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Inspection on 06/11/07 for Cleveland House Nursing Home

Also see our care home review for Cleveland House Nursing Home for more information

This inspection was carried out on 6th November 2007.

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

What has improved since the last inspection?

The home continues to maintain good standards of care. Staff have worked hard to introduced new care documentation, and the documentation was comprehensive and identified in detail the care people needs.

What the care home could do better:

Care plans should be kept up to date to show the care that the person needs. When a drug administration sheet states one or two tablets, the amount of medication given should be recorded to ensure that accurate records are maintained.

CARE HOMES FOR OLDER PEOPLE Cleveland House Nursing Home 2 Cleveland Road Edgerton Huddersfield West Yorkshire HD1 4PN Lead Inspector Karen Summers Key Unannounced Inspection 6th November 2007 08:45 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 Cleveland House Nursing Home DS0000001112.V354097.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. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cleveland House Nursing Home Address 2 Cleveland Road Edgerton Huddersfield West Yorkshire HD1 4PN 01484 512323 01484 548043 waltonjo@bupa.com www.bupa.co.uk BUPA Care Homes (GL) Ltd 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) Mrs Joan Walton Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability (5), Terminally ill (5) of places Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can accommodate one named service user under 65 years of age category LD 22nd November 2006 Date of last inspection Brief Description of the Service: Cleveland House provides personal care and nursing for up to 45 older people. The home is a large stone built, converted residence with two purpose built extensions. It is approximately half a mile from Marsh and 1 mile from Lindley with all their local amenities. Huddersfield centre is about 2 miles away with the bus stop at the end of the road. There are spacious gardens for people to use and there is ample car parking. The provider informed the Commission for Social Care Inspection on the 06.11.07 that the fees range from £368.12 to £635.00 per week. There are additional charges for private chiropody, hairdressing, newspapers, and magazines. Information about the home and the services provided are available from the home in the statement of purpose and service user’s guide. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to an inspection, which included an unannounced visit to the home by an inspector on Tuesday the 6th of November 2007, commencing at 8.45am, and the length of the inspection was 6.75 hours. Prior to the visit, the manager was asked to complete an annual quality assessment document. This she did, and the document provided the Commission for Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. During the visit the inspector spoke with members of staff, people who receive care and relatives to obtain their views. The inspector also looked at a sample of care records, staff recruitment records, staff training records, quality assurance audits and looked around the home. To enable people who use the service to comment on the care it provides, ten surveys were sent out to people, all of which were returned, ten to their next of kin, four were returned, and local doctors and health care workers (social workers, community nurses). Four were returned. The feedback the Commission received about the home was very positive. Below are some examples of the feedback we received: • “I am very happy living here.” • “Always a pleasure to visit Cleveland House, they appear to be working well as a team.” The commission would like to thank all the people who gave feedback about this home, and would like to thank the manager and staff for their cooperation throughout the inspection process. What the service does well: The surveys received from people living at the home said that they received enough information about the home before they decided that it was the right place for them. Comments included, “Good information and personal visit.” At the time of the visit people were sat chatting, and generally passing the time of day. Comments from relatives were positive and include: • Staff give my relative a choice over their life and respected their rights to be allowed to smoke in a certain area. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 6 • • “Each individual has the choice as to how they wish to lead their life. Whether to join in activiites or not. Meals are good and well presented.” “The home appears to be kept in good order and staff are always pleasant.” The comments received from doctors in their surveys were also positive and include: • “I am always satisfied by the staffs concerns, reactions and actions.” Everyone said that individuals’ health care needs are met by the service, and the individuals’ privacy and dignity are respected. • “Provides high standard of personal care and accommodation, the best in our region of Huddersfield.” Staff spoke positively about the manager saying she was supportive and approachable. The information supplied by the home in the annual quality assessment document states that they have achieved the Investors in People accreditation. 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. Cleveland House Nursing Home DS0000001112.V354097.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 Cleveland House Nursing Home DS0000001112.V354097.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): 3&5 Standard 6 - the home does not take people who require intermediate care. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are assessed prior to them moving into the home and are able to visit the home to establish whether or not it is the right place for them. EVIDENCE: The care records of three people who use the service were examined, all of which contained a pre-admission assessment carried out by the funding local authority. Each assessment contained detailed information about the person’s current needs, and in addition to this there was evidence that the home had also carried out an assessment of the persons needs. The information in the annual quality assessment document confirmed that all prospective people undergo a pre-admission assessment to ensure the home can meet any identified need and the placement will be appropriate. The manager also said that people were encouraged to visit the home and spend some time there before making a decision to move in. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 9 With the exception of one person, the surveys received from person living at the home said that they received enough information about the home before they decided that it was the right place for them. Comments included, “Good information and personal visit.” The comment from the person who did not receive enough information about the home said, “It all happened a bit quick. I don’t feel I was well informed.” Cleveland House Nursing Home DS0000001112.V354097.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): 7 -10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The level of care people need, which includes their health, personal and social care needs are clearly highlighted within their care plan. People are treated with respect. EVIDENCE: New care documentation had recently been introduced, and the manager explained how all care staff have had training to a standard before been allowed to use the documentation. Three people’s care records were looked at in detail and the documentation was of a very good standard and clearly identified the care needs, risk assessments, movement and handling assessments, nutritional assessment, social interests and the likes and dislikes of the people living at the home. There was also evidence that the care plans are updated monthly or as the needs of the person change. However, the daily record of one person showed that they had returned from hospital and some of their needs had changed, but their care plan had not been updated four days following their return. The manager was aware that the records should have been updated to show the changing needs of the person. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 11 People either said that they always or usually receive the care and support they need. Feedback from one person said they were “generally very satisfied” and another that they were “happy living here”. One person said that staff continued to give their relative a choice over their life and respected their rights to be allowed to smoke in a certain area. Other people asked felt that the home generally meets the needs of their relatives. There was also evidence in people’s care records that they are able to access health care services, such as the dentist, chiropodist, optician and everyone living at the home is registered with a doctor. Feedback from doctors said “I am always satisfied by the staff’s concerns, reactions and actions” and that the home “provides high standard of personal care and accommodation, the best in our region of Huddersfield.” Everyone else who was asked said that individuals’ health care needs are met by the service, and the individuals’ privacy and dignity are respected. A sample of medication and records were also looked at. Two out of three checked were correct, and the third had a discrepancy where the drug sheet stated, “one or two tablets”. The amount given had not been recorded; therefore the amount of tablets left in the bottle did not match the record on the drug sheet. Staff should ensure that the amount of tablets given to a person is recorded to ensure that accurate records are kept. Cleveland House Nursing Home DS0000001112.V354097.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): 12 – 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to maintain contact with their family and friends, and staff assist people in having a choice in most things they do. Meals provided are good, varied and served in a pleasant environment. EVIDENCE: At the time of the visit people were sat chatting, and generally passing the time of day. The routines of daily living were seen to be flexible and people commented on how they were able to choose how they wished to spend their day. The home employs an activities person who works Monday to Friday, 30 hours a week, and she was seen to be encouraging people to play Bingo. The social and recreational preferences of people are recorded in their care records, and the activities that they are involved in on a daily basis are also recorded. Activities include, baking, dominos, bingo, quiz, Halloween party, snakes and ladders, leaf framing, watching a film, and walks, reminiscence book, etc. The activities person also writes a “Cleveland House News and Views” newsletter, and copies were sent out in April and September this year. The newsletter Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 13 keeps people up to date with happenings within the home, things of interest, and forth-coming events. The information in the annual quality assessment document said that the home has a structured activities programme tailored to the individual needs and preferences of the people living there, and that there is an open visiting policy that takes account of peoples wishes. Relatives of people living at Cleveland House said that the home helps their relative to keep in touch, and one person said that their relative is encouraged to phone the family regularly, and that her friends and family are always made welcome when they visit. One of the relatives commented, that each individual has the choice as to how they wish to lead their life, whether to join in activiites or not, and that meals are good and well presented. Feedback was received from relatives and people’s doctors that the home appears to be kept in good order and staff are always pleasant. When people who use the service were asked, “Are there activities arranged by the home that you cant take part in?” One person said always, three people said usually, and three people said sometimes. Comments received from people who use the service include: • • • • • “Enjoy TV, family visits etc., no interest in group activities but did enjoy garden party event.” Not able to take part in a lot of things but the option is open.” “Some days I don’t want to join in.” “Some are not to my taste but activities are available most afternoons.” “Activities person has been on holiday – not experienced much by way of activity.” A varied menu is available in the home that offers choice and special diets were seen to be catered for. Food and beverages are also available 24 hours aday to meet individual needs. People who use the service were asked, “Do you like the meals at the home?” One person said yes, six said usually, and one person did not make a comment. The chef has an intermediate food hygiene certificate and the manager said that the staff that handle food have the basic food hygiene certificate or will be having the training in the near future. As a tribute the home has received a four stars, “Very Good” award in association with Kirklees Council’s Health Choice Award. “Scores on the doors” Cleveland House Nursing Home DS0000001112.V354097.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): 16 &18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are protected from abuse and they can be confident that their complaints will be listened to and acted upon. EVIDENCE: The complaints procedure is displayed in the entrance of the home. There have been four complaints since the last inspection, which records show that they were properly investigated, and responses given to complainants within the timescale set out in the policy and procedure. The policies and procedures regarding protection of people are satisfactory, and training records showed that staff have regular training in this area. Further training is planned for February 2006. Without exception relatives and people who use the service said that they knew how to complain and who to complain too. One person said, “The manager or her deputy always have time to talk to residents and their relatives.” Staff who were spoken with said that they were aware of the procedure to follow if they suspected abuse of a person, and that they also were aware of the homes Whistle blowing policy. The information in the annual quality assessment document said that, “BUPA Care Homes has robust policies for dealing with allegations of abuse or neglect. Staff can not only raise concern Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 15 within the home they have access to senior staff outside the home.” Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 16 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): 19 & 26 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home offers people a homely, comfortable and clean environment. EVIDENCE: As part of the inspection a tour of the home was conducted which included the communal areas, a number of peoples bedrooms, and the laundry. Since the last inspection new carpets have been laid in the entrance, lounge and dining room, and new furniture and curtains have be bought for the dining room. The corridors in a number of areas were showing signs of wear, and the manager said that there are plans to replace the corridor carpets and redecorate early next year. The bedrooms were tastefully decorated, and there was evidence in people’s rooms that they had been able to bring small personal items of furniture with them. A relative commented that, “The home appears to be kept in good order.” Comments received from people who live at Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 17 the home include: “The staff do their best to keep everywhere clean, which is not always easy.” Externally there was a wooden gazebo that housed a sensory garden, with wind chimes and a pleasant area for people and their visitors to sit. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 18 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): 27 – 30 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. There are sufficient numbers of staff to meet peoples’ needs. Staff receive training to assist them to carry out their responsibilities and they have had all the necessary checks before working with people so that they are kept safe. EVIDENCE: The information in the annual quality assessment document states, that there are comprehensive human resource policies to aid effective recuitment and staff management, and that the correct recruitment checks are carried out. It also said that the home maintian the correct numbers of staff agreed with the Commission and take into account the individual needs of the people in their care. A sample of three recruitment records were inspected and the correct information and check had been carried out. Evidence was also seen in the staff records, and staff confirmed that they had induction training. Training in palliative care, mental capacity act, abuse awareness, fire training and movement and handling. The list of staff on duty showed that there was a qualified nurse on duty at all times, and that there were sufficient staff in number to meet the needs of the people in their care, and the manager confirmed this. This included support staff: administrator, maintenance, activities co-coordinator, kitchen staff, and laundry and housekeeping. Two people who live at the home said that there Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 19 are always staff available when you need them, and five people said that there are usually staff available. One person commented, that there was usually staff available, “In the main – yes. But they are always very busy and more staff would be an advantage.” Fifty three percent of care staff have an NVQ (National Vocational Qualification) level two or above, and a further three staff are working towards the qualification. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35 & 38 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People benefit from the management approach of the home and the manager ensures so far as is practicable that the health, safety and welfare of people and staff are protected. The home is run in the best interest of people who live there. EVIDENCE: Mrs Joan Walton the manager is a registered general nurse, and has a number of year’s experience of working with older people in a care home setting where nursing care is provided. She has also achieved the NVQ level 4 award in Management. Staff spoke positively about the manager saying she was supportive and approachable. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 21 The information supplied by the home in the annual quality assessment document states that they have achieved the Investors in People accreditation, and that they send out annual customer satisfaction surveys. The information also said that the home have Health and Safety meetings, and there are dedicated Health and Safety staff within the Quality and Compliance directorate to assist the home. The manager explained how satisfaction surveys are sent out to people who use the service each year and an external company collates the results in the form of a report, which is made available to everyone in the home. The results of the December 2006 report was seen and the information included quality of care, privacy, dignity, respect, the internal and external environment etc. With each area a percentage was recorded and the manager had written an action plan as to how improvements would be made. In all areas identified the outcomes were good. In addition to this BUPA have comprehensive audits that take place annually and these include the management practices and the running of the home. Reports of the outcomes of these audits were seen and were positive. “Personal best” initiative is an initiative used by BUPA to encourage staff to have commitment to their work, and through the nomination of people, staff are financially praised for “going that extra mile”. Evidence of minutes were seen that staff meeting take place on a regular basis, and relative/ people who use the service meeting also take place approximately monthly. The manager confirmed that the home does not hold monies for people living at the home. Satisfactory records were seen for practice fire alarms and emergency lighting. There was also evidence to suggest that all staff have had fire drills/ lectures and movement and handling training, and staff also confirmed this. Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 22 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 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 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 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X N/A X X 3 Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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. 2. Refer to Standard OP7 OP9 Good Practice Recommendations Cleveland House Nursing Home DS0000001112.V354097.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Cleveland House Nursing Home DS0000001112.V354097.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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