Inspection on 13/02/06 for Geel And Hitchen Court

This inspection was carried out on 13th February 2006.

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

Other inspections for this house

Geel And Hitchen Court 27/06/07

Geel And Hitchen Court 11/05/06

Geel And Hitchen Court 10/11/05

Geel And Hitchen Court 09/02/05

Geel And Hitchen Court 29/07/04

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

CARE HOMES FOR OLDER PEOPLE Geel And Hitchen Court Woodlands Road Aigburth Liverpool Merseyside L17 Lead Inspector Andrea Morris Unannounced Inspection 13th February 2006 6:30 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 Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 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. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Geel And Hitchen Court Address Woodlands Road Aigburth Liverpool Merseyside L17 0151 261 2000 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) Nugent Care Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2005 Brief Description of the Service: The Geel and Hitchen Care Home is part of the Nugent Care Society and is a purpose built nursing home that offers single accommodation on a ground floor level. All bedrooms have hand wash facilities and there are several assisted baths, showers, and toilets. There is a large lounge, quiet room and a separate dining room. There are long corridors for residents to wander in. There is access to a patio area and secure garden. The interior and exterior of the home is well maintained. The home is set in grounds shared with another home owned by the Nugent Care Society, however, both homes have separate amenities and staff. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over 6 hours. During the inspection the inspector spoke to staff and some residents. A tour was made of the home. A selection of documentation was examined including resident care files, health and safety certificates including the fire safety file. What the service does well: What has improved since the last inspection? What they could do better: Care files must be improved to ensure care plans are appropriate and reflect changes in residents needs. Risks assessed as high and very high must have a care plan implemented and all care plans and risk assessments must be reviewed at least monthly. Medication must be recorded correctly and all staff must be made aware of the homes policies and procedures. An activity programme must be implemented in order to provide residents with a cultural and socially stimulating life. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 6 The areas of the home identified i.e. garden area and bathroom near the lounge area must be tidied up so that residents benefit from their potential use. All complaints received must be documented and the action taken must be recorded. All complaints received in the home must be available for inspection. The home must improve the staffing levels so that agency staff usage is kept to a minimum. All staff must receive training so to promote high standards of care. Effective leadership must be made available in the home to ensure all aspects of care is maintained. Staff must receive supervision 6 times per year. Communication between staff must also be developed through staff meetings. Fire procedures must be adhered to at all times. Documentation must be recorded accurately and in the time frames directed by legislation. All staff must receive at least 2 fire drills per year in order to promote the safety of all in the home. 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. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 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 Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5, 6 All potential clients are assessed prior to admission; however lack of detail recorded on the pre-admission assessment could leave residents at risk. EVIDENCE: The homes statement of purpose contains adequate information as required. Every resident entering the home is issued with a written contract, this gives clear details of the terms and conditions of residency. Prior to admission a senior nurse carries out a pre-admission assessment to determine needs can be met. On examination of several residents’ files, details documented on the form were found to be vague and did not contain sufficient information to assess the potential needs of the resident. The home encourages all potential residents’ and their families to visit the home prior to making a final decision. There is an opportunity to spend a few hours or to stay for a meal at no additional cost. The home does not provide intermediate care. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The handling of medication is not safe, medication is not documented accurately, and neither is medication returned to the pharmacy as per policy. EVIDENCE: A selection of residents’ care files were examined. Although care files were formulated for all residents’ it was found that care plans were not reflecting the needs of clients. One residents’ needs had been changing over a 10-day period no care plan had been formulated to identify the care needed. Care plans in general were found to be vague and lacked detail in areas relating to residents’ mental health. Not all care plans were reviewed on a monthly basis; this leaves residents vulnerable to receiving the incorrect care. Risk assessments had been formulated for all residents; it was found that residents’ determined as high risk of falls or very high risk of falls did not have a care plan in place. These risk assessments were also only recorded and reviewed on a 2 monthly basis, which puts residents’ care at risk. The homes accident book was examined and it was found that accidents were being recorded. The completed forms must be removed to a secure place as per Data Protection Act details. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 10 The medication was examined. It was found that hand written entries were not signed by two staff. Records of medication received into the home was not recorded. Medication was found to still be sealed in the blister pack but signature to say it had been given was evident. The controlled drugs were examined and initially the staff member was not aware of any controlled drugs being held in the home, on examining the controlled drug book it was found that there were controlled drugs, the number recorded was found to be correct however the medication for the resident had been discontinued since November 2005, this medication should have been returned to the pharmacy when it was discontinued. It was found that the daily fridge temperatures were recorded accurately. However on checking medication held in the fridge it was found that medication with a short shelf life did not have dates recorded of opening. Evidence was seen of staff treating the residents with respect. During the tour staff were seen to knock on doors prior to entering residents’ rooms. Residents were assisted where necessary but staff respected when they tried to do things themselves. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Activities are not being carried out therefore the home is not encouraging residents’ to lead socially and culturally lead lives. EVIDENCE: Activities are not carried out on a daily basis. Care staff are at times encouraged to deliver activities and to record the activity that has taken place. There is no evidence of trained staff having monitored the documentation of activities. On examining the activity records available, it was found the activities offered are very limited. A poster had been displayed on the front door of an entertainer that is due to visit the home in the near future. It appeared only a small number of residents’ were being offered activities. The home operates an open visiting policy. Families are encouraged to participate in residents care, a new system is planned to be introduced to invite residents families to review the care plans created and to discuss the care being delivered. Staff did allow residents’ to make some choices these are limited as the mental capacity does restrict some residents ability. The menu was displayed on the board in the dining area, however it was noted to be written very small and in writing that was joined up, this is not appropriate to residents who suffer from forms of Dementia. The menu is on a Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 12 three week rota, only one option is available however, residents can if they choose make requests for an alternative, which is provided for them. There was no record noted of residents with special diet, staff in the kitchen have not received any training in catering for special diets. It was noted that the liquidised diet is now being served as would an none liquidised diet; this is an improvement to the last inspection where all liquidised diet was mixed up together. Residents who spoke to the inspector stated they liked the meals. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Complaints are not recorded and therefore there is no evidence that complaints are listened to and actioned. EVIDENCE: The complaint procedure is adequate; however there was no complaints listed in the complaint file. The nurse in charge of the shift informed the inspector that complaints of a minor nature are listed in a separate book. On examination of the book it was found that only two complaints had been listed by staff since April 2005. When asked the inspector was informed that verbal complaints are not recorded. The National Minimum Standards requires all complaints received to be documented and action taken recorded so to assist in protecting all residents and staff. Residents’ legal rights are protected by residents’ being able to maintain their vote, staff will assist any resident to attend the local polling station if they choose or residents can use the postal vote system if they prefer. Staff only open residents’ post if an agreement is made, this however is not documented and they always open post in front of the resident. There is currently one issue of adult protection, which is currently being investigated by the home. Appropriate action was taken at the time to protect residents. Staff informed the inspector that some of them had received training in adult protection in November 2005; further staff are still awaiting to receive the training. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 25, 26 Residents’ rooms are personalised to promote the feeling of belonging for residents’. EVIDENCE: The home was found to be generally well maintained. All areas were found to be clean except one bathroom that was found to be very untidy and the toilet dirty. There was a quantity of pads left all in the bathroom. The small garden area which is mainly a terraced area used by residents in the summer is in need of tidying. Residents are able to access the outside area by use of ramps. Staff and residents who spoke with the inspector stated they regularly use the garden in fine weather. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 15 All rooms seen by the inspector were found to be clean and well maintained. Residents are encouraged to bring in small pieces of personal items to make their room more like home and also to assist those with advanced dementia to identify their own space. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staff training is limited and therefore residents are potentially at risk of harm. EVIDENCE: Staff rotas were examined and found to be staffed appropriately, however there is a high agency staff usage to ensure numbers are correct. The home does ensure agency staff provided to the home is consistent to promote continuity of care. Some staff have completed the NVQ in care, some staff have recently started on the programme and are due to complete in the autumn of 2006. Staff who spoke to the inspector stated they felt training was restricted to only certain staff. All staff must receive regular training in order to ensure high standards of care is maintained. Staff training that has been provided by the company is: Health and Hygiene POVA (Protection of Vulnerable Adults) Challenging Behaviour Breakaway Techniques Care Planning First Aid No staff have received any recent training in Dementia care, this is essential so that staff develop vital skills in caring for the client group within the home. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 17 It was not possible to assess any staff files as no one in the home had access to the locked cupboards. The main staff files are held at Head Office. The home must make available staff personnel files for inspection. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37, 38 There is no leadership and the home is not managed well, thus leaving residents’ at risk of potential harm. EVIDENCE: There is no manager in post at present and therefore there is no effective leadership in the home. Care staff that spoke with the inspector stated they felt very frustrated as each nurse in charge does things differently. Staff felt the home was not managed well. The staff stated they felt ‘frustrated and not valued’. Staff stated they felt the home was ‘in chaos’. Only one staff member has received supervision since October 2005. Other staff have not received any supervision recently. Staff also raised the comment that no staff meeting have been held since September 2005. They felt they were not listened to and again felt under valued. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 19 At present the home is not run in the best interests of the residents’, due to the lack of leadership and poor management. Residents’ finances were found to be managed appropriately. Evidence was seen that all transactions were accounted for and receipts were obtained as necessary. Head Office audits the finances in order to ensure all finances are correct. Certificates relating to Health and Safety were examined and found to be appropriate and all were in date. However, on examination of the homes fire records these were found to be poorly maintained. The weekly fire tests have not been carried out regularly. It was noted that when the maintenance man is on duty the records were maintained, however in the absence of the maintenance man no provision had been made to ensure the up keep of the records. This practice must be corrected immediately in order to comply both with the National Minimum Standards and Fire regulations. It was also noted that there was no record of any fire drills being carried out for staff. Staff also could not recall when they last had received fire training. An immediate requirement was issued at the time of inspection so to ensure the home complies with all legislation. Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 N/a 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 N/a DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 3 18 2 3 3 N/a N/a N/a 3 N/a 2 STAFFING Standard No Score 27 2 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 1 3 3 1 1 3 Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1)(a) Requirement The registered person shall not provide accommodation to a service user at the care home unless the needs of the service user have been assessed by a suitably qualified or suitably trained person. The preadmission assessment must contain detailed information of the potential clients needs. The registered person shall make the service users plan available to the service user. 1) All care plans must be detailed to determine care required. 2) Care plans must be written where a risk assessment has identified a high or very high risk factor The registered person shall keep the service users care plans and risk assessments under monthly reviews to ensure safety is maintained. The registered manager shall notify the service user of any revision to care. The registered person shall make DS0000025103.V282566.R01.S.doc Timescale for action 28/02/06 2 OP7 15(2)(a) 28/02/06 3 OP7 15(2)(b) 28/02/06 4 5 OP8 OP9 15(2)(d) 13(2) 28/02/06 28/02/06 Page 22 Geel And Hitchen Court Version 5.1 6 OP12 16(2)(m) 7 OP12 16(2)(n) 8 OP16 22(1) 9 10 OP16 OP16 22(2) 22(3) 11 12 OP19 OP26 23(2)(o) 23(2)(d) arrangement for the recording, safekeeping, safe administration and disposal of medication. 1) All medication received into the home must be recorded 2) All handwritten entries must contain 2 signatures 3) Dates of opening medication must be recorded on the day of opening 4) All medication discontinued must be disposed of appropriately The registered person shall consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities. The registered person shall consult service users about the programme of activities arranged by or on behalf of the care home, and provide facilities for recreation including, having regard to the needs of service users, activities in relation to recreation, fitness and training. The registered person shall establish a procedure for considering complaints made to the registered person by the service user or person acting on the service users behalf. The complaints procedure shall be appropriate to the needs of the service users. The registered person shall ensure that any complaint made under the complaints procedure is fully investigated. The registered person shall ensure that the external grounds are appropriately maintained. The registered person shall ensure all parts of the home are DS0000025103.V282566.R01.S.doc 01/03/06 01/03/06 28/02/06 28/02/06 28/02/06 31/03/06 20/02/06 Page 23 Geel And Hitchen Court Version 5.1 13 OP27 18(1)(a) 14 OP30 18(1)(c) 15 16 17 OP30 OP31 OP32 18(1)(c) 8(1) 21(2) 18 OP33 21(1) 19 OP36 18(2) 20 OP37 23(4)(v) 21 OP38 23(4)(e) kept clean. The bathroom leading off from the main lounge is in need of through cleaning. The registered person shall ensure that at all times suitably qualified staff, competent and experienced persons are working at the care home in such numbers as appropriate for the health and welfare of service users. The registered person shall ensure that all persons employed by the registered person to work in the care home receive training appropriate to the work they perform. All staff must be able to access mandatory training. The registered person shall ensure all care staff receive training in Dementia The registered provider shall appoint an individual to manage the care home The registered person shall make arrangement to enable staff to inform the registered person and the commission of their views about any matter to which this regulation applies. This regulation applies to any matter relating to the conduct of the care home so far as may affect the health and Welfare of service users. The registered person shall ensure that persons working at the care home are appropriately supervised. The registered person shall ensure all fire equipment is tested at the intervals specified and appropriate records made. The registered person shall ensure by means of fire drills and practices at suitable intervals, that the persons working at the care home are DS0000025103.V282566.R01.S.doc 28/02/06 02/03/06 01/04/06 31/03/06 28/02/06 28/02/06 28/02/06 13/02/06 13/02/06 Geel And Hitchen Court Version 5.1 Page 24 aware of the procedure to be followed in case of fire, including the procedure for saving life. 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 3 Refer to Standard OP15 OP15 OP15 Good Practice Recommendations It is strongly recommended that all kitchen staff receive training on special diets so to ensure the well being of all residents. It is strongly recommended that a second meal option is made available and written so that service users are aware of the possible options It is strongly recommended that menus be written in appropriate form so that residents’ with Dementia are able to read them easily. No abbreviations should be used and handwriting must be printed It is strongly recommended that all staff including ancillary staff receive training in Adult Protection. 4 OP18 Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Liverpool Local Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Geel And Hitchen Court DS0000025103.V282566.R01.S.doc Version 5.1 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. 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!