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Inspection on 30/11/05 for Chalkmead Resource Centre

Also see our care home review for Chalkmead Resource Centre for more information

This inspection was carried out on 30th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has an experienced manager that provides management stability and leadership to the staff team. During a meeting staff remarked " the management is helpful, kind and get things done." A service user commented " staff are very good we have lovely girls that treat us well " The home is committed to staff training and development and the company has its own accredited learning resource centre. Staff stated " the home offered good training opportunities " and one staff remarked she had recently completed her National Vocational Qualification (NVQ) and received a pay rise. The home has a hospitality assured award that reflects a good standard of catering and food in the home.

What has improved since the last inspection?

The home has met the previous requirements that have resulted in improvements in documentation, a nice homely environment and a wellequipped kitchen that has improved the working conditions for staff. The inspector noted Kingfisher and Robin units had new carpets in the corridor. Magpie unit had been decorated and had new carpets that made the environment attractive for service users. With respect to the new kitchen equipment, the kitchen assistant stated that " it is nice and easy to work " and other staff remarked " the quality of the environment has improved "

What the care home could do better:

The home must review and update some of the guidelines to do with the management of medications to ensure it is accurate and safeguards the safety of service users. The way in which staff make written records in service usersplans must be reviewed and guidelines put in place to ensure written records are permanent and made in ink. The home must review the arrangements for activities for service users by considering appointing an activities organiser and developing the activities schedule to ensure service users have opportunities for social and leisure activities.

CARE HOMES FOR OLDER PEOPLE Chalkmead Resource Centre Deans Road Merstham Surrey RH1 3HE Lead Inspector Deavanand Ramdas Unannounced Inspection 12th December 2005 10:00 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 Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 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. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chalkmead Resource Centre Address Deans Road Merstham Surrey RH1 3HE 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) 01737 644831 Anchor Trust Care Home 50 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (50), of places Physical disability over 65 years of age (12) Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may be admitted in the categories OP (Older people) of whom 3 may fall into the category DE(E) Up to 12 people with physical disability over the age of 65 years may be accommodated PD(E) 7th June 2005 Date of last inspection Brief Description of the Service: Chalkmead is situated in Merstham in Surrey in a quiet residential area and is home to fifty older people. It is conveniently located for the local shops and not far from Redhill town centre. The home has five living areas each with a lounge, dining room and kitchenette where service users can entertain guests make their own tea, coffee and light snacks. Main meals are cooked in the central kitchen and served in the dining room using heated trolleys. The home is on two floors and the upper floor can be accessed using a lift. The property is set around a nicely established courtyard with shrubs, flowers and seating and the gardens are well maintained, private, secure with wheelchair access. Parking is available to the front of the property. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector over a period of 7 hours. A tour of the premises took place and staff, service users and relatives were spoken to. Documents and care records were examined. The inspector would like to thank staff, service users and relatives for their contributions to the inspection. On the day of the inspection the manager and deputy manager were on study leave. What the service does well: What has improved since the last inspection? What they could do better: The home must review and update some of the guidelines to do with the management of medications to ensure it is accurate and safeguards the safety of service users. The way in which staff make written records in service users Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 6 plans must be reviewed and guidelines put in place to ensure written records are permanent and made in ink. The home must review the arrangements for activities for service users by considering appointing an activities organiser and developing the activities schedule to ensure service users have opportunities for social and leisure activities. 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. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 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 Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,4,5 & 6 The homes statement of purpose and service user guide are good providing service users and prospective service users with details of the services the home provides enabling an informed choice to be made about admission to the home. The arrangements for meeting the assessed needs of service users are satisfactory ensuring service users needs are identified and met. The admission policy is satisfactory ensuring service users and relatives have the opportunity to visit and assess the suitability of the home. EVIDENCE: The home had a statement of purpose and service user guide that described the services the home offered. The statement of purpose was nicely presented in a corporate folder and available to service users and relatives. The inspector noted a statement of purpose was in the foyer for information and covered aims of the home, philosophy, staffing and arrangements for meeting social and health care needs. The home had an enquiries, admissions and allocations policy dated May 2002 that described how service users needs would be met at the home. During a meeting staff stated the company offered training courses that gave them the skills to support service users. The inspector noted staffs have the NVQ qualification in care and additional training Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 9 that covered dining with dignity, dementia and continence. The inspector sampled care plans and noted one service user of Asian ethnicity had his special dietary and religious needs identified in his care plan. It was recorded the service user did not eat pork products and liked Asian meals and this was reflected in the menu plan kept in the kitchen. The inspector noted a review meeting was held on the 14/6/05 and it was recorded the service user was receiving good care at the home: the care plan was signed by the care manager. The home had a policy on resident licences dated May 2002 that stated the home offered trial visits. The inspector sampled contracts and noted trial visits were offered as part of the admission process. The staff stated service users and relatives are encouraged to visit and assess the home before admission. One service user who lived locally stated she “ visited the home with her daughter and met staff and service users before admission to the home”. The home did not offer intermediate care and this standard was not assessed. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9,10&11 The arrangements for managing medications must be improved to ensure guidelines on medications are accurate and the safety of medications is maintained. The arrangements for health and personal care are satisfactory ensuring service users are treated with respect and their right to privacy upheld. The policies and procedures on dying and death are adequate ensuring service users and their families are treated with dignity and respect. EVIDENCE: The home had a policy on medications dated May 2002 and guidelines for the administration of medications. The inspector noted stock medications were stored in a locked metal cupboard and medications were kept in each of the units in a locked cupboard. Staff stated the senior care officer is responsible for the medication keys that are on her person at all times. The inspector sampled medication record sheets and noted they were dated and signed by staff and staff medication training records were up to date. The inspector noted some staff were assessed as competent in May 2005 and three staff had a written test on medications on 7/9/05 and deemed proficient. The home had controlled drugs and a controlled drugs register that was correctly completed. The inspector noted one service user had been given a Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 11 controlled drug on the 29/11/05 and the balance was checked and found to be correct. The staffs recorded the temperature of the medication refrigerator containing insulin and other medications and the inspector noted gaps in the recording: this was discussed with the senior care officer and action has been required in respect of this matter. Guidelines on medications were dated 2002 and in need of updating and action has been required in this area. Service users were treated with respect and staff addressed service users by their preferred names. The inspector noted the homes administrator knocking on doors before entering service users bedrooms and some service users had telephones in their bedroom for use in private. The home had a policy on dying, death and resuscitation dated May 2002 and staff received training on how to support service users, families and colleagues during dying and death of a service user. The inspector noted the home had teaching aids and a training video on bereavement and staff stated the training offered was appropriate. Staff stated a training course on end of life care was planned on the 6/12/05 and senior care officers were booked to attend. The inspector noted this was recorded in the homes management diary. The home had information on local services and provided support to families whose relatives are dying by booking accommodation and providing meals and refreshments free of charge. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13&14 The arrangements for activities for service users need to be improved to ensure the social and recreational interests of service users are met. Links with the community are good and support and enrich service users’ social and leisure opportunities. The systems for consulting service users are satisfactory ensuring service users exercise choice over their lives. EVIDENCE: The home had a policy on activities and interests dated May 2002 and staff stated the home had a fulltime carer who is also the activities organiser working 25 hours a week. The inspector noted the home had a weekly activities schedule that was under review and included activities such as games, puzzles, bingo, music and sing a long. A volunteer visited the home weekly to play scrabble with a service user that was recorded in his diary sheet and a musician visited the home monthly. During a meeting staff stated they would like to see more music and singing activities in the home because service users appear to be happy and relaxed during the sessions. A service user stated “ the home had made progress on activities ” but remarked recently there had been no organised activities in the home. This was discussed with senior staff and action has been required in respect of this matter. The home had guidelines for visitors that were reflected in the service Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 13 users information pack and visitors could see their relatives in private in the lounge when not in use, office and bedrooms. The inspector noted in Kingfisher Unit one service user met her relative in the privacy of her bedroom. Staff stated the home had good links with the local community and remarked a local businessman offered gifts for a raffle to raise money for the service users welfare fund. Service users were supported to make choices and the inspector noted service users had personal effects in their bedrooms such as family photographs, televisions, books, and video’s of favourite films. The inspector noted the home had compiled a list of organisations that acted as advocates with contact numbers that were in the service users care plan for information that included help the aged care advisory service, counsel and care and the citizens advice bureau. One service user stated her daughter visited regularly and “ kept an eye on her interests.” Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The complaints process at the home is adequate with complaints information available to staff, service users and relatives. EVIDENCE: The home had a complaint policy that was available throughout the home and a complaint box in the foyer. The inspector noted the local complaint policy was reviewed and amended in July 2005. Staff stated the home had a complaint register that was sampled and the inspector noted the last complaint had been recorded on the 27/10/05 and management action had been taken. During a meeting staff commented they were aware of the complaint policy that was in the foyer for information and a service user remarked he was “ happy with the way management responded to his complaint”. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20&24 The arrangements for managing the premises are satisfactory ensuring service users live in a safe well-maintained environment. The arrangements for communal space are adequate ensuring service users have access to safe and comfortable shared facilities. Furniture and fittings are adequate ensuring service users live in comfortable bedrooms with their own possessions. EVIDENCE: On the day of the inspection the home was clean, well presented with good ventilation and free from malodour. The garden was tidy, well maintained, private and secure. The home employed a handyman who is responsible for the upkeep and maintenance of the garden. A service user stated he visited the home regularly and “ the standard of cleanliness was good” he remarked he took his wife for “ walks in the garden to give her some fresh air ”. Staff stated the home had a development plan and the inspector noted contractors were decorating areas of the home and fitting new carpets. Communal areas were nicely decorated and well furnished with tables, chairs, settees and Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 16 display cabinets that reflected a homely atmosphere. The home had single bedrooms that were carpeted and well furnished with wardrobes, chairs, chest of drawers with a lockable space and doors were fitted with locks. The inspector noted bedrooms were personalised with family photographs, plants, ornaments, books, video’s and televisions. One service user that had a television in her bedroom stated she “ liked her bedroom as it offered her privacy ” and she could watch television programmes of her choice such as come dancing. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28&29 The procedures in place for recruitment and vetting of staff are adequate ensuring service users are protected from the risk of harm or abuse. The arrangements for NVQ training are adequate ensuring service users are in safe hands at all times. EVIDENCE: During a meeting staff stated the home was committed to training and development and the company has its own accredited learning and resource centre. The inspector noted the manager is an NVQ assessor and working towards an internal verifiers award. The inspector sampled records and noted care staff had the NVQ qualification and others were working towards completion of the award. The home have a recruitment and selection policy dated May 2002 and staff recruitment files were kept in the manager’s office that were sampled. The inspector noted files contained completed application forms, references, statement of terms and conditions, health questionaire, CRB disclosure information and a recent photograph. One staff that joined the company on the 11/10/05 had a POVA First check and was working under the supervision of a senior staff. The inspector noted the company had sent an application to the criminal record bureau for a police check to be carried out. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,34,35,37&38 The systems for quality assurance are adequate ensuring the home is run in the best interests of service users. The financial procedures at the home are satisfactory ensuring financial viability of the home that safeguards service users. The arrangements for managing service users money are adequate ensuring service users financial interests are safeguarded. Record keeping at the home is satisfactory safeguarding the rights and interests of service users. The arrangements for health and safety are satisfactory ensuring health, safety and welfare of service users are protected. EVIDENCE: The inspector noted the home had a qualified and experienced manager in post who needs to submit an application for registration as manager to the Commission and action has been required in respect of this matter. The home had a quality assurance system based on a quality management manual and self-assessment policy. The inspector noted the home consulted Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 19 with service users using questionnaires that were kept in a folder in the manager’s office that were sampled. The inspector noted questionnaires covered areas of personal care, food and staff attitude that were completed on the 24/5/05. It was recorded in one questionaire staff are great, couldn’t ask for better. The home also had quarterly meetings with service users that were sampled and inspector noted the last meeting was held in February 2005. A copy of the CSCI inspection report and action taken in meeting requirements was displayed in the foyer for information. The home had a business plan dated April 2005 and employers liability insurance dated March 2005 that was displayed in the foyer for information. The home employed a homes administrator with responsibility for managing service users’ money, which was kept locked in a safe in the office. The inspector sampled records and noted the home had a personal allowance sheet that was individualised, dated and signed by the service user and the homes administrator. The inspector noted all transactions involving service users’ money were recorded and receipts were kept that included incidental spending on hairdressing, chiropody, newspapers and toiletries. The inspector sampled finance records, recruitment files, policies and procedures and noted records were up to date however an entry had been made in pencil in a service user care plan that was discussed with the manager and action has been required in respect of this matter. The home had a policy on health and safety dated 2002 and safety procedures and notices were available throughout home. The inspector sampled fridge and food temperature records and water temperature records and these were found to be satisfactory. Small electrical appliance testing was completed in October 2005 and the home had service certificates for the lift, boiler and fire alarms that were current. The home had a contract with an approved contractor for the disposal of clinical waste dated April 2005 and the inspector noted the kitchen was inspected on 26th July 2005 by food inspectors and no recommendations were made. Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 20 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 3 X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 X X X 3 X X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 3 X X 3 3 Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 21 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 NMS-OP-9 Regulation 13(2) Requirement Timescale for action 10/12/05 2 NMS-OP-12 16(2)(m) (n) 3 NMS-OP-31 8 4 NMS-OP-37 17(4) The registered person must ensure written guidelines on medications that are in the medication folder and in the medication cupboard are updated to ensure accuracy. In addition, the registered person must ensure daily temperature records are made of the medication refrigerator to ensure it is operating within the correct range and that the quality of the medication can be assured. The registered person must 01/03/06 review the overall arrangements for activities for service users. Consideration should be given to the appointment of an activities organiser and the weekly activities schedule should be reviewed, updated and circulated for information. An application for the 10/01/06 registration of the manager of the must be submitted to the Commission without delay and by the timescale stated. All records relating to service 20/12/05 users must be permanent and DS0000013591.V267974.R01.S.doc Version 5.0 Chalkmead Resource Centre Page 22 recorded in ink. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 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 Chalkmead Resource Centre DS0000013591.V267974.R01.S.doc Version 5.0 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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