Inspection on 15/04/08 for Clifton House

This inspection was carried out on 15th April 2008.

CSCI found this care home to be providing an Adequate service.

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

Other inspections for this house

Clifton House 24/04/07

Clifton House 12/12/05

Clifton House 26/05/05

Clifton House 13/10/04

Clifton House 28/04/04

Clifton House 22/09/03

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Clifton House 3 Clifton Road Heaton Moor Stockport Cheshire SK4 4DD Lead Inspector Jackie Kelly Unannounced Inspection 15th April 2008 09:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clifton House DS0000008549.V361710.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. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clifton House Address 3 Clifton Road Heaton Moor Stockport Cheshire SK4 4DD 0161-432 8287 F/P 0161 432 8287 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) Clifton House (RCH) Limited Mrs Lynne Carol Hudson Care Home 12 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (9) Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 9 OP and up to 3 MD (E). Date of last inspection 24th April 2007 Brief Description of the Service: Clifton House is a residential care home that is registered to provide care for up to 12 people whose primary care needs are due to their old age, including up to three people who may have a diagnosis of mental illness. Mr and Mrs Hudson are the registered proprietors of Clifton House. Mrs Hudson is the registered manager of the home. Clifton House is a large, detached house set in its own grounds; it is clean and provides comfortable accommodation. All bedrooms are single person occupancy and are spread over two floors, there are no en-suite facilities, however all bedrooms have a washbasin. There is an assisted bathroom on the ground floor, which also has a walk-in shower for those service users who prefer a shower. There are two lounges, a larger one on the ground floor with a smaller one on the first floor, and a separate dining room. Clifton House is not suitable for wheelchair users. There is a passenger lift to assist residents to their bedrooms on the first floor. There are car-parking facilities to the front of the home and pleasant gardens to the rear. The home operates a ‘no smoking’ policy. The home is situated in the Heaton Moor area of Stockport. Local shops, cinema, library and park are within walking distance of the home. Stockport town centre, motorway network and public transport are easily accessible. The current weekly fees range from £340 to £400, dependent on the individual care needs of people living in the home. Further details regarding fees are available from the manager. Additional charges may also be made for hairdressing, chiropody and other personal requirements. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a key inspection, which included an unannounced visit to the service, which took place over one day, with a short visit the following day to see more staff and residents. The first day was spent talking with one of the providers who is also the registered manager and responsible for day-to-day administration of the home. Records were looked at which included the care plans of three residents and staff files. Before the inspection, we asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helped us to determine if the management of the agency saw the service they provided the same way that we saw it. The form was completed with information that was concise and adequate which enabled us to make this assessment. At the time the AQAA was completed, the home employed ten care workers who provided a 24-hour, seven day a week service. On the day of the inspection there were 11 residents living at the home with one vacant bed. Also employed were an activities manager and a domestic assistant. The senior care worker on duty did the cooking. One care worker had terminated their employment over the past 12 months. Four completed resident and four completed staff survey forms were returned to the Commission. The majority of the questions were answered positively such as: all said that they received enough information about the home before they moved in. With regard to care and support three always; one usually said that they received the care and support needed, that the staff were available when they needed them and that they received the medical support needed; three always, one usually said that they liked the meals at the home; all said staff listened and acted on what they said. Written comments were very few, however people during the visit to the home said that they were ‘happy with the care provided, very homely’; ‘staff were lovely’; ‘they had no complaints’. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 6 There was, however, one area which was not as well received and that was activities; the response was - one always, two usually, one sometimes said that activities were arranged by the home that they could take part; a comment made was ‘not as often as some would like.’ There was also a comment on one of the staff survey forms; ‘It could do better with entertainment for service users’. The staff surveys were also mainly positive and with a few more written comments such as: ‘All the staff work as a team and all information is passed on to each member of staff to ensure everyone is kept informed’; ‘the service ensures that all residents are treated with dignity and respect, at all times cared for, make sure all needs are met and to make sure the transition from the resident’s own home into the rest home be as pleasant as possible;’ ‘the home does well regarding personal care, good standard of hygiene and cleanliness and good home cooking. I believe that our main strength is that we offer a very homely atmosphere to our residents, which helps them to feel able to have a say in what is going on, as a team the staff are very aware that Clifton House is the residents’ home, with all that implies and that we are here to support them in that’. There was a comment regarding lack of information on the assessment document (which has been recommended for improvement by us) as follows:I believe it could be fuller; there is often a gap between what information we have on new residents and what becomes apparent during the six-week assessment period, which can be unhelpful to staff, resident, and resident’s family. In the case of respite this can be a real problem’. The care files, which included care plans, risk assessments, GP and District Nurse visits were looked at along with the daily records for each resident and medication administration sheets. Staff personnel files and supervision files were also seen. Two people had been admitted for respite care and had decided to stay on and make Clifton House their permanent home. There had been no complaints or safeguarding referrals made, either to the manager of the home or to the Commission. Information from the survey forms returned and the visit to the home indicated that everyone knew who to speak to if they were not happy with any aspect of the care they received. They also knew how to make a complaint. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: The service user guide and any other information, which includes the address and telephone number of the Commission, needs to be amended to reflect the recent move to Preston. The written assessment documentation should be completed fully, so that care workers are aware of the differing needs of the people. It is also recommended that the document have a name change, as it was confusing having two documents called a care plan, both of which had different functions. As with the assessment forms, the care plans need to include more detailed information and all sections should be completed. The daily recordings should have information about the person’s general well being. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 8 The carpet in the dining room should be replaced as soon as possible. The carpet on the stairs should be repaired without further delay, as it is a health and safety hazard to the people who use these stairs which is predominately staff. One of the downstairs toilets needs to be renovated, with a second requiring the lock to be replaced with one that allows care workers access in an emergency situation. The application form should have a statement with regard to previous employment history in order to clarify what is required. The manager must ensure that all the information asked for is completed irrespective of whom the applicant is. The manager agreed to produce a quality assurance report, which would include the results of the most recent survey conducted by the manager. This report should reach the Commission no later than 31st May 2008. The manager should inform the Commission of any significant event, as required under the Care Homes Regulations. 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. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 9 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 Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 10 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): Standards 1, 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The assessment form did not contain sufficient information to ensure that residents’ specific likes, dislikes and needs would be met when first admitted to the home. EVIDENCE: There was a service user guide and statement of purpose available. The address and telephone number of the Commission needs changing to the new one at Preston. A care needs assessment had taken place; however, the document is called a care plan which is confusing as there is another document also called a care plan. It is recommend that the document be changed to a ‘Care Needs Assessment’ or something similar. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 11 It is important that all the information asked for on the form is completed. This is to ensure that the care workers are aware (on the person’s admission) of their likes and dislikes and their differing needs and requirements. People were visited before being offered a place at the home unless they were referred as an emergency placement. The most recent people who had decided to make Clifton House their permanent home had initially been admitted for respite care. The company did not provide intermediate care beds. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The residents’ personal and health care needs are met and their privacy and dignity respected. EVIDENCE: There were care plans in place; however, as stated in previous standard, it was confusing when there were two sets of documents which, although slightly different, were called the same. The manager suggested printing the ‘working care plan’ a different colour but it is recommended that the first ‘care plan’ be changed to ‘Care Needs Assessment’ or something similar. All the information asked for on the care plan should be completed and there should be no gaps. If a section does not apply, it should say so. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 13 Other documentation for recording falls, GP visits and moving and handling risk assessments were available. As stated previously, the amount of information provided could be more detailed. There were records kept of GP and District Nurse visits together with evidence of referrals to hospital, as and when necessary. Daily recordings could contain more information about the resident’s state of well being; both physically, emotionally and socially. The information was basic and task based. The medication was recorded and administered according to pharmacy guidelines. All the residents had a single room, with care workers acknowledging the residents’ right to have their privacy and dignity respected. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home was a friendly and relaxed place for people to live in. EVIDENCE: A person was employed Monday to Friday, 10am to 3pm, to encourage and support residents with ‘in house’ and community based activities. Residents were supported to maintain their personal routines whenever possible. A number of residents had brought with them personal possessions from their homes. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 15 The second visit to the home took place at teatime. All the residents said that they had enjoyed the meal. One person who was not feeling too well had requested an omelette, which was being cooked specially for them and was being served in their room. No-one had any complaints about the food. It was normal practice for an alternative to be offered if someone did not like what was on the menu and people had the opportunity to have their meals in their rooms. The residents and care workers said that the home was a relaxed and friendly place to live and work. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 16 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): Standards 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents were protected through policies and procedures and care worker training. EVIDENCE: There had been no complaints or safeguarding referrals. There was a complaints procedure available which needed to have the address of the Commission changed to the most recent, which is Preston. None of the people who were spoken with had any complaints. All who completed a survey form said that they knew how to make a complaint and who to. Care workers had received training on safeguarding adults and knew what to do if they had any concerns. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home was comfortable and clean with no offensive odours. EVIDENCE: The home was clean throughout and had no offensive odour. Bedrooms were freshened up, wherever possible, when they became vacant. A number had been personalised with items of furniture, photographs and small ornaments. The dining room carpet was very threadbare in places, however the manager said that a new carpet had been ordered and would be fitted soon. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 18 The stair carpet was also threadbare and had a small hole on one of the treads. This was extremely dangerous and whilst it was recognised that the residents did not use the stairs, the care workers did. The manager said that the carpet fitter was to mend the carpet; this needs to be done without further delay, as it was a health and safety hazard. The downstairs corridor was in the process of having the paintwork renovated. One of the toilets downstairs needed to have the tiling and wall covering fixed back onto the wall. Another toilet needed to have the lock replaced. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Recruitment and selection procedures did not fully protect residents from the employment of unsuitable care workers. EVIDENCE: Staffing levels were appropriate to meet the current care needs of the people living in the home. The AQAA stated that six care workers had a National Vocational Qualification (NVQ) and two were working towards the qualification. A training record and training plan was available, which showed who had taken training in core skills and what was still required. The file for the most recently employed person was looked at. It is recommended that a statement be added to the application form when requesting employment history. The statement should read ‘from leaving school or full time education and explain any gaps’. The application form seen had not been completed satisfactorily, as the applicant had not given any dates with regard to previous employment. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 20 The manager said that induction training was in place for all new employees. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 21 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): Standards 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home is run in the best interests of the residents. EVIDENCE: There was a registered manager in place who had the necessary qualifications and skills. The manager was also one of the providers. Quality monitoring questionnaires had been circulated to relatives and service users. These were briefly looked at during the inspection, when it was seen that they were mostly positive. Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 22 The manager was to produce, as required under the Care Homes Regulations, a quality assurance report, which would include the results of the surveys. It was agreed that the report, which would include the results of the most recent surveys conducted by the manager, would reach the Commission no later than 31st May 2008. The manager/provider had over the past 12 months failed to inform the Commission of her working arrangements; to report the deaths of residents and to produce an improvement plan when requested. This was not satisfactory and contravened the Care Homes Regulations. In making the current judgment, consideration had been given to the circumstances, which had prevailed over this period. There were policies and procedures in place, which the AQAA showed had been reviewed. The AQAA also indicated that safety checks on equipment had also been carried out. The manager said that the fire safety officer had recently visited the home and that he was satisfied with the procedures. Clifton House DS0000008549.V361710.R01.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 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 2 Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 25 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 OP1 Good Practice Recommendations The service user guide and any other information, which includes the address and telephone number of the Commission, needs to be changed to reflect the recent change to Preston. This will enable people to contact us if they wish to. The written assessment documentation should be completed fully so that care workers are aware of the differing needs of the people. It is also recommended that the document have a name change, as it was confusing having two documents called a care plan both of which had different functions. Both of these recommendations will help care workers to meet the needs of the residents more effectively. The care plans need to include more detailed information and all sections should be completed. The daily recordings should also have information about the person’s general well being. These recommendations will assist care workers to meet the needs of the residents and ensure that they are kept safe and receive the care they require. The carpet in the dining room should be replaced as soon as possible. The carpet on the stairs should be repaired without further delay, as it is a health and safety hazard to the people who use these stairs which is predominately staff. One of the downstairs toilets needs to be renovated with a second requiring the lock to be replaced with one that allows care workers access in an emergency situation. These improvements will benefit the residents by providing a comfortable and pleasing environment for them to live in. In order to protect the residents from unsuitable care workers it is essential that the application form be amended to clarify what is required with regard to employment history and all sections of the form should be completed. DS0000008549.V361710.R01.S.doc Version 5.2 Page 26 2 OP3 3 OP7 4 OP19 5 OP29 Clifton House RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 6 Refer to Standard OP33 Good Practice Recommendations The manager agreed to produce a quality assurance report, which would include the results of the most recent resident/relative surveys conducted by the manager. This report should reach the Commission no later than 31st May 2008. This is a regulation under the Care Homes Regulations and will enable us to make judgements about the service along with any other information we receive. The manager should inform the Commission of any significant event as required under the Care Homes Regulations. Again this information is required to assist us when assessing the service and helps us to judge the general management of the home and the health and safety of residents. 7 OP38 Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Clifton House DS0000008549.V361710.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!