CARE HOME ADULTS 18-65
Bannigans 19 High Street Corby Northants NN17 1UX Lead Inspector
Keith Williamson Key Unannounced Inspection 29th November 2006 10:00 Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 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 Bannigans DS0000067635.V312615.R03.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 Adults 18-65. 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. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Bannigans Address 19 High Street Corby Northants NN17 1UX 01536 263296 01536 402253 kathrynclarke@btconnect.com www.concensusupport.com Consensus Support Services Limited 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) Miss Lisa Ann Carvell Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No person falling within the category of MD, Mental Disorder excluding Learning Disability or Dementia, may be admitted to Bannigans unless that person also falls within the category LD, Learning Disability ie. Dual Disability The maximum number of persons to be accommodated within Bannigans is 4 This is the first inspection of a new service. 2. Date of last inspection Brief Description of the Service: Bannigans is located in the old village area of Corby, which is close to local shops and within easy access to Corby Town centre and its amenities. The Home is owned Consensus Support Services Limited and managed by Miss L. Carvell. The Provider owns several other Homes collectively recognised as Gretton Homes. Bannigans will like other Gretton Homes provide care for people with Prader-Willi Syndrome from all over the country. The premises consist of a detached house set in shared gardens with Vale House, the second of the two “Gretton” Homes in Corby. There are 4 single bedrooms which all have en-suite toilets and showers. There is a dining room, lounge and small conservatory, which are shared by residents. There is also a kitchen with separate utility room. Bannigans is a no smoking home. In common with all other Gretton Homes, Bannigans enjoys the benefit of its own transport for residents which enables then to benefit from access to a wider variety of resources located elsewhere in the county. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection (csci) is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation. This inspection took place over one weekday, commencing at 10.00am took five hours to complete, and was assisted by the registered manager. An opportunity was taken to look around the home, view records, policies and care plans and to talk to the residents and staff. Both residents were seen during the inspection though no comments were made to the inspector on their impressions of the home, so are therefore not included in this report. A number of questionnaires forwarded by the commission for social care inspection, to the residents in the home, their relatives or other interested professionals, have been returned, and any comments have been included as part of this report. There are no privately funded service users at the home, and the cost of each placement falls between £1500.00 and £1691.25 per week. The Commission for Social Care Inspection are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people whose knowledge about social care services comes directly from using those services. Positive comments made by the Expert by Experience indicated • • • One resident said that the night sleepover staff member was ‘my friend X’. The staff were “very friendly”. The staff weren’t expecting us until the inspector told them we were coming on the morning of the inspection and the place was really neat and tidy. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 6 • • • • • • • • • • • Resident Y kept going to the same gym that she used to go to in another town, when she lived there because she liked it and is used to it even though there is a gym in Corby that resident Z goes to. Resident Y liked the food. Both residents have TV’s DVD’s and stereos in their room. There is lots to do for the residents and they choose for themselves including bowling and meet-ups with other houses in the group. Lucy has family to visit at the home. The residents go on holiday with other similar homes. Staff asked residents if they could go into their room. Residents had keys to their own bedrooms. We were able to meet and talk to residents on their own. Residents choose the colour and look of their bedrooms. They have residents meetings to sort things out; resident Y said this ‘sometimes worked’. The house was nice and has a homey feel. On Saturdays the residents have ‘partners evening’. Some less positive comments made by the Expert by Experience were • • • • • • The residents didn’t have a person centred plan, there are lots of choices at Bannigans but a plan would go further and move on with a person. I suggested it to the house manager and she said that one of the other houses was trying out person centred plans and that it was a ‘priority’. Neither resident knew much about advocacy, there is a Corby People First that they could try. The signs around the house weren’t in easy words and pictures (this could affect visitors to the home, more than the current residents). Resident Y said she only gets on with resident X “sometimes”. When we asked the manager what if someone new comes and the other residents don’t like them she said that they try hard to check if people get on. The residents don’t get to choose their staff, this should happen. Resident Y wanted to go to college this September to do pottery and something else but because a staff member didn’t understand she didn’t get to go. She wants this to happen because there is no learning going on in her life. Written comments to the Inspector from residents included: “I wanted to move from (my other home)” “I sometimes fall out with my mate” “I would like to work in a cattery and go back to college” Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 7 What the service does well:
Residents’ needs are assessed prior to moving into the home. Contracts are issued and are signed by residents. The residents’ care plans contained information as to how the individual care needs of the residents are to be met, risk assessments are also in place. Care plans are negotiated with and are signed by, the resident. Decision-making and autonomy is promoted in care plans, and pointers are given to staff how to promote resident choice. Care plans are held in the office along with other sensitive information being appropriately secured. Residents’ participation in the home has commenced with regular resident meetings and questionnaires being circulated to the residents and wider circle of relatives and professionals involved with the home. The manager spoke at length of plans to gradually increase resident participation in the home. Documents are securely locked in the office, and confidentiality is maintained. Personal development is recognised in each residents individual care plan and weekly timetable. No current education or occupation is being undertaken by either resident currently. One resident hopes to commence a college course in the new academic year. Both residents have individual weekly timetables in place; recognition is given to individuals continuing to use facilities familiar to them, even though this involves staff in extended travel. Both weekly timetables are personalised and negotiated with the residents prior to commencement, and covers leisure activities and personal development. Daily routines are reflective of individual resident lifestyles, and are designed to suit the residents’ needs. Meals and mealtimes are strictly controlled, and these restrictions are well covered in the contract and plan of care. Meals are produced to suit the individual residents dietary requirements. The monitoring of residents healthcare is regularly undertaken, and visits from specialist medical staff and General Practitioners is undertaken flexibly and recorded individually. Medication is administered appropriately, the staff when spoken with, showed a good awareness of administration techniques.
Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 8 The manager has the necessary complaints procedure and policies in place. . There have been no complaints recorded since the last inspection of this service, and none forwarded to the commission for social care inspection. Detailed examination of the adult protection policy indicated that sufficient information is contained in the document for staff members’ guidance on how to prevent abuse in the home. The environment of the home is excellent and has recently been refurbished in providing all bedrooms with en-suite shower facilities. The maintenance and decor of the home is of a very high standard. Bedrooms are individually decorated, personalised and include a range of personal electrical equipment, and all bedrooms provide en-suite facilities. The public areas of the home provide a homely comfortable atmosphere. Residents spoke very highly of the staff group, one resident stating she regarded them “as her friends”. The staff turnover at the home is low and this provides residents with continuity and consistency of care. Job descriptions are in place for all staff members to clarify their understanding of the various roles and responsibilities. A thorough recruitment procedure is followed with references and criminal record bureau clearances being obtained prior to new staff working with residents. Staff are encouraged to undertake National Vocational Qualifications and currently 100 of the regular staff group have completed their training, in level 2 some in level 3 and the Learning Disability Training (ldaf) course. Staff members spoken with felt that the manager was easily accessible and was willing to discuss any issues and guide practice. The manager was viewed as very supportive to the staff team. Residents felt the manager was approachable, and commented that they had almost daily contact with her. Residents felt that their opinions were listened to, valued and acted upon and that they had trust and confidence in the staff group as a whole. Residents confirmed they were involved in the quality assurance of the home by participating in questionnaires issued by the manager. A selection of records including fire and accident were inspected. Fire safety was well maintained with weekly fire tests and regular drills carried out. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 9 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. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 10 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 11 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 5. Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The admission process is detailed and effective resulting in accurate information for prospective residents and staff. EVIDENCE: Resident’s needs are assessed prior to moving into the home. The manager compiles information using the health and social care assessments, and previous knowledge of the resident, providing an information base from which comprehensive and detailed care plans and risk assessments are then produced. The case tracked resident’s files were viewed; completed signed contracts are in place. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 12 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents are looked after well in respect of their individual personal care needs, areas of risk are assessed appropriately. EVIDENCE: The care plans and records of both residents were viewed. The care plans contained information as to how the care needs of the residents are to be met. Care plans are negotiated with residents, and both plans were signed by the resident. Decision-making and autonomy is promoted in care plans, and pointers are given to staff how to promote resident choice. Care plans are held in the office along with other sensitive information being appropriately secured. Residents’ participation in the home has commenced with regular resident meetings and questionnaires being circulated to the residents and wider circle of relatives and professionals involved with the home. The manager spoke at length of plans to increase resident participation in the home.
Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 13 Risk assessments are in place, which details how care is to be delivered, this promotes the health and welfare of both service users and staff. Most documents are securely locked in the office, and confidentiality is maintained, however there is some work to be done with the staffs recording of daily events, this is dealt with later in the report. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 14 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. Residents experience an appropriate and fulfilling lifestyle. EVIDENCE: Personal development is recognised in each residents individual care plan and weekly timetable. No current education or occupation is being undertaken by either resident. One resident hopes to commence a college course in the new academic year. Both residents have individual weekly timetables in place; recognition is given to individuals continuing to use facilities familiar to them, even though this involves staff in extended travel. Both weekly timetables are personalised and negotiated with the residents prior to commencement, and covers leisure activities and personal development. Daily routines are reflective of individual resident lifestyles, and are designed to suit the residents’ needs.
Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 15 Meals and mealtimes are strictly controlled, and these restrictions are well covered in the contract and plan of care. Meals are produced to suit the individual residents dietary requirements. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 16 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21. Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. Resident’s health and personal care needs are met on an individual basis. EVIDENCE: Personal support is offered on a flexible basis, care plans reflect what abilities residents have; these plans are reviewed and updated. The monitoring of residents healthcare is regularly undertaken, and visits from specialist medical staff and General Practitioners is undertaken flexibly and recorded individually. Medication is administered appropriately, the staff when spoken with, showed a good awareness of administration techniques. Medication is stored securely, the medication administration records (mar charts) being up to date, signed appropriately and having no omissions. The final wishes of residents are recorded appropriately in each of the residents’ plans of care. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents are protected by the policies and procedures regarding complaints and adult protection, produced by the home. EVIDENCE: The manager has the necessary complaints procedure and policies in place. Staff spoken with demonstrated a good awareness of both the complaints and adult protection policies and procedures were operated. There have been no complaints recorded since the last inspection of this service, and none forwarded to the commission for social care inspection. Detailed examination of the adult protection policy indicated that sufficient information is contained in the document for staff members’ guidance on how to prevent abuse in the home. The manager stated that this was openly discussed at resident and staff meetings. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28 & 30. Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. Residents live in a homely, comfortable and clean environment. EVIDENCE: The environment of the home is excellent and has recently been refurbished in providing all bedrooms with en-suite shower facilities. The maintenance and decor of the home is of a very high standard. Bedrooms are individually decorated, personalised and include a range of personal electrical equipment, and all bedrooms provide en-suite facilities. The public areas of the home provide a homely comfortable atmosphere, with numerous public areas giving residents an excellent scope of utilising the space available, with a flexible approach to time spent in the home. Staff showed a good awareness of cross contamination issues, with laundry facilities being appropriately sited and domestic in nature. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The Home has a well-trained, competent and supportive staff group who continue to promote and protect the well being of Residents in their care. EVIDENCE: Residents spoke very highly of the staff group, one resident stating she regarded them “as her friends”. The staff turnover at the home is low and this provides residents with continuity and consistency of care. Staff rotas showed that appropriate numbers of staff are on duty on all shifts including a sleeping in night “companion”, thus reinforcing the “friendship” type relationship experienced by residents. Staffing levels are adjusted according to residents needs and to take account of residents’ activities and numbers. Job descriptions are in place for all staff members to clarify their understanding of the various roles and responsibilities. The staff group also demonstrated that they worked as a close-knit team protecting the well being of their residents.
Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 20 A thorough recruitment procedure is followed with references and criminal record bureau clearances being obtained prior to new staff working with residents. Files were viewed and are upto date, with copies of all documents also being held centrally at the company main offices. Staff are provided with comprehensive training and the training plan showed that this included induction, core training, updates and specialist training such as dealing with challenging behaviour. Staff are encouraged to undertake National Vocational Qualifications and currently 100 of the regular staff group have completed their training, in level 2 some in level 3 and the Learning Disability Training (ldaf) course. The staff member spoken with confirmed that she received supervision and support from the manager. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42. Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The Management of the Home is effective, accessible and responsive to the needs of both the residents and staff. However some recording of information may lead to a conflict with the Freedom of Information Act. EVIDENCE: Staff members spoken with felt that the manager was easily accessible and was willing to discuss any issues and guide practice. The manager was viewed as very supportive to the staff team. Residents felt the manager was approachable, and commented that they had almost daily contact with her. Residents felt that their opinions were listened to, valued and acted upon and that they had trust and confidence in the staff group as a whole. Residents confirmed they were involved in the quality assurance of the home by participating in questionnaires issued by the manager. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 22 The system for safekeeping of residents’ moneys monies was inspected and found to be secure. A selection of records including fire and accident were inspected. Fire safety was well maintained with weekly fire tests and regular drills carried out. Accident records were carefully documented and showed that action had been taken to prevent a similar occurrence. A good approach is taken to ensuring safe working practices. Staff receive regular updated training in this area. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 3 X 3 X 3 3 X Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA41 Good Practice Recommendations The Registered Manager should ensure that resident’s daily records adhere to the Freedom of Information Act, and residents are not named in any record other than their own. Bannigans DS0000067635.V312615.R03.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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