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Inspection on 14/01/08 for Coniscliffe Rest Home

Also see our care home review for Coniscliffe Rest Home for more information

This inspection was carried out on 14th January 2008.

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

Service users, where able, described good relationships with the staff and said they were all polite and helpful. Staff were friendly and relaxed and showed a good understanding of their needs. Arrangements for service users to maintain contact with their family and friends are good. A variety of social activities were available providing service users with varied and interesting days.Meals are varied, well balanced and nicely offering a good choice and nutritious food at all meals. All of those spoken to were pleased with the quality and choice available. Hygiene practices were good protecting the health of service users and staff. The home is well staffed with a skilled, consistent and trained staff team giving security to service users. Staff recruitment and training records were clear and concise and contained all relevant information. The vetting process helps protect service users. The staff had a good understanding of service users individual needs. More than ninety percent of staff is qualified to National Vocational Qualification in Care level 2 (NVQ) or above providing service users with a trained, skilled staff team. The service users were very complimentary about the staff. One service user said, "I have been in several care homes, and this one is by far the best, the care I receive is first class". Another said, "The staff are excellent, always willing and respectful".

What has improved since the last inspection?

Since the last inspection, new menus have been introduced, and service users are happy with the choices available. Service users are actively involved in meaningful activities. The bathroom on the ground floor has been refurbished, and all bathrooms now have a thermometer to test the water temperature. Service users now receive appropriate support to manage their finances.

What the care home could do better:

To improve hygiene and promote the health and safety practices in the home for both staff and service users, a mechanical commode washer should be installed in the sluice room. The window in the kitchen should be fitted with a fly screen.

CARE HOMES FOR OLDER PEOPLE Coniscliffe Rest Home 37 - 43 Grosvenor Place Jesmond Newcastle Upon Tyne Tyne & Wear NE2 2RD Lead Inspector Jim Lamb. Key Unannounced Inspection 14th January 2008 09:30 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 Coniscliffe Rest Home DS0000000437.V346279.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. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coniscliffe Rest Home Address 37 - 43 Grosvenor Place Jesmond Newcastle Upon Tyne Tyne & Wear NE2 2RD 0191 281 2553 0191 281 8690 coniscliffe@highfield-care.com 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) Southern Cross Home Properties Limited Mr Terence Lillico Care Home 43 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (31) of places Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One identified service user with Mental Disorder aged over 65 years. Date of last inspection 11th September 2006 Brief Description of the Service: Coniscliffe is a care home that provides personal care to 43 older people and older people with dementia. The Home is located in Jesmond, a residential area of Newcastle upon Tyne and is a conversion of five large terraced houses. There is a range of local shops and amenities within walking distance and the area is well served by public transport. The current weekly fees are £ 355 £499. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Summary: How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 11.9.06. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 14.1.08. During the visit we: • • • • • • Talked with people who use the service, staff and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager/provider what we found. What the service does well: Service users, where able, described good relationships with the staff and said they were all polite and helpful. Staff were friendly and relaxed and showed a good understanding of their needs. Arrangements for service users to maintain contact with their family and friends are good. A variety of social activities were available providing service users with varied and interesting days. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 6 Meals are varied, well balanced and nicely offering a good choice and nutritious food at all meals. All of those spoken to were pleased with the quality and choice available. Hygiene practices were good protecting the health of service users and staff. The home is well staffed with a skilled, consistent and trained staff team giving security to service users. Staff recruitment and training records were clear and concise and contained all relevant information. The vetting process helps protect service users. The staff had a good understanding of service users individual needs. More than ninety percent of staff is qualified to National Vocational Qualification in Care level 2 (NVQ) or above providing service users with a trained, skilled staff team. The service users were very complimentary about the staff. One service user said, “I have been in several care homes, and this one is by far the best, the care I receive is first class”. Another said, “The staff are excellent, always willing and respectful”. What has improved since the last inspection? What they could do better: To improve hygiene and promote the health and safety practices in the home for both staff and service users, a mechanical commode washer should be installed in the sluice room. The window in the kitchen should be fitted with a fly screen. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 7 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. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 8 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 Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 9 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): 1 3 6 People who use the service experience good quality outcomes in this area. Prospective service users are provided with enough information about the service to enable them to make a choice about where they want to live. All service users are appropriately assessed prior to admission into the home. All are provided with a written contract explaining their terms and conditions with the home. EVIDENCE: Details of the extra charges and what these are for, are in the contract given to service users and are agreed prior to their admission. The homes Statement of Purpose and the Service Users Guide both contained the full range of information required. Information is also available on audiotape. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 10 Three service users’ files were checked and each included a full needs assessment. They contained a range of appropriate information. The service users are involved in drawing up both these initial assessments and the home’s subsequent service user plans. The 2 service user plans checked by the inspector were comprehensive, and listed details of service user’s needs and actions taken by the staff to meet these needs. The service users spoken to said their needs were met and they were happy with the care offered to them. Two care plans were checked and three staff interviewed, which confirmed that a range of specialist services was provided to service users. Staff interviewed had had a range of relevant training and experience. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 11 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 8 9 10 People who use the service experience good quality outcomes in this area. The care planning system is clear enough to ensure that staff has the information they need to meet the assessed needs of the service users. Service users are supported to make decisions about their lives, and take risks to promote their independence. EVIDENCE: There are comprehensive assessments in the service users’ care plans. There is also a comprehensive risk assessment of service users. It is recommended that all risk assessments are agreed and signed by service users and their representatives. There are advocacy arrangements, as well as family input, to represent service users. Each service user has an allocated key worker. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 12 Care plans are drawn up with service users. Plans are amended and reviewed on a regular basis. There are systems in place that will ensure that the placement and the service users plans are reviewed annually. These involve the care managers and the service users representatives. Service users moving and handling needs have been assessed, and this promotes their safety. Service users confirmed that their privacy and dignity are respected at all times. Service users care records showed that they have access to external health care services. G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. The medication systems were examined for ordering, receiving, administering and disposal. Staff who have completed relevant training administers medication. A sample of medication records was examined. These include photographs for identification purposes. Clear directions were recorded and each dose of medication was signed for, or a code entered to verify the reason not given. The Controlled Drugs register was appropriately recorded. Privacy and dignity issues are built into the home’s policies and procedures and staff training. All personal care and medical examination/treatment is carried out in private. The dispensing pharmacist offers good support and advice. Service users’ said that they that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 13 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 13 14 15 People using the service experience good quality outcomes in this area. The meals in the home are good, offering both choice and variety. The service users have opportunities for personal development and leisure activities. They are supported to maintain very good links with the community and their relatives and friends. EVIDENCE: Each service user has a life skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users are supported to live a normal life in the community. They are supported and encouraged to be in control of their own lives, to enjoy their own interests and hobbies. The home has an activities co-ordinator, who provides very practical support, Service users are encouraged to participate in activities such as; arts and crafts, karaoke, board games, chairobics, bingo, reading group, and memory recall sessions. There are also regular outings to local places of interest, pubs, theatres, shops and church services. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 14 The service users have also been actively involved in painting the large garden mural located in the rear courtyard. The mural depicts well-known streets of Newcastle City centre. One service user has also recently won an art competition, and another has had their painting printed in the Southern Cross annual calendar. Arrangements are in place for the service users to have their own art exhibition, this will be held over several days in the local church hall. All service users are supported to maintain very close links with their families. They can choose who they want to see and when. Daily routines promote independence, choice and freedom of movement. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day. The home has recently introduced Nut Meg menus; the menus appear to be well balanced and nutritional. The service users were very complimentary about the new menus, and they said that they are always provided with a good choice of food at all times. The chef had very good knowledge about the service users likes and dislikes, stock levels were good and this included fresh fruit and vegetables. The kitchen was clean and well organised. Currently the kitchen window has fly chains fitted, these are not effective hence, and it is recommended that a fly screen be fitted to the window. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 15 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 the service experience good quality outcomes in this area. The home has a good, clear, user-friendly complaints system and service user’s views are listened to and acted upon. Procedures are in place to protect service users from harm, and these are followed. EVIDENCE: There is a complaints procedure. It contains details of how to contact the CSCI to make a complaint, if complainants are not happy with the homes investigation and response. The procedure is written in a way that ensures service users fully understand its contents. Service users said that they had been given copies of the procedure and that staff listened to their complaints and dealt with them fairly. The home keeps a record of complaints. Since the last inspection visit there has been three complaints received, two were investigated properly and easily resolved and one is currently being investigated. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 16 The home has a Whistle Blowing policy and the Local Authorities Vulnerable Adults procedures. The home also has a copy of the Department of Health’s document, “NO SECRETS”. Adult protection training is ongoing for all staff. The Home keeps detailed financial records on behalf of the service users, and these are regularly audited. Receipts of personal spending are kept. Coniscliffe Rest Home DS0000000437.V346279.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): 19 20 21 22 23 24 25 26 People who use the service experience good quality outcomes in this area. The home provides a comfortable and safe environment for those living there. The standard and decoration within the home is generally good. Some areas still need to be improved. Communal areas and bedrooms meet the service users needs. All areas within the home are well maintained, clean, tidy and free from offensive odours. EVIDENCE: The home was clean, well decorated and well maintained. The home is in a residential location, near to local amenities. The grounds were tidy, safe, attractive and accessible. The rear courtyard has a decking area with seating for service users and their visitors. The fire service and the environmental health department had made visits to the home. Requirements made by these organisations had been met. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 18 The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. The main lounge areas on the ground floor are having new carpets fitted. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. Lighting was bright and domestic in design. Doors have privacy locks. Room sizes meet the minimum required. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. The bathroom on the ground floor has been refurbished, the bath removed and a walk in shower installed. Service users’ bedrooms have opening windows with restrictors fitted. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. There was emergency lighting throughout the home. Water is stored at over 60°C. Valves at water outlets ensure water is provided close to 43°C to prevent scalding. The laundry facilities are well organised. The kitchen was clean and well organised, and has recently had new flooring laid. It is recommended that the sluice room be fitted with a mechanical commode washer. The washing machines had the specified programme to meet disinfection standards. There are plans to have new entrance doors fitted to the front of the building, this is a conservation area and the Local Authority has approved planning for this. Coniscliffe Rest Home DS0000000437.V346279.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): 17 18 19 30 People who use the service experience good quality outcomes in this area. There is a good match of well-qualified staff offering consistency of care within the home. There are robust procedures in place for the recruitment and selection of new staff, which helps to protect service users. The staff receives supervision and this provides them with a good understanding of the service users support needs. EVIDENCE: Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 20 Staff levels on the day of the inspection met the agreed level. Samples of 4 weeks’ rotas showed the required numbers of staff were on duty: 5 staff between 8am and 9pm with 3 between 9pm and 8am. Staff said that staffing levels were appropriate. All the staff were over 18 years of age and those left in charge were at least 21. Training needs of staff are identified in supervision and appraisal sessions. The training programme has been reviewed to ensure it meets The National Training Organisation requirements for the first six months. Over 90 of care staff have achieved National Vocational Qualifications (NVQ) in care at Level 2 or above. NVQ Level 3 training is being organised for some staff. A sample of two staff recruitment files was examined. A recruitment checklist has been introduced to make sure all the relevant information is in place. Files contained appropriate documentation. This included photograph and proof of identification, application form, and references from suitable sources, interview record and health statement and questionnaire. References are requested from previous employment addresses, as opposed to referee’s home address. All staff is recruited subject to Criminal Records Bureau (CRB) checks being carried out. CRB checks were also examined. The home maintains an annual staff training schedule, and records of training courses and certificates. In the past year staff have received training in the following areas: induction training for new staff, National Vocational Qualifications, protection of vulnerable adults, health and safety, fire safety, moving and handling, first aid, and continence care. In-house training is also provided. Coniscliffe Rest Home DS0000000437.V346279.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): 31 33 35 38 People who use the service experience good outcomes in this area. The manager is supported by the organisation in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The systems for service users’ consultation are good, and service user’s views are both sought and acted upon. The health and safety of the service users is promoted. The service is aware of equality and diversity and its implications. EVIDENCE: The manager has the appropriate qualifications, experience and skills necessary to manage the service. Staff spoken to were clear about their responsibilities. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 22 Staff spoke positively about the manager saying he had encouraged both staff and service users to contribute to the development of the service. Service users are told when inspections take place and they are shown inspection reports. These are also summarised and discussed in service user meetings. Copies are available for relatives and others to see. A quality system is in place to monitor the quality of the service provided, this involves gaining feedback from service users, relatives and professionals involved with the home, the outcomes will be published and made available to all prospective service users. The home is also in the process of implementing an annual development plan. The records inspected were found to be appropriately completed. These included the fire log book, accident book, personal allowance records and Health and Safey manual. There are appropriate maintenance contracts for the home. Water storage tanks, gas and electrics are checked annually. Coniscliffe Rest Home DS0000000437.V346279.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 2 3 3 3 3 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 3 X 3 X X 3 Coniscliffe Rest Home DS0000000437.V346279.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. 1. Standard OP21 Regulation 16 (j) Requirement The Registered Person must ensure that a mechanical sluice machine is installed in the sluice room. Timescale for action 01/08/08 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 OP19 Good Practice Recommendations Consider replacing the window chains in the kitchen with a fitted fly screen. Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Coniscliffe Rest Home DS0000000437.V346279.R01.S.doc Version 5.2 Page 26 - 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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