Inspection on 14/01/08 for Southwoods Nursing Home

This is the latest available inspection report for this service, carried out on 14th January 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Southwoods Nursing Home 28 Thirsk Road Northallerton North Yorkshire DL6 1PH Lead Inspector Denise Rouse Unannounced Inspection 14th January 2008 10:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southwoods Nursing Home Address 28 Thirsk Road Northallerton North Yorkshire DL6 1PH Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01609 780362 01609 772533 Vorg Limited Mrs Theresa Mary Watkins Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30/01/07 Brief Description of the Service: Southwoods is a former dwelling house which has had a significant extension built to provide nursing care for up to 38 residents. It was first registered in February 1990 and is located a quarter of a mile south of the North Yorkshire county town of Northallerton on the west side of the main 168 Thirsk Road. It has two floors including the ground and there is a vertical lift providing level access to the first floor. Most of the garden area at the rear west facing side of the building is given over to car parking with flower / shrub beds round the rear and south side of the property. The fees charged on the site visit undertaken on 14/01/08 ranged from £400.00 to £540.00 for private care. A copy of the last inspection report is available to people. The service user guide is available; this contains a summary of the services the home provides. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good, quality outcomes. The accumulated evidence used in this report has included: • A review of the information held on the home’s file since its last key inspection. • Information submitted by the registered provider in the Annual Quality Assurance Assessment. • Surveys received from two people living at the home, one relative, and four health care professionals. • An unannounced visit to the home, which lasted five hours. This included a full tour of the premises by one inspector. • • Evidence gained by direct observation during the site visit; which involved talking with people living at the home, two visitors, the manager and staff. Inspection of records, including care profiles, medication administration records, staff files and some of the home’s policies and procedures. What the service does well: Assessments of peoples needs are undertaken and include details of risks, to ensure people’s needs can be met. Activities being provided are varied and staff put themselves out to take people on trips. People receive care in a way that respects their privacy and dignity. A robust complaint’s procedure is in place to ensure that any concerns raised are investigated and dealt with thoroughly. Training for staff is provided to ensure that care is given by people who have relevant knowledge of how to give care safely. Audits on how the home runs are carried out by the manager and other staff, to ensure the quality of the service is monitored and any shortfalls identified are dealt with thoroughly. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (6 Not Applicable) People who use this service experience good quality outcomes in this area. People are assessed and have information provided about the home, so they can make an informed choice. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Planned admissions are fully assessed before people are offered a place in the home. This assessment is undertaken by staff who are confident and competent. Information is gained from the individual, their relatives and chosen representative and the discharging hospital to ensure people’s needs are known and can be met. People are invited to visit the home and are given a welcome pack, which contains information about the services the home has to offer. This enables people to make an informed decision about if the home is the right place for them. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 9 Trial periods are offered to help people experience the home and clarify that it is suitable and staff can meet their individual needs. Fast track admissions for people who need care immediately are taken from the local authority. Information is gained initially by telephone to ensure that the home can meet the individual’s needs. Once the person arrives then a full assessment of their needs is undertaken. One relative commented “ I had a look round, and was made welcome, matron came to assess my relative in hospital and talked to both of us about the home”. Another relative said, “ I came in to see the manager, I was shown round and received a contract and information about the home”. Intermediate care is not undertaken in the home. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 8 9 10 People who use this service experience good quality outcomes in this area. People’s care needs are met and their privacy and dignity is respected, however there were some shortfalls relating to medication, which may place people at risk. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Information from the pre admission assessment is used to create individual care plans and risk assessments. This ensures people’s needs are known and can be met. These are reviewed each month, or as the persons need change, to ensure the care being provided is relevant. However two peoples care plans inspected had not been reviewed in December, these were reviewed at the time of the site visit. People who are admitted to the home under the fast track system have a 24 hour assessment of their needs undertaken. This forms the basis of their care plans and risk assessments to ensure that their needs are met. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 11 Key workers and associated staff are allocated to each person so that a strong relationship can develop to help people feel supported. The manager was in the process of updating the Key worker list. People are also assessed in relation to their vulnerability and their risk of falling. This helps to keep people safe. People living in the home who are very unwell, are regularly reassessed by their health care professionals, to ensure that hospital admissions are appropriate to them. People can choose how to spend their time and can get up and go to bed when they wish, assisted by the staff where necessary. Equipment is available in the home to ensure that people’s special needs are met. Staff accompany people to hospital appointments, opticians and dentists as required. People’s individual nutritional needs are monitored and acted upon to ensure that their health is maintained. Inspection of the medication systems operating in the home revealed some issues. The temperature of the treatment room was 24.0 degrees centigrade with the door open. There is a large radiator in the treatment room. The manager is to monitor the temperature to ensure that the room is not to hot, to allow medication to be stored safely. Two peoples eye drops were inspected. One did not have the opening date recorded. This should be recorded to ensure that eye drops are discarded timely. Guidance should also be gained relating to the way the home records by hand people’s medications upon the medication administration record. To ensure that it complies with current legislation. People are treated with dignity and respect. Staff addresses people by their preferred names and knock on their bedroom doors prior to entering. One person said “ The care my relative receives is excellent, they are quite happy and say that they feel at home here”. And “ one thing that never ceases to amaze me as a relative, is the good humour of the staff whilst giving care, if there are any issues staff say it’s no problem and sort things out”. Another said “ If my relative is not well, I am phoned and at any time, it may be 10.00 pm. Staff spend time to talk with me and inform me of any issues, I feel comforted and am able to go to bed”. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards12 13 14 15 People who use this service experience good quality outcomes in this area. People’s social needs are met, however their preferred social activities are not always recorded. People are provided with a nutritious diet. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: One-persons care profile inspected contained information about their life history and chosen social preferences. However this was not evident for all the peoples care profiles inspected. The manager stated that this would be implemented and social care plans created to ensure that peoples preferred social needs were known and being met. It was evident that the care staff knew each person who used the service well and was providing activities, which interested them. Money is raised by the home to ensure that the outings are not charged for. Bingo, dominoes and arts and crafts are just a few of the activities available. Staff give their time at no cost to take groups of people out on trips. Relatives really appreciated the staff giving their time freely and said it was commendable. Motivational classes are held which provide physical or mental stimulation and recall for people participating. There is a carer who undertakes activities in the home eight hours per week. One to one and group activities are available as Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 13 well as shopping trips. A monthly activities programme is to be produced so that people can plan what they wish to attend. One person said “I am going to go out to see Cinderella with my relative this weekend. Staff volunteer and take people out on trips in wheelchairs, they come in and do this on their days off”. Another relative said “ We went out to Thirsk races and also to a concert at Hambleton Forum Centre, a Colliery Band and male voice choir”. A quarterly newsletter is also produced and circulated to keep everyone informed. Two relatives hold regular resident and relatives meetings with the manager in attendance. People can put their views and suggestions forward. Local schools and colleges are involved in the home. Performing Art students are providing a concert. Local school children performed a Christmas Carol service. There was a Boxing Day buffet provided for people and their relatives, which was well attended. Visiting is open and people go out with their relatives and friends if they wish. The home also arranges for some people to go home to their relatives for visits. A hairdresser and chiropodist also attend the home, as well as local clergy. A chiropodist visits the home as well as local clergy. A choice of food is available, people can choose to eat in their bedrooms or in the dining areas provided. The kitchen inspection confirmed that the cook knew peoples special dietary needs. Lunch served looked appetizing and people said, “ The food is good”. People needing assistance with eating are assisted by staff that are patient, this ensures that people are not being rushed. Two relatives confirmed that they could stay and have a meal with their loved one. One relative said, “ My relative gets plenty to eat and I can eat with them”. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16 18 People who use this service experience good quality outcomes in this area. People can be assured that complaints would be dealt with and they are protected from abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a complaints policy available to people living in the home. There have been no complaints received since the last inspection. Two people spoken with said they felt able to talk about any concerns they might have with the manager or staff within the home, and that they felt any issues raised would be investigated and dealt with. The policies and procedures in operation at the home ensure that people are protected from abuse. Staff receive training about safeguarding adults this is updated yearly for all staff and it is mandatory training. All new staff are given information in their induction about safeguarding adults. Criminal Record Bureau checks are carried out to ensure that people are protected from staff that may not be suitable to work within the care industry. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 26 People who use this service experience good quality outcomes in this area. People live in a homely environment, which is being improved, however sluices needed cleaning and floor covering in one sluice required replacing to ensure Infection control measures were in place. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a welcoming atmosphere and is homely. There is ample parking with extra parking available on the road. New corridor carpets have been fitted. There are separate lounge areas and people can choose to stay in their bedrooms or use the communal areas as they wish. A programme of maintenance and improvements is being undertaken to ensure that the environment is pleasant for people living there. This includes changing the heating system in people’s bedrooms from storage heaters to radiators, so that people can control the temperatures in their bedrooms. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 16 There are plans to replace the existing bedroom furniture and develop a sensory garden for people to enjoy. This will enhance the facilities available to people. Laundry procedures in place ensure that infection control is maintained. Hand washing facilities are available throughout the home to ensure people are protected from cross contamination. The sluices on both floors inspected required cleaning; this was undertaken on the day of the site visit. Sterisan tablets were removed from both sluices to be locked in a storage cupboard; this ensures that people’s health and safety was maintained. The ground floor sluice required floor covering to be fitted to the full length of the floor. There had been a leak of some fluid, which had gone into the exposed floorboards. This must be addressed to ensure that thorough cleaning can take place, and ensure infection control measures are in place. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27 28 29 30 People who use this service experience good quality outcomes in this area. People receive care from adequate numbers of well-trained staff. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The numbers and skill mix of staff ensures that care is received timely. Staff were seen to be patient and helped and supported people living in the home. Staff are recruited using thorough processes, to ensure people are protected, from staff that may not be suitable to work in the care industry. Staff receive induction in relation to safeguarding adults, fire, moving and handling and infection control. Regular updates are provided in all statutory areas. Staff files inspected confirmed that two members of staff had one written reference on file; the others were with the employment agency or at head office. These should be available in the home. Nurses Pin numbers were checked before they commenced at the home to ensure that they were registered and safe to practice nursing. The home has achieved a 50 ratio of care staff who hold the National Vocational Qualification In care at Level two or three. This helps to enhance the care given to people and provides staff with good knowledge. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 18 Staff meetings are held regularly to allow staff to voice any issues. Supervision and a yearly appraisal takes place to ensure that staff are supported and can highlight any training needs they may have, which can then be provided by the home. A relative said “ The staff all work tremendously hard, I have been very grateful for the help I have received, I have been able to do things for my relative that I wouldn’t have been able to do. Staff are always kind and very helpful and attend to any issues with my relative promptly”. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use this service experience good quality outcomes in this area. People live in a home that is well managed, people’s health and safety is protected, however there are small changes required to the personal allowance system, and to monitor the safe use of bed rails. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has an experienced manager who is well liked by people living at the home, relatives and staff. She operates an open door policy, which allows anyone to speak with her at any time. Regular observation is undertaken by the manager of staff undertaking their duties and she likes to spend time talking with people living in the home. She acts to ensure that people living in the home are central to each decision made, and has undertaken and completed her Registered Managers Award. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 20 Quality assurance systems are in place, these including surveying people in the home and their relatives. The outcomes of the surveys are available for everyone to see. The manager undertakes a monthly audit of all care profiles; this had not been completed at the time of the site visit and was to be completed. The ancillary departments are audited six monthly, by another member of staff and the outcome of these audits are shared with the manager. Any shortfalls found are addressed to ensure that the level of the service provided is maintained. The proprietor is available to the manager and is supportive. Regular reports are provided about how the home is running, along with notifications to the Commission for Social Care Inspection. This ensures that management are constantly checking that the home is providing services at the required standard to people living there. Personal allowance accounts are available for people living in the home. Balances could not be checked individually as monies are pooled. Each person has an individual statement of the transactions made. Cash received by the administrator should be countersigned. The system should be adjusted so that balances can be checked and two people witness money received. To ensure that people using the system and staff are protected Health and safety checks are routinely undertaken. It was found that one set of bed rails was not positioned correctly to ensure that people’s health and safety was protected. However the handyman and nurse inspected all bed rails at the time of the site visit and these were all safe before the inspection was completed. Systems are being introduced to ensure that these checks are maintained and documented, so people’s health and safety is protected. The boiler is situated in the laundry and there is no carbon Monoxide detector available. This should be provided to ensure that laundry staff are protected. Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 1 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 2 Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement The manager must ensure that medication procedures and practices, and storage facilities in the home comply with the Royal Pharmaceutical Guidelines. The floor covering in the downstairs sluice must be replaced to ensure that proper cleaning can take place. And both sluices must be kept clean. Timescale for action 21/02/08 2 OP26 12 (1) (a) 23 (2) (b) 21/02/08 Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP12 OP29 OP35 Good Practice Recommendations The manager should continue to audit all care profiles to ensure monthly review has taken place. The preferred social preferences of people living in the home should be recorded. Two written references should be available within the care home for new staff, and not stored at head office The personal allowance system in operation should be reviewed and systems put in place to ensure peoples individual balances can be audited. Monies received should be countersigned to protect administration staff. Systems should be introduced and maintained to ensure a record is kept of checks made to all bed rails to ensure that people’s health and safety is protected. A carbon monoxide detector should be provided where the boiler is situated. 5 OP38 Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Southwoods Nursing Home DS0000068036.V352960.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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