199.65 566.41 m 566.1 566.41 l S 0.001 w 93.48 w 31.2 477.96 m 91.05 477.96 l S 0.001 w 93.48 w 93.3 477.96 m 197.4 477.96 l S 0.001 w 93.48 w 199.65 477.96 m 566.1 477.96 l S 0.001 w 78.9 w 31.2 389.52 m 91.05 389.52 l S 0.001 w 78.9 w 93.3 389.52 m 197.4 389.52 l S 0.001 w 78.9 w 199.65 389.52 m 566.1 389.52 l S 0.001 w 93.48 w 31.2 301.08 m 91.05 301.08 l S 0.001 w 93.48 w 93.3 301.08 m 197.4 301.08 l S 0.001 w 93.48 w 199.65 301.08 m 566.1 301.08 l S 0.001 w 78.9 w 31.2 212.65 m 91.05 212.65 l S 0.001 w 78.9 w 93.3 212.65 m 197.4 212.65 l S 0.001 w 78.9 w 199.65 212.65 m 566.1 212.65 l S 0.001 w 108.06 w 31.2 116.92 m 91.05 116.92 l S 0.001 w 108.06 w 93.3 116.92 m 197.4 116.92 l S 0.001 w 108.06 w 199.65 116.92 m 566.1 116.92 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 644.39 m 568.3 644.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 606.98 m 568.3 606.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 525.83 m 568.3 525.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 430.1 m 568.3 430.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 348.95 m 568.3 348.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 253.22 m 568.3 253.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 172.07 m 568.3 172.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 697.46 m 30.07 60.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 697.46 m 567.22 60.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 716.78 m 568.4 716.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 696.38 m 568.3 696.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 697.46 m 92.17 60.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 697.46 m 198.52 60.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 716.78 m 568.4 716.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 696.38 m 568.4 696.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 644.39 m 568.3 644.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 606.98 m 568.3 606.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 525.83 m 568.3 525.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 430.1 m 568.3 430.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 348.95 m 568.3 348.95 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 253.22 m 568.3 253.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 172.07 m 568.3 172.07 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 61.76 m 568.3 61.76 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 717.86 m 92.17 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.47 717.86 m 198.47 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 695.3 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 770.16 Tm (Recommendations)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 752.59 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 738.01 Tm (Minimum Standards and the registered person\(s\) should consider them as a way of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 723.42 Tm (improving their service.)Tj ET /F1 10 Tf BT 1 0 0 1 34.05 702.6 Tm (No)Tj ET /F1 10 Tf BT 1 0 0 1 96.15 702.6 Tm (Refer to Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.45 702.6 Tm (Good Practice Recommendations)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 680.2 Tm (1)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 680.2 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 680.2 Tm (Pre-admission assessments should provide written evidence )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 665.61 Tm (that all of a person's nursing needs can be met by the )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 651.03 Tm (home.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 628.21 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 628.21 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 628.21 Tm (Care plans should be written in clear and measurable terms )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 613.63 Tm (and the use of generalistic wording be avoided.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 590.79 Tm (3)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 590.79 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 590.79 Tm (Where a person is having their fluid intake measured, the )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 576.22 Tm (amount taken in should be totalled in 24 hours.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 561.64 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 202.5 547.05 Tm (This was identified at the last inspection. It has not yet )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 532.47 Tm (been actioned.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 509.64 Tm (4)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 509.64 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 509.64 Tm (Where a person has a wound photographed, the date )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 495.07 Tm (should be included on the photograph and a "signing )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 480.48 Tm (off"/archiving system be developed for healed wounds.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 465.9 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 202.5 451.33 Tm (This was identified at the last inspection. It was not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 436.74 Tm (reviewed at this inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 413.92 Tm (5)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 413.92 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 413.92 Tm (Where a person has a urinary catheter in place, the clinical )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 399.33 Tm (indicator for the catheter should be documented.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 384.76 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 202.5 370.17 Tm (This was identified at the last inspection. It has not yet )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 355.6 Tm (been actioned.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 332.77 Tm (6)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 332.77 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 332.77 Tm (Written additions to the medication administration record )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 318.18 Tm (should be signed, dated and checked by two members of )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 303.61 Tm (staff.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 289.02 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 202.5 274.45 Tm (This was identified at the last inspection. It was not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 259.86 Tm (reviewed at this inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 237.04 Tm (7)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 237.04 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 237.04 Tm (Records for the use of creams and lotions should be made )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 222.46 Tm (by the staff applying those products.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 207.88 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 202.5 193.29 Tm (This was identified at the last inspection. It was not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 178.71 Tm (reviewed at this inspection.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 155.88 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 155.88 Tm (12)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 155.88 Tm (All activities participated in by residents should be )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 141.3 Tm (documented and the home should develop systems so that )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 126.72 Tm (they can review and document how successful or not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 112.14 Tm (activities have been for people.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 97.57 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 202.5 82.99 Tm (This was identified at the last inspection. It was not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 68.4 Tm (reviewed at this inspection.)Tj ET endstream endobj 34 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 35 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (15)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 218.61 w 32.32 674.79 m 564.97 674.79 l S 0.001 w 1 1 1 RG 64.32 w 31.2 663.09 m 91.05 663.09 l S 0.001 w 64.32 w 93.3 663.09 m 197.4 663.09 l S 0.001 w 64.32 w 199.65 663.09 m 566.1 663.09 l S 0.001 w 64.32 w 31.2 596.53 m 91.05 596.53 l S 0.001 w 64.32 w 93.3 596.53 m 197.4 596.53 l S 0.001 w 64.32 w 199.65 596.53 m 566.1 596.53 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 629.81 m 568.3 629.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 697.46 m 30.07 562.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 697.46 m 567.22 562.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 716.78 m 568.4 716.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 696.38 m 568.3 696.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 697.46 m 92.17 562.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 697.46 m 198.52 562.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.4 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 716.78 m 568.4 716.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 696.38 m 568.4 696.38 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 629.81 m 568.3 629.81 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 563.24 m 568.3 563.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 717.86 m 92.17 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.47 717.86 m 198.47 695.3 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 787.43 m 567.32 695.3 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 770.16 Tm (Recommendations)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 752.59 Tm (These recommendations are taken from the best practice described in the National )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 738.01 Tm (Minimum Standards and the registered person\(s\) should consider them as a way of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 723.42 Tm (improving their service.)Tj ET /F1 10 Tf BT 1 0 0 1 34.05 702.6 Tm (No)Tj ET /F1 10 Tf BT 1 0 0 1 96.15 702.6 Tm (Refer to Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.45 702.6 Tm (Good Practice Recommendations)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 680.2 Tm (9)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 680.2 Tm (26)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 680.2 Tm (All topical creams should be named and dated on opening.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 665.61 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 202.5 651.03 Tm (This was identified at the last key inspection. It has not yet )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 636.46 Tm (been actioned in full.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 613.63 Tm (10)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 613.63 Tm (38)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 613.63 Tm (The fire risk assessment should be further developed.)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 599.04 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 202.5 584.47 Tm (This was identified at the last inspection. It was not )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 569.89 Tm (reviewed at this inspection.)Tj ET endstream endobj 36 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 37 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (16)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 768.28 Tm (Reader Information)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 28.35 746.8 m 229.46 746.8 l S 0.001 w 1 1 1 RG 20.58 w 231.71 746.8 m 581.74 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 723.97 m 229.46 723.97 l S 0.001 w 1 1 1 RG 20.58 w 231.71 723.97 m 581.74 723.97 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 701.14 m 229.46 701.14 l S 0.001 w 1 1 1 RG 20.58 w 231.71 701.14 m 581.74 701.14 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 28.35 678.31 m 229.46 678.31 l S 0.001 w 1 1 1 RG 20.58 w 231.71 678.31 m 581.74 678.31 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 735.39 m 583.94 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 712.55 m 583.94 712.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 689.72 m 583.94 689.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 758.22 m 583.94 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 735.39 m 583.94 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 712.55 m 583.94 712.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 689.72 m 583.94 689.72 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 666.9 m 583.94 666.9 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 759.29 m 27.22 665.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 230.59 759.29 m 230.59 665.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 582.86 759.29 m 582.86 665.82 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.2 742.03 Tm (Document Purpose:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 742.03 Tm (Inspection Report)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 719.2 Tm (Author:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 719.2 Tm (Care Quality Commission)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 696.37 Tm (Audience:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 696.37 Tm (General Public)Tj ET /F1 12 Tf BT 1 0 0 1 31.2 673.54 Tm (Further copies from:)Tj ET /F1 12 Tf BT 1 0 0 1 234.56 673.54 Tm (0870 240 7535)Tj ET /F1 12 Tf BT 1 0 0 1 335.41 673.54 Tm (\(telephone order line\))Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 652.59 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 638.01 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 623.42 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 78.9 w 25.8 581.46 m 563.3 581.46 l S 0.001 w /F1 12 Tf BT 1 0 0 1 34.05 605.84 Tm (Our duty to regulate social care services is set out in the Care Standards Act 2000.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 591.27 Tm (Copies of the National Minimum Standards )Tj ET /F1 12 Tf BT 1 0 0 1 303.94 591.27 Tm (Care Homes for Older People can be )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 576.68 Tm (found at www.dh.gov.uk or got from The Stationery Office \(TSO\) PO Box 29, St )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 562.1 Tm (Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 547.53 Tm (the Stationery Office is also available: www.tso.co.uk/bookshop)Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 526.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 509.36 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 494.79 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 480.2 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 34.16 w 25.8 460.61 m 563.3 460.61 l S 0.001 w /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 455.08 Tm (Helpline:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 420.92 Tm (Telephone:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 147.95 420.92 Tm (03000 616161)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 389.27 Tm (Email:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 99.55 389.27 Tm (enquiries@cqc.org.uk)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 357.61 Tm (Web: )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 88.63 357.61 Tm (www.cqc.org.uk)Tj ET /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 327.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 299.21 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 28.35 276.5 Tm (We want people to be able to access this information. If you would like a summary in a )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 259 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F1 18 Tf BT 1 0 0 1 28.35 232.98 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 210.26 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be reproduced )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 192.76 Tm (in whole or in part, free of charge, in any format or medium provided that it is not used for )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 175.27 Tm (commercial gain. This consent is subject to the material being reproduced accurately and )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 157.77 Tm (on proviso that it is not used in a derogatory manner or misleading context. The material )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 140.28 Tm (should be acknowledged as CQC copyright, with the title and date of publication of the )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 122.78 Tm (document specified.)Tj ET endstream endobj 38 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 39 0 obj <>stream %!PS-AdobeFont-1.0: Verdana Typeface and data 1996 Microsoft Corporation. All Rights Reserved %%CreationDate: Thu Oct 09 15:25:10 2008 % Converted from TrueType font 'VERDANA.TTF' by ttf2pt1 program % %%EndComments 12 dict begin /FontInfo 9 dict dup begin /version (Version 2.35) readonly def /Notice (Typeface and data 1996 Microsoft Corporation. All Rights Reserved) readonly def /FullName (Verdana) readonly def /FamilyName (Verdana) readonly def /Weight (Regular) readonly def /ItalicAngle 0.000000 def /isFixedPitch false def /UnderlinePosition -88 def /UnderlineThickness 59 def end readonly def /FontName /Verdana def /PaintType 0 def /StrokeWidth 0 def /FontType 1 def /FontMatrix [0.001 0 0 0.001 0 0] def /FontBBox {-30 -207 1447 1000} readonly def /Encoding 256 array dup 0 /.notdef put dup 1 /.notdef put dup 2 /.notdef put dup 3 /.notdef put dup 4 /.notdef put dup 5 /.notdef put dup 6 /.notdef put dup 7 /.notdef put dup 8 /.notdef put dup 9 /.notdef put dup 10 /.notdef put dup 11 /.notdef put dup 12 /.notdef put dup 13 /.notdef put dup 14 /.notdef put dup 15 /.notdef put dup 16 /.notdef put dup 17 /.notdef put dup 18 /.notdef put dup 19 /.notdef put dup 20 /.notdef put dup 21 /.notdef put dup 22 /.notdef put dup 23 /.notdef put dup 24 /.notdef put dup 25 /.notdef put dup 26 /.notdef put dup 27 /.notdef put dup 28 /.notdef put dup 29 /.notdef put dup 30 /.notdef put dup 31 /.notdef put dup 32 /space put dup 33 /exclam put dup 34 /quotedbl put dup 35 /numbersign put dup 36 /dollar put dup 37 /percent put dup 38 /ampersand put dup 39 /quotesingle put dup 40 /parenleft put dup 41 /parenright put dup 42 /asterisk put dup 43 /plus put dup 44 /comma put dup 45 /hyphen put dup 46 /period put dup 47 /slash put dup 48 /zero put dup 49 /one put dup 50 /two put dup 51 /three put dup 52 /four put dup 53 /five put dup 54 /six put dup 55 /seven put dup 56 /eight put dup 57 /nine put dup 58 /colon put dup 59 /semicolon put dup 60 /less put dup 61 /equal put dup 62 /greater put dup 63 /question put dup 64 /at put dup 65 /A put dup 66 /B put dup 67 /C put dup 68 /D put dup 69 /E put dup 70 /F put dup 71 /G put dup 72 /H put dup 73 /I put dup 74 /J put dup 75 /K put dup 76 /L put dup 77 /M put dup 78 /N put dup 79 /O put dup 80 /P put dup 81 /Q put dup 82 /R put dup 83 /S put dup 84 /T put dup 85 /U put dup 86 /V put dup 87 /W put dup 88 /X put dup 89 /Y put dup 90 /Z put dup 91 /bracketleft put dup 92 /backslash put dup 93 /bracketright put dup 94 /asciicircum put dup 95 /underscore put dup 96 /grave put dup 97 /a put dup 98 /b put dup 99 /c put dup 100 /d put dup 101 /e put dup 102 /f put dup 103 /g put dup 104 /h put dup 105 /i put dup 106 /j put dup 107 /k put dup 108 /l put dup 109 /m put dup 110 /n put dup 111 /o put dup 112 /p put dup 113 /q put dup 114 /r put dup 115 /s put dup 116 /t put dup 117 /u put dup 118 /v put dup 119 /w put dup 120 /x put dup 121 /y put dup 122 /z put dup 123 /braceleft put dup 124 /bar put dup 125 /braceright put dup 126 /asciitilde put dup 127 /.notdef put dup 128 /Euro put dup 129 /.notdef put dup 130 /quotesinglbase put dup 131 /florin put dup 132 /quotedblbase put dup 133 /ellipsis put dup 134 /dagger put dup 135 /daggerdbl put dup 136 /circumflex put dup 137 /perthousand put dup 138 /Scaron put dup 139 /guilsinglleft put dup 140 /OE put dup 141 /.notdef put dup 142 /.notdef put dup 143 /.notdef put dup 144 /.notdef put dup 145 /quoteleft put dup 146 /quoteright put dup 147 /quotedblleft put dup 148 /quotedblright put dup 149 /bullet put dup 150 /endash put dup 151 /emdash put dup 152 /tilde put dup 153 /trademark put dup 154 /scaron put dup 155 /guilsinglright put dup 156 /oe put dup 157 /.notdef put dup 158 /.notdef put dup 159 /Ydieresis put dup 160 /space put dup 161 /exclamdown put dup 162 /cent put dup 163 /sterling put dup 164 /currency put dup 165 /yen put dup 166 /brokenbar put dup 167 /section put dup 168 /dieresis put dup 169 /copyright put dup 170 /ordfeminine put dup 171 /guillemotleft put dup 172 /logicalnot put dup 173 /hyphen put dup 174 /registered put dup 175 /overscore put dup 176 /degree put dup 177 /plusminus put dup 178 /twosuperior put dup 179 /threesuperior put dup 180 /acute put dup 181 /mu1 put dup 182 /paragraph put dup 183 /middot put dup 184 /cedilla put dup 185 /onesuperior put dup 186 /ordmasculine put dup 187 /guillemotright put dup 188 /onequarter put dup 189 /onehalf put dup 190 /threequarters put dup 191 /questiondown put dup 192 /Agrave put dup 193 /Aacute put dup 194 /Acircumflex put dup 195 /Atilde put dup 196 /Adieresis put dup 197 /Aring put dup 198 /AE put dup 199 /Ccedilla put dup 200 /Egrave put dup 201 /Eacute put dup 202 /Ecircumflex put dup 203 /Edieresis put dup 204 /Igrave put dup 205 /Iacute put dup 206 /Icircumflex put dup 207 /Idieresis put dup 208 /Eth put dup 209 /Ntilde put dup 210 /Ograve put dup 211 /Oacute put dup 212 /Ocircumflex put dup 213 /Otilde put dup 214 /Odieresis put dup 215 /multiply put dup 216 /Oslash put dup 217 /Ugrave put dup 218 /Uacute put dup 219 /Ucircumflex put dup 220 /Udieresis put dup 221 /Yacute put dup 222 /Thorn put dup 223 /germandbls put dup 224 /agrave put dup 225 /aacute put dup 226 /acircumflex put dup 227 /atilde put dup 228 /adieresis put dup 229 /aring put dup 230 /ae put dup 231 /ccedilla put dup 232 /egrave put dup 233 /eacute put dup 234 /ecircumflex put dup 235 /edieresis put dup 236 /igrave put dup 237 /iacute put dup 238 /icircumflex put dup 239 /idieresis put dup 240 /eth put dup 241 /ntilde put dup 242 /ograve put dup 243 /oacute put dup 244 /ocircumflex put dup 245 /otilde put dup 246 /odieresis put dup 247 /divide put dup 248 /oslash put dup 249 /ugrave put dup 250 /uacute put dup 251 /ucircumflex put dup 252 /udieresis put dup 253 /yacute put dup 254 /thorn put dup 255 /ydieresis put readonly def currentdict end currentfile eexec oc;jtD[2^t$cdreYjRZb@e F>" F+$l `v .H֢T)&wa{vIt%Նswg,lonrMWWIZ7p6\5JHrtPb E~1Cew|;d}Tym8 B Tc gPUcOx {OqqQF4-UټXODU8o\kswKami%ޗﶥB$S/1LW~'T^<T4PX+ԯ({A34.KUĖn%*R_g!g(F4%ٸD K~ɕy8e!lcx# |< -}^^i(XlŨ3K a[y3E7Oz,߉1N6+Pj)cpS-mR\7߃Ra0bRTl,SQYKO׏C8y'߭sU5d}DҰMۭT[I[(㏭AK9%+,E B`6P( :8|NoYo>XImF;:Bŀÿ Kt,!fa"X0*Im Srߋ{8w;Ҵ+DIZy41Żp m`Z# 2;7aޗ8~$6<+p Uk!i͢m~~ I[z)*a0wmNQ ^\تw?@ċ=0}Ơ6YWUfo&|*aGѤrvʧ:q9h@) 6u%sBo$N?J6(Ah:m~\ZXݐ^NR(>^;:i~f6{'Y &'W|-}犁$$S Cp`Ӎ+Wǧ`q4{W_E&9YXs1sZQ<*`(SaD~e y_~IF}dUBfHQԙNM{&%S)XL`Gļ jPo_`p5NMbNzwst/ KC7JdTi@,$^-GFIkYJ.G926VFAq21Ƃ٣/ יtZa)9Og % XRgø+q`h~S 5R_CqD׹9ՅZ]yEK#sk* YbQ ɬXM]S~+x dXn7Y>y_u2b%_sU,;byga6 ;߷@# 3[WQOӗH\ަբHπ/nWUXFٓ%u_`Fo7e"ƢF G] l T`ca]Qߝ|Y+5DmA˗oRsl_x-!Е3X0S%l4 iݭq9ę>)h%3 #=W6Y'P=yxRX)vh,KGD{4|l^kw%4 8=sMDF~;`Q*lpQ&7A^q-9B1GvRM9~'QZ]_ȏ% G;W8m׍9C`Wnb˻mR,ͤ29-a+ᒶᑝ豤n*9Ckxf'qB[t@@˛/QȒ ԻѢkleCD1o2]'9y3Sř+V0r ЯU 7=Ѕ݉r/}g(U d`QxGOveߺa?! ބdA70nylFZ({Dƪؠ kM >d\l>B͹"GI Td u~bJ|hJ>]Vn?Q55߯JG@Jmd'2u:{El8FD(W7)v8`|d`vci={ah,,ݘH{DW3C<ź|Y/ϼAc4<@Gsfp0ڃ8Gw di+Hu'^-bZh҉bꏱ<+ϋM#A{OJ5`8蜌8?""TF '>֐f z׫ÚZ@BG!MC,>b {Xyk',XNx 'ދ!Y-2+W+/7xCkҮ[T<(|+AiBㆼ,X׶|t˯hzVxMF[~sHQ# S4֦5!p%Ra#wfM@wB:H֜KF<SZ%H'6zU)(.t!zr6لY4*0G˒hTvYKa@$ioahىϚ1fn=lOn..):Z`(Ǽl}yZmDP;${%RK a$e+WD:(_yNw/Ya kF?4"dKg?7PV O#=GDGބEOBDCƲ(<;̘Fl@V}O.{3X6V<-^7z|Indc.<67ͼBk\~ctg. Mmºhh/ ٠KWAS!Xȹ*`veOoH_w fD=B'z$_,ȧeammOyX$֓@rA eQVއW@U!2OSۊV7sZI 4ځod _ 8m\ߣpRv왍>1 J8dEϜ4 *bQ|ܧ׸{)f3}ad2 LcB@GCK[i$Ψ7}ԓT$O߈Fx 5N>w-*#?.鼹+DjH'TNVBOc).禼W ڒgw۳vyc mO4$P؂}b=< JT0\ZƗi,s/Q,D+TףM+jcl+`±t eۈ~_6c ۡQ!key4,FT.!E0t//n)!M0adnMnrҸ]On lŪ|k'T1z+yt?;@FVY5WAuGMDC"ec%b,2lCbQ聾";LE=3! 9`kW ymW!O;SLui8_:ӐNCbvč|۷%)ǻN^9I87 tCj2HІ0~^uhƧ6(s@ː+q‰d,puD1(~%9YLǿL 0=odՄH]#)ľ&\fz6x,ʨ\ IGwY~t]"@Q`< $ej+7 9ߧ dUe Pmxq^4Ѓ=)z7v)0 |G—m?O;+^JإįrRNd¹x $Pd7{_T(UR=|$:N;G niΠ:w={}&o, Bh;~ +?al0c ?hlG;;Dsά\8}Tb]W=ݬ\4aEmNGwA=˪yƢ[ >FO"EF'P\sA` cGB=fu 7EWYSY]H]AWIm|#[4o*֓֫h)X%%'.7GDF<p}n(o>wMm]j}{ƀ|!G.bƩ #ۄnA\prO59y%.i4/h"G _lL]H˹ 6bzF!ڪ}gZEf,r˽Ù$oK6wz;u͞O+h_i߈h"UwziBqۊA( a( PUXGV+:~>3ZXK$7_T}%Du?*1lUAWg>4'C'\?q6wb "w}IDWzp+D{AK44$͡ Um3JKw|{hJnIj)LJ?qlk^iaWk69TZ%= Z;|T|1GŽY[0 C63#xೇ>=x_Vj&WKx0Ō(3w|? gEJ"ṚX=xS՞seL|BK? Q.X8+)PO Q݃\RZ鋞ON& [ jo&QbY`roJnH,im,֏^&\)q9ݟ6P"'Rb/bcazn5K$j6~fS(z}j_Q/8[Hs dK_imev]r*txj(-o>\tK$A,G2ey=ZhɑoxR^N`N:vQ}'RS3|is"5g`ѓϸYoU@¡UnwUהL?!w&mLۉE9R1Kϟ#Lt1]v*{B^,W4@y`T+V9Vm{cp&_ـgT,(NKM5`A9ف.Tld7Y:DRԞT9j cv{5l=5v1윏{4"(a. =R '(^,92njno?hCl aǺK9@P\ ",:pH)᰺]L ة;EDUf/(cү{WQuHa292|I9z:[} $~CZ%t|%!jJ#fWJ/Zv0?5 8"j,!`A-ӫRyNP}4_Ce)xZDo:/S}$$f2\Sʋ6bo^C⌦mYc2VѼ=;\2+y#?6RMks4e#1rJQJ $J^`֯\!z@4h#ŗGJ &pf22B ^캇!bie"G6纤Q55Ql̎AJ2e{2 8m0͵ į%DO pt/.xfv$ h̑qQ S>ZQme\=Z>OZ=ɨ~hO/Xx-sn؏O۶3B3Ŏp-XLę޼g*De\Ex%[r)"6;do5/˥7 RnZ]OŇ?su$L mx/{&kٮR5x>; 6RMÛniZ8I\J K]$"n#aJB4^ ur@](K֐mm"`6""@R̃ӵ{VÈD3CCD)q2tyJEL]l]Xi!CU#JNP+UMB1I_ WÍ>kb }$n9!u;ڽ֦2c՝zlJO{uʃ6+\OK YU!&zjTPą-wD#+:,w@ {JV -2}ÇXo@{C[]\~ќ+C2T1.yaa겮fnd 4,c52b]%C~JrP~ߴ_Q|,u`% ڗnhZyP{cr9/j/58E$zUmv ^PE΁سS sCl=|" ~CzQ[)u6ZLw[u$@~n&E\CoyZs J?$>mY qƱ媭)[#I{eR`Vw}|.bvqlr2D\YBx-kStϢ;9D]c!?7uFtAׯ$;}!+fTKSaf!+T Wj)~/8`ǒ2H9V f>FG<W(}i^#s $;WG=$e}_ֿ.qElSw)1gԟbv^om(mp4Bk 9մ.\jPJOzR+ܢڃIz a,{/Z2͉Miωlϒs&Ao9rq T"gh}q@T7$;e9Hrl⁔2(9'4qB`h}S1XI`((G-%Δ-.ݪu68&U$¶8HӬ2M&w6x]/$!g_9pB9IUn[e_7O \;c )Y]2J¯/;'llmXJiQ +RF*h"X(=݊6`Jeܪ>HI({?o2f{b3Zzohe0G>so: BQiWAր.&hq;N_Ю$ a#s iծPxHhK I 2}2uowRfR'`A֌m!fzSEU}B(otO+YWH)(z|p=}%fsd2j+lڵ&7 = /gGR$IĹI &u+ViD/1)?0sue P=C'hZrҢ ZͶJĉj`폃QF=Ժ0’||Xϛ7C޶ 6-h+E_:xVf<ꪰhn )ͅPAZF$3Lͯzh&1r4*xW7gm׆`QgOZU$P8o r[zmotA}QY;@oH{}̞`!1:DwSDkCL><.z<{8Luo m zA{m6YQ?@RW}%u/NCd;1`sUbP?ɸ#mtjzq"kk>D?'H; vu]l@xF7J| v, (+Tv [ ADK @?t)2~5".bppVxD?o|xzh+Ɂ1Fz]0V̞w•ޭ(c!b~…WXŀvSpNgREDl@SB 4#hvlGqkI{0 vrizl=2 c}A j0OcSTGlVoQs%wy} LM:kI>~ЦU̙ck</J'V}7]-j/\E]w9!ȇ ,(VJeφBIm!-\P nt}L|2MChA܅{W1V c'XXiUKJ<-0m?戞Y^@fD~g![L/(G 2|٤޵&~:NoMMv# $G4y"ɰ M.@&/t.9Aۉ{ 2-c&gU|;p*fNTS֛AfrHg;'hMປp۱xI fzTw3YVB\aC2% m^de|~urgG\UT#jVTmk{pc(EJPun 2kIqM\ 30 IcOW5C}Ydm.g$5%}a–Z'Ltq{T>Fy"ъWT}]+*5'~p4nd=afʥVD nGѫS.F uS`)-&C$\/:К/[ 0]Td\ұ$"AN km]Tb`SFZjyJ2+H4%*l1.ߏۢƊ^%Rdv @GsL̅ﴣ̟<'@E.j=P$$" F-HDѵ9dVͭPܖ$iO=ȋ`ԠH#LoO9D?~V\jC5|)ۿ#$iNČ@(oVBQ}<0na.:k{Nx1L+K$Ov%[4F/FU$Æh G$8ͫ9NVW6FZΖpB1O6X%ŲX"qFT+bFT}7a jO W^_Cizс)vJ0@8v3:7};lA1 ]LL_O N0Bｖ_n)]+[fEzIbq`"-]kPФ۷v=B9:EŮ ݡ`"k\ooolZ)?~iK~Ȅ=Ė2da#w&&v|fV»nݚJ|zes ?"a] ԲB=:+E --N67@Z^\298@51ny~$L|Jt]׎u4YGv\^ܳԹ6^=[E<:{!6+edѐٱܚsrAE|ځR3!~;˲.4[?(%5-SE܎J:ShB M e j0u3tȧRK 8A:JB#ޒ.; _rc+V}Vl3>OL5yj߷\Qۯ-; =HMUʡpJnE;YK7+%~|MH$ڪGQÂ/'%V.(42zV|tf]},dfx̩2>'ZhOUQ%1_MO kqb2GBy|CX͗.ZɝBK1Wc5k2=J}D8锑ň4r:}0oB۬֏k Z[cg*Wd(S\8_n#x8AG!lu|n2e PU$acJaj\fBf٧`vIwBKT*@@=a 9MUZ4r /ALEoɢK Ft??zk.3fP!&}hnSs^tn; ̬ z#5 h}N0[;G{S襓5U2.4h+16_t,knSx np-w|.Hh- m "5MOHkvRU~&m@A$jq)bܐFPPuh+փv+pd_Igw)Z(uQdGS@-zU<Ԟ*|QîPDVWn7 ,0;/]y0[?o@ v ą6|ٱ^6a+(b>6 x? ,ZߴlrN\4@ 'HUS·Y; 3!~z  vlU;7*E^͵C^w ?]J}86Us4:]-I#ʠWW(ON J32D{o+cR7 mw3T.:Lj/al*ƝQk wipLd?]_G.nR2(GN+HX4z6Յ|s$ͦ,q+A@^۰{T.!CHE:KWܔNzf*0ʸax5"P̨)J._~.$&=S,(BAFIgFԏ ѽӊ ьbR">5Lt{.QOfZxJ.`~wG}u,G2%2$D֧2]snҽOXdzXo(N9ȶd_%Di +5̂WUY֪h" G&:}WۣzA̭` 77ZS G <&s9 Q x{9od[6reLM*ãD/?适\WS"5ZЈ#SXR'>ghzs>!YQ8/+7DF'g]z C$sn L!2i!6}x.k4}20Ը{Ƃ+2tf;J\>9;(f:SF Μ&P@st ^įr4f|9'G7DRegNC^SOf #"3ֱ\> E#f靶jߣ{!)m.jid2s jȥbd܋TZ506Fߴw|avdp`Ky_?=S{gٌH6"9@<9xS+ڢ3@@unc~hGJ2&緕8YNBF֠Nwˣ4G.xپxncD{'t`A֛tb+h-S"e qۂb*T|fwbocP:VveBQ(eHp<JBuTk7Q`Omn;&Z/'v\Xs|U⯧X v>W@%uG3驌z=?'hRIU-mD>VfAƒ)S8`qM>nغSH}fRD;G([LА2TϦY6 U u~Aj]G4VWd=d<ߓ<7,/vj cVJ0(Q-O56_OJ()80Plu` Dfl)Z SqRgz+HKmZ/ uFEK1ئ-lr4܋"&ol|>R"9aZ`Q^|A-=AW5ne;N yu*h^j<GYyU}K+0"rR,mf1i"zT#`2 cTƞ PSAp΍tEGBcedƕ4DT#)LwJF۹ j;oDrxSt8U1&P=U̹xK\,IƵ^|Y7p27?r:}`>,x\@"z񝸵*U2ILk_شÆB5m܊#יGmrXQ4ϔ#- 'TE+h:I^g^?D`$LRKbjfzUЪ_Ù5~NYvei{:\fA9zkh#-6w0}%‚1%a[M7+lksVSaw|$\O,lm܅+Ibd!QXB[c2Bɑ35+u0oPճcO#[ \a;Ǭ~&mZ"{' pظN.࢓wҌ?0 4`w}; (tLEu;n'XsdS3>1H0 Ď}U4(S)hڰW?cTehc=zWaO.|mwB@`2D/SN௛;VuHUWwSřeȺuB-FZD]lbX3K=vbylͥ Ȧ碒 zY5Ibn~pw&JO o42|oy38haI7 (n _u*y/{DYo+0k>J- YcU%F+EWn:_NUN ݘ JhPo%2!r%2׳YLOs27_]&Ma&Sg~m |T5w7dױO5GD d!E3XVqT_9UY&P@\ɠ"O:ǿ sBqZ1Ӯru^/$7n~~ Ax)G+񋙍}; yL޳ OToLhO%2LOڕ:}󶟕@?>zs]Ǎ!#B~y' ~\? ʙK<`PXb idZoeՋT[VdwV9X7ReiO^MUj( 3BnUCK ⢒60H]];q RAˑ,"n- -x\//8f:;P#[HLCnʥ9,պlv4;`@U]Y\$B {FN)Uđ^i>۲=Sef(19 Λ߮8_<s·Ӛ3 qxZ;887dX^\m(ZrsTAI8TTZKee3m03q8c~&}w|j(!YUK(+NHjǥo NĤNI=&= mޛ$ԁ(,JmVkr_|+%"9/99*^|"q4OǨ3~pW͔T)$Wt|L[U^p;7Z G~.{ 1i5hm6E+XD +1#J$W u< y q ~m?;[#<&Nj{ Pv򧦕F?K.us Z#gh*fK_vSe܆ǟs8LI^Ӓ.<;FDlINѺy_tB KoϦ[iIn\9~PUӇZq)) ~Io[%1?`Eyiuƪ̜,%g-y9 1 XYGĻzp~[ p13]H⭘{:;;1#=?d55ڑ,zgfMٰJL})5D. T? 6}Uf:Aڇ`oauյ+)Lz nQUx%yֶ~Ols5*px*:i$4)Wh\>^UyEyxdRK5dbJefߡՐR6rZL;aguop- W38 M*Cx ![|AtVKl:7a10S=fl򣮿,SVވ30psY3չbX#/9~*PJpO6Yc>oz:]Xz7K _!%qD3ӀԜs/^Hwo1jIyD ^pc梵hl|V܂O~N u*S}\sFSCnm- h]%138<O3Xf[#fȅsKw1P'=e_| eB6p6)N;RL&+'WG,] z[\Mh`m`nJKbTt:[}SDbcc!@5Ā$f#O( */df24%>$K[ M _~?^g&߾Td9Cnm:P>|ဉs:|=1J 2}:ni@R:E!Y'%^_B]pG?lތB"C=)?NkQ ߁F[D'k5:t8kh۴&oB)׌u<QE];|b#Iw*nN_23 ECSF _jd^*I鄈mli8'(!PVF:dΎO)9_U69F./ |΁PGJX[} gx<,/=~t4IF lS_AR,3~ zfS<>V,*0!DTi?cJn)1tЉfE>y0iݤØ/J$&0rcfB9ne]^QcbQVK2klJWpZB)σdױ||@=ebcۊLa(uwbD4ӓ#fiZQ"$k]vC[{4dP~jG1hyZւYVz@+Z?'-5PXwW:捇6Bz"qP(-8Pkr_$:ew8ܹ*K T뛩.& hz#zҖAF5)#Ze@lOp-ϵ%FRʿ$ט$쐜hG"88_ybTE]R38WGOMUSzlc2\3ԯ^:MrER) qr3p@YR$ vj\\~0C;0rGx_7r)i ¼|'nъQī_2[s5%Ќr`ģ<:- u)k"(}k 96t~3t%.,1-pgUGQ/5+ #]jYgeBy7IwT dZڏѯ0m\@%7׻ȣ*cZ^.жAW>wLWb4U\/x7etuD)axqҥ\>MG+*#,=whx{L  ی?M5t}P%8C̒ GF?Ki_}ް_VeBrBA,c@Wjwt'@[Bs(6rFtƮ?B>N}*WR`Е\(Pz!:B0hq'T6Fd'2$MDMԏ҇B*rJSwьDp[NpxE#J2,CElt&|Sq[V4";.p_]!t a7UYDI= jB>@Rw˦D۬Ý9_07ы2'B+[e䶗 o fB*3|ߚ̨T<1U Nk@nB6!@:"7 %v( i'Bǫϊ, ]Un˜> F,:nqӧM^N|+l?c3|cIR3[{6 bQ9'VUʹ]sfƔ0A8֚I*x&FP]{d! wEyhB-֖%z-:䷅}̻A#OqGawu^ktf9Ay6ADGQޞW $ lbCLLzJG '%)qk"h/&_I׋BApb4%[F5:5_⿪y㓤C|lt{sET(/(wɮ1'q!ڒʝF&MLJ@-Wù ,]>{Z~u F࿝mN^"ɁpF=uu`π l 2e̾<=Y7mt6>dḾGh ZPZaC8hwMVqB ۔d҅Ñ 8o~nw3\ßj8 )ļW12LW/e88$=`^&zqx_U j&Dݥ٭Twk򁬱pP7y$eoS^ f>H[XBK@/)mOH{h ׯ9sVͣ 0F=WFA-tUjb +ϣtf065d½wåJ_WU?Zɤ1"2_ eƭ>gI}CXNeC$ezL0S0w,*/pV- {8h]bfHÀϒx^qnЍv (#VɎu;d6tWL[]?mָ>mw9ueWXgp@N{~"Kv9H0X׈kz!10齿g&5SQL쭜#)ɞU|FgnuJ"5JQzC+^ 2RȎ-ޤ.M@B^!]9Ւ ~H̨ڨQZњZ̯״F 4N.!0'Pu~! :oK 90ery/Qj|F\]qcUhE oᗊAXz%j}v4M +-""Hl˜ l@Է;Z"'P%]I$"8V*bz{2+_᪻d8+fV`<{Y<~=Ma L#1_\y\?SġvuXm"[wݮm""U9{MW}g62 *A۲Zқ񶶃w*YՂd' h܈'uZ 9a^K54vP^[\eշyyjX8Lfsk(lmo@WR_/7~TXMF 7Ty켌Y@ơ"4=7,{a ٻEyuy,%Mg W"J^K sk 9_7?]H$> $zC;1eo0[PK6ʕ7qMeܱڥؓ\BM ()B4V|,G /XI;AdPfͽZ~:{6xJ)@AQu `sd$yԧIaC=B>2r5[#lѹyk 2 TM^VaJn/|Lp_M"N~'q pTgfoL{@7'v^6*:j4 ^vlc;-LC궿#9O v=7=DBʅS |œ~%3cGX6v_8O?[E1yV>QNV[)]}P|2|p:@Ն.1nGddд bP q >&n+JQ4a͡&Co^Z[Qvs4%:S/,҈ O-\СvC`_LlP<9_d['.r]&%v=p*7Jqh;|Y8W fbxJ aVKǑ7Kb<MtM4O>43ζ*BsF.Q:-;krh̛1|vorhcagoY*iwg ,AfYk=8,%8Nl{b^oױ~q3+(gAS2'ЇF%ΐ!SͶqd #2wBKRjDQACMR૝<^Z Ì$01q-y߀7AZGnfNݔ ֍5Uݦ]9ul"s>\ջpVP9dq8ˢ*繪apH ="O3Z+)@߈.6q|;:yLFflm/72#Z{%9 S/Ovp#jO};~d03RR'sIҜ, =ΨVyX?qth x&wY;0ӹĮ5V 76,D `ڸ9vO{* n`BdbH~!5:un|>I堾>Kxm^Oʂ&νͩYDBl{1UёSZI^{:4S8b GĸDi%fCe)H\Oނg&{+ڕkO<թrPT1V5J!؟.E,'Q?G;N^dbUxLNKh"#; CV_/8' D4䤟)l(9>Oy8r#M6rKIY *\TF @a+;~"D5Qyn9\v pUBkȝu|T@1]+})N>7ʠ5x}lvߑXD'>HHGd.=roy7 54!θ?Y@JɣԯR<;A<йky(T ʭ1'3 Ev;[PQJmӂX+ǓrIXې^݅[Fk"%J:9BFtH@9Cֻ38.ҹfjȰLA'aͧ+dQzXRFmUMaf+/+a&&ڎP9=}v dQY^nx,jDX 6+փ$Y} lXk qq :xpйfqvTmA<ttŤ MS[ ҙ 3]ǃĞ5rA;1ABy^xCgF͚z wdbAm X+30 h\n(g`3(tJl׉`\lKd/ơJ YpX'!yɆ)[:#ґӀVnei9'Qp׬L<u ~rSH5,߷7D'^Ȯ>YrO_Qѷ iWx+<N.J^4RINɓ>Tˈ' #5Z.KM'ek!TDXLH<4ǵng }x"&k;߁zGe{DJ:n43MTMc(T sJ@ 0fh},տG@Ϙ[͕lrősss@}iļIZ@ c7 C^Y{h l9b!&a`u}k=uuT2LE@ 97d +Β]j{,)3Ksm!`tNچEAXu ߝ+b4wP*kBN'q䖇9ĸHj2?lzM AkI̹T6TZr+E}|-3X V"MR$~f!&TIۇ.NRT7]_J{kpw<짃uy('&[)xe^@E*efE&%$ I~پ.V:au2o o\}0kV wЁ߰gLUO)/E6~e_cDuKj +s_b2}ڋ1KĺuSPq1酞vѧ.*$t4tE)-v0"3 &]秾 DY]ҏ6`I}zhZn& n lPfDsF,ub{7|yMR x9MjjfY*1)Uگk Q3AKG:@)"QGQ̽jFh lȊC˴q#1ƭO<2L99&MVtcHnF--=!37x7+@SJOv KeRPGA$4QÑ!!Ř[K& Mchy'h+|\@p|riJbȱO Zß}a_-E?-7Uӏ SO*F-^kΜc^o~n'(Z&bƿdp̗TֱZ+SDe> endobj 2 0 obj<> endobj 41 0 obj <>stream  cvt gxfpgm;_glyfˬ ^head< H6hhea$ $hmtx ploca76maxp 1t prepF 8}11c1bbDu1c111D1>}1(111{-1(3c1J`7]1bP2Jb2(11124bb(()_b{8P>2;IV`bbz!&BF7>>TtNmmn{{(hxAYiU\.t/J\cx{{{ ""(/23>CFHPSfijkrsx,.88AMP\ik| ,,Alx=>o:BX~9`/111:<JJLWstx  ((-WYZZZZprr."+`x =.:WX]]SlCcM*SclAq],C]"D>;KeJPBQLQLT7Z\WU:rrE@78743210/.-,+*)('&%$#"!  ,E#F` &`&#HH-,E#F#a &a&#HH-,E#F` a F`&#HH-,E#F#a ` &a a&#HH-,E#F`@a f`&#HH-,E#F#a@` &a@a&#HH-, <<-, E# D# ZQX# D#Y QX# MD#Y &QX# D#Y!!-, EhD ` EFvhE`D-, C#Ce -, C#C -,F#pF>F#pFE: -,EJ#DEI#D-, E%EadPQXED!!Y-,Cc#b#B+-, EC`D-,CCe -, i@a ,b`+ d#da\XaY-,E+G#DGz-,TX CTXJIDDYY-,CXE+#DzEi #D QX+#Dz!zYY-,-,KRX!ED#E %ERXD!!YY-,/-, %EI#DEJ#DEe#E %`j #B#hj`a Ry!J@JE TX#!?#YaDRyI@ IE TX#!?#YaD-,C#C -,C#C -, C#C -, C#Ce -,C#Ce -,C#Ce -,KRXED!!Y-, %#I@` c RX#%8#%e8c8!!!!!Y-,Ei C`:-,%# `#-,%# a#-,%-, ` <<-, a <<-,++**-,CC -,>**-,5-,vK#p KE PXaY:/-,!! d#d@b-,!QX d#d b@/+Y`-,!QX d#dUb/+Y`-, d#d@b`#!-,&&&&Eh:-,&&&&Ehe:-,E# E %PX&a&`YD-,F#F`F# F`ab# #KKpE` PXa@Yh:-,3+**-,CXY-,CXY-#@/?103!%!!8 P@+  { /999?999/10&''&&'632!!!!67`,9) KgJ*JJ&J (""" """ zJzJee") """"!!""+ ]+PV =`9PPPP""""""""""""""""""""""kk4!!!!!!!!!!!!o!!!!!!!o!!!!!!!!!po==!!!!!!!!!!!!!!!!!!b!Q!?!.!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!}!&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&`9_@ FF@H H2 %H2 #H2 "H2 !H2  H2 H2 H2 H2 @[H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 yH2 nH2 dH2 _H2 ]H2 ZH2 XH2 H2 H2 H2 H2 H2 H2 H2 @LH2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 \H2& & 7E@CzweaWU$"   KKSBKcKb S# QZ#BKKTB8+TXCXYY++++++++++++++++++++++++++++++++KPyAP*&+++++KSyAP*&+++++P2Ka`+++++++++++++++++++++++++++++++++++++++++++++++++++++++++EiSBKPXBYC\XBY CX`!YBp>CX;!~ +Y #B #BCX-A-A +Y#B#BCX~;! +Y#B#B endstream endobj 42 0 obj<> endobj 43 0 obj<>/Subtype/CIDFontType2/Type/Font/W [53[891]133[891]]/CIDToGIDMap/Identity/DW 1000>> endobj 44 0 obj <>stream /CIDInit /ProcSet findresource begin 12 dict begin begincmap /CIDSystemInfo << /Registry (Adobe) /Ordering (UCS) /Supplement 0 >> def /CMapName /Adobe-Identity-UCS def /CMapType 2 def 1 begincodespacerange <0035><0085> endcodespacerange 2 beginbfrange <0035><0035><0052> <0085><0085><00a3> endbfrange endcmap CMapName currentdict /CMap defineresource pop end end endstream endobj 23 0 obj<> endobj 5 0 obj<> endobj 27 0 obj<> endobj 45 0 obj<> endobj 46 0 obj<> endobj 47 0 obj<> endobj xref 0 48 0000000000 65535 f 0000000015 00000 n 0000155982 00000 n 0000002248 00000 n 0000018182 00000 n 0000162647 00000 n 0000024309 00000 n 0000024499 00000 n 0000035359 00000 n 0000035515 00000 n 0000038419 00000 n 0000038576 00000 n 0000045397 00000 n 0000045555 00000 n 0000052627 00000 n 0000052785 00000 n 0000059607 00000 n 0000059765 00000 n 0000066693 00000 n 0000066851 00000 n 0000073691 00000 n 0000073849 00000 n 0000076705 00000 n 0000162515 00000 n 0000076863 00000 n 0000083974 00000 n 0000084142 00000 n 0000162774 00000 n 0000087348 00000 n 0000087507 00000 n 0000096075 00000 n 0000096234 00000 n 0000102962 00000 n 0000103121 00000 n 0000111239 00000 n 0000111398 00000 n 0000114802 00000 n 0000114961 00000 n 0000120821 00000 n 0000120980 00000 n 0000155810 00000 n 0000156530 00000 n 0000161709 00000 n 0000161888 00000 n 0000162103 00000 n 0000162875 00000 n 0000162934 00000 n 0000162980 00000 n trailer <]/Root 46 0 R/Size 48>> startxref 163198 %%EOF