Inspection on 24/08/09 for Highbray

This inspection was carried out on 24th August 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highbray 10/07/08

Highbray 31/07/07

Highbray 22/06/06

Highbray 20/10/05

Highbray 08/06/05

Highbray 23/09/04

Highbray 06/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Highbray 84 Mount Pleasant Road Exeter Devon EX4 7AE     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Judy Hill     Date: 2 4 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Highbray 84 Mount Pleasant Road Exeter Devon EX4 7AE 01392676863 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Josefa McLeod care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Highbray is an end of terrace house in a residential area of Exeter. It is less than a mile from the city centre and close to local amenities, including a health centre, shops and bus stops. The home is registered to provide accommodation and care for up to three people who are over sixty five and who have a learning disability or mental health needs. No staff are employed and the care is provided by the registered owners, Mr and Mrs McLeod, and their daughter in law Lesley McLeod, who is the registered manager. The weekly fees range from 281 pounds a week to 450 pounds a week. 0 0 Over 65 3 3 Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection ended with an unannounced visit to the home that was carried out on 24th August 2009. The information contained in this report was gained during the site visit, from the report of the last inspection which was completed on 25th July 2008 and from information received by us between inspections. The information received prior to the site visit included an Annual Quality Assurance Assessment, that had been completed by the registered manager and surveys that had been completed and returned to us by all three of the people who use the service. During the site visit we carried out a physical inspection of the premises, spoke with the registered owners, the registered manager and two of the three people who use the service. We also case tracked two of the people who use the service by looking at their needs assessments, care plans and how their care is delivered. We also looked at other records, including the records of food provided, medication administration Care Homes for Older People Page 5 of 27 records and maintenance and service reports. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Statement of Purpose and Service User Guides do not provide enough information about the home and the service provided. Care planning and review records are not being signed and dated by the people who use the service. This means that there is no evidence to show that people are involved in planning and reviewing the care they need. All of the care is provided by the registered owners and the registered manager, therefore they need to attend training courses and gain the qualifications that are required and recommended for care workers. Although she is very experienced in the provision of care, the registered manager needs to gain the qualifications that are recommended for care home managers. An annual development plan needs to be produced to ensure that the service can adjust to changes in the expectations of the people who use care services and people commissioning care services. Care Homes for Older People Page 7 of 27 The gas appliances and central heating system need to be serviced annual to ensure that they are safely maintained. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the initial needs assessment practices are good, the Statement of Purpose and Service User Guides do not provide people with enough information about the home and the service provided. Evidence: We requested and were given a copy of the homes Statement of Purpose. This document does not provide all of the information that is required to be made available to current and prospective residents and their representatives. We also requested and were given a copy of the Service Users Guide. This document also needs to be revised as it does not include all of the required and recommended information. Highbray is a small family run home which provides accommodation and care for a maximum of three people. No new residents had been admitted since the last Care Homes for Older People Page 10 of 27 Evidence: inspection and the records kept at the home told us that the needs of the current residents had been assessed by the contracting authorities who arranged the placements prior to admission and by the registered manager. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs of the people using the service are being identified and every effort is being taken to meet their needs. Evidence: We looked at the plan of care for two of the three people who use the service. These were clearly written and outlined the support people need. We spoke with one of the people who lives at the home who told us that he was very happy and that the home was meeting his needs. Another person told us that although she was not unhappy with the service provided, she felt that she would be happier in a larger home. The registered manager confirmed that the NHS Care Trust was actively trying to find suitable alternative accommodation for her. Peoples care plans are being regularly revised and updated to meet their changing needs. Although we were told that the people using the service are involved in their care planning and reviews, recorded evidence of this was not available as people had not signed their care planning and review documents. Care Homes for Older People Page 12 of 27 Evidence: Some individual risk assessments had been carried out, however, we would expect to see more risk assessments and recorded plans on how to minimise risk while encouraging people to maintain their independence and autonomy. The people who use the service require very little physical help with their personal care but the registered manager said that they do need prompting. All three residents are over sixty-five years of age. Two of them have mild learning disabilities and the third has a diagnosed mental illness. Although the registered manager and the service providers are very experienced in the provision of residential care, we are concerned that they have not kept their First Aid training up to date and have not attended any specialised training courses in caring for people with learning disabilities and people with a mental illness. We saw records to show us that the physical health of the people who use the service is monitored and that they are helped to access professional health care services as and when necessary. Only two of the three residents need prescribed medicine and this is administered by the registered manager and one of the registered service providers. Medicines are stored in a locked cupboard and the records of administration were clear and up to date. Each of the residents has his or her own bedroom and their right to privacy is respected. Two or the bedrooms are lockable and the registered manager said that she was looking for a suitable lock for the third resident who could not turn a key. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to maintain contact with their families and to engage in social and recreational activities in the community. Evidence: All three of the people who use the service have family living locally and two of them have maintained very close links with them. One person said that his family had found the home for him and that this had enabled him to move from the North of England to Exeter to be closer to them. Records were seen to show that in addition to going out alone, arrangements are made for people to be accompanied on outings by the registered manager or one of the registered service providers. The registered manager demonstrated in conversation that she had good knowledge of the local clubs, day centres and support groups and that she had actively arranged for people to attend these. Some had proved popular but others less so and no pressure had been placed on people to continue to attend them. Meals are served in the dining area of the kitchen that the residents share with the Care Homes for Older People Page 14 of 27 Evidence: service providers. There are set meal times but these are not rigidly adhered to so people can enjoy their meals earlier or later if they have a social engagement or have gone out. The records of food provided showed us that the residents enjoy a varied diet. The main meal of the day is served in the evening and consists of a main meal and a pudding. Lunch is a lighter meal and followed with fresh fruit. One of the people who uses the service told us that the meals were always very good. One said that she would like more of a choice because the meals were not always to her liking. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and concerns are listened to, taken seriously and acted upon. Evidence: All three of the residents completed and returned surveys to us which told us that they would know how to make a complaint if they were not happy with the service provided. Although no complaints were recorded the registered manager told us that she had liaised with the NHS Trust to ensure that regular visits are carried out by a case manager to help one of the residents to find an alternative home after she expressed a wish to move on. No evidence was seen to suggest that any of the residents are at risk of abuse. However, the registered manager and the registered providers who provide all of the care for the residents have not attended any training on the Protection of Vulnerable Adults. Care Homes for Older People Page 16 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a comfortable family run home that is domestic in scale. Evidence: Highbray is an end of terrace house that is located within a mile of Exeter city centre. There is a frequent bus service to and from the city centre and local facilities, including a health centre and shops within easy walking distance. Mr and Mrs McLeod, who are the registered service providers, live on the premises and their daughter in law, Lesley McLeod, who is the registered manager, lives a short distance away. On the ground floor there is a sitting room and a kitchen with a dining area. This accommodation is shared by the three residents and Mr and Mrs McLeod. There is also a middle room which is not accessible to the residents. On the first floor there are three bedrooms and a bathroom. Each of the residents has his or her own bedroom and the bathroom, which is the only one in the house, is shared by the residents and Mr and Mrs McLeod. Mr and Mrs McLeod have exclusive use of the rooms on the second floor. Care Homes for Older People Page 17 of 27 Evidence: There is a small garden to the front of the house which seperates it from the payment and a yard at the back of the house which provides a private sitting out area for the residents. We looked at all of the parts of the home that are used or accessed by the residents. The sitting room is well decorated and comfortably furnished. The Service User Guide tells us that although there are no time restrictions on bedtimes, the residents are asked to vacate the communal lounge, which is also used by Mr and Mrs McLeod, by 9pm to minimise disturbing other residents who may have already retired. The residents, who all have television sets in their bedrooms, seemed happy with this arrangement. The large kitchen has a dining area in it and meals are served in this room, although people can eat their meals in their bedrooms if they prefer to eat alone. There is a payphone in the kitchen which people can use to make and receive calls and privacy will be provided if necessary. The washing machine is in the kitchen and although this is not ideal in terms of hygiene, soiled linen is not stored in the kitchen and the washing machine is not loaded when meals are being prepared or served. A Health and Safety officer has recently carried out a routine inspection of the food premises. The report of this visit was seen and it contained no requirements for change. Each of the residents has a single bedroom on the first floor. All three bedrooms were seen and each of them was found to be adequately decorated and furnished. Television sets are provided in each of the bedrooms so that people can choose to watch television in the communal lounge or in their bedroom. There is a bathroom with a bath, shower attachment, bidet, wash basin and toilet on the first floor. These are the only bathroom and toilet facilities in the house and are used by the three residents and Mr and Mrs McLeod. Consideration could be given to providing a second toilet if space permits. The home appeared to be in a good state of repair and was seen to be clean and homely throughout. Care Homes for Older People Page 18 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered owners and the registered manager are able to provide the level of care that the current residents need without employing additional staff. They do, however, need to attend training courses to ensure that their skills and knowledge are kept up to date. Evidence: Highbray is a small family run home. The registered owners, Mr and Mrs McLeod, live on the premises and their daughter in law, Mrs Lesley McLeod, is the registered manager. No staff are employed. Lesley McLeod said that she moves into the home when her parents in law go away on holiday and that her parents in law provide cover when she goes on holiday. This arrangement appears to work well with the current residents, as none of them require a high level of care. We looked at the training records and saw that very little training had been undertaken by either the registered manager of the registered owners. We saw certificates that told us that registered manager and one of the registered owners had attended training courses on Health and Safety and on the Boots MDS system but no other training records. Although it is accepted that the registered owners and the registered manager have a vast amount of experience in the provision of care, we would expect them to ensure Care Homes for Older People Page 19 of 27 Evidence: that they receive up to date training in Basic Food Hygiene, First Aid, Fire Safety, Infection Control and Adult Protection as well as training in the more specialised areas of caring for people with learning disabilities and mental illness. None of the people caring for the residents have a National Vocational Qualification in Care. Care Homes for Older People Page 20 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are well cared for but the management have not fully adjusted to the changes in expectations generated by the introduction of the National Minimum Standards. Evidence: The registered owners employed their daughter in law, Lesley McLeod, to manage the home over twenty years ago and she continues to hold this position in the home. Although she is very experienced and was able to demonstrate to us that the service is generally well managed, she has not gained the formal qualifications that a registered manager is expected to achieve or attended training courses to enable her to keep up to date with good practice development and guidance. We saw records to show us that surveys had been used by the home to gain feedback from people working with the residents in a professional capacity. Feedback from the residents is provided through daily contact and the registered manager demonstrated that she has good links with the families of the people who use the service. No Care Homes for Older People Page 21 of 27 Evidence: evidence was seen, however, to demonstrate that the information gained is being used to formulate an annual development plan for the home that is based on a systematic cycle of planning, action and review. The Service User Guide tells us that the people who use the service are encouraged to seek help from their families if they need support to manage their financial affairs. The registered manager told us that all of the current residents are able to manage their own personal spending money. One of the residents confirmed that she did not need any help to manage her spending money. Small safes were seen in the residents bedrooms so that they could stored their money and other valuables safely. The Annual Quality Assurance Assessment that was completed by the registered manager prior to the inspection told us that some policies, procedures and codes of practice were in place but that many were missing. Some are not necessary because of the nature of the service but others including a policy on aggression towards staff, an Annual Development plan for Quality Assurance, a Code of Conduct, Health and Safety, Food hygiene, Individual Planning and Review, Missing Service Users. Record Keeping, Referral and Admission, Safeguarding Adults and the prevention of abuse, Values of privacy, dignity, choice, fulfilment and independence do need to be written up. The Annual Quality Assurance Assessment tells us that that the fire safety equipment has been serviced regularly and that premises electrical circuits have been serviced recently. The gas appliances and heating systems have not been serviced since April 2006 and should be serviced annually to ensure that they are safely maintained. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 The Statement of Purpose must be rewritten to include all of the information listed in Regulation 4 and Schedule 1 of the Care Homes Regulations. This is to ensure that current and prospective residents and their representatives know what to expect from the home and the service provided. 25/11/2009 2 1 5 The Service User Guides 25/11/2009 need to be rewritten to include all of the information listed in Regulation 5 of the Care Homes Regulations. The information listed in National Minimum Standard 1 should also be included to meet this standard. All of the people who use the service must be given a Service User Guide. Care Homes for Older People Page 24 of 27 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This is to ensure that people have access information they need about the service provided. 3 8 13 The registered manager and 25/10/2009 at least one of the registered service providers must attend certificated training courses in First Aid. This is to ensure that there is always at least one person on duty who is a qualified First Aider. 4 38 23 The registered service providers must ensure that the gas appliances and heating systems are serviced annually. This is to ensure that they are safely maintained. 25/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Evidence, in the form of a signature and date, should be included in all care planning and review records to demonstrate that the people who use the service are actively involved in planning the care that they are to receive. The registered persons should attend specialist training courses in caring for people with learning disabilities and with mental illness as this will help them to keep their knowledge base up to date. Page 25 of 27 2 8 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 3 4 15 18 People should be offered a choice of meals to ensure that they enjoy their food. The registered manager and the registered service providers should attend a training session on the Protection of Vulnerable Adults. Consideration could be given to providing a second toilet if space allows. The registered manager should hold a National Vocational Qualification in Care at Level 4 or an equivalent qualification and at least one of the registered owners should hold a National Vocational Qualification in Care at Level 2 or above. The service providers should make arrangements to attend training courses in Basic Food Hygiene, Fire Safety, Infection Control, Adult Protection and specialist training in caring for people with learning disabilities and mental illness. This is to ensure that they keep up to date with current good practice. The registered manager should make arrangements to enrol on a National Vocational Qualification in Care at Level 4 and a Registered Managers Award or equivalent qualification. The registered manager should use the feedback that she has obtained from the people who use the service and their families and professional representative to develop an Annual Development Plan. The registered manager should ensure that all relevant written, policies, procedures and codes of practice are written up and kept at the home. 5 6 21 28 7 30 8 31 9 33 10 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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