Inspection on 21/02/08 for Hill House

This inspection was carried out on 21st February 2008.

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

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

Other inspections for this house

Hill House 26/02/09

Hill House 15/10/07

Hill House 01/05/07

Hill House 05/04/06

Hill House 24/10/05

Hill House 07/04/05

Hill House 22/09/04

Hill House 29/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hill House Elstree Hill South Elstree Hertfordshire WD6 3DE Lead Inspector Julia Bradshaw Unannounced Inspection 21st February 2008 10:00 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 Hill House DS0000019427.V360144.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. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill House Address Elstree Hill South Elstree Hertfordshire WD6 3DE 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) 0208 236 0036 0208 236 0944 www.bupa.com BUPA Care Homes (AKW) Ltd A R (Ben) Domah Care Home 76 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (58), of places Physical disability (19) Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. This home may accommodate 6 older people who require personal care. This home may accommodate 17 people (aged 18-65 years) with physical disability who require personal care. This home may accommodate 53 older people who require general nursing care. The home may admit one named service user who is under the age of 65 years. This condition will cease to be in force when the service user permanently leaves the home for any reason or reaches the age of 65 years. The number of places for YA with PD will revert to 17 when a named service user either leaves the home permanently or is transferred to the ground floor YPD unit. 15th October 2007 5. Date of last inspection Brief Description of the Service: Hill House is a care home situated in the village of Elstree, which offers nursing and residential care to elderly people and residential care to young adults with physical disabilities. The building is a period building with modern additions. All rooms are in excess of the National Minimum Standards for Older People. In the two areas used for the young adults the rooms also meet National Minimum Standards for Young Adults with additional space now available in the ground floor therapy room and the bedrooms are large enough to count towards the day space standard. All rooms have en-suite facilities and there are a variety of day rooms throughout the building. Hill House is situated in a convenient location for links with motorways and routes to London. There are small shops, a post office and a GP surgery nearby. The home has extensive grounds to the rear and off road car parking facilities to the front of the building. Information regarding the service is available in the Statement of Purpose and the Service User Guide. These and a copy of the last inspection report are freely available on request. The range of fees for Hill House are between £480 and £900. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. For this inspection we (the Commission for Social Care Inspection) looked at all the information that we have received, or asked for, since the last key inspection of Hill House. This key inspection was unannounced and carried out by two inspectors over one day. During the inspection a number of documents were examined including seven care plans, staff files, medication logs, health and safety records and staff training records. A full environmental tour was also carried out covering bedrooms, communal lounges, the dining rooms, bathrooms, laundry and kitchen areas. We observed the lunchtime experience for the residents and a total of 24 residents were spoken to during the course of the day. We also took the opportunity of talking to staff at various intervals during this inspection. What the service does well: The inspection’s main finding is that majority of the standards assessed on this visit have been achieved. The manager and staff have worked hard to meet the requirements that were made at the last inspection carried out in October 2007. There is a range of social and leisure opportunities provided for everyone living at Hill House. The activity workers should be congratulated on providing an interesting and varied programme of activities. Service users are actively encouraged to maintain contact with family, friends and significant others. The home has appointed a new chef since the last inspection, which has improved both the standards of the meals provided and also the variety and choice that is offered to people. Staff spoken to were aware of both the safeguarding and whistle blowing policy and their commitment and responsibility to disclose any incidents of abuse within the home. The home is clean and comfortable and service users are encouraged to make it their home, by being involved in the choosing and the decorating of their rooms. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 6 Information on how to raise a concern is well publicised and service users are being empowered to make a complaint if they are dissatisfied with any aspect of the service. Generally service users spoken to said they were happy with the care provision and comments from residents included “Staff are all very approachable” The manager is always around to chat to”. The food has got much better since the new chef has come and there is always plenty of choice”. The interaction seen between staff and residents was good and there was a pleasant and calm atmosphere. Staff said they enjoyed working at the home and training opportunities were good. The management team are providing good support to staff and residents and are ensuring that the procedures are followed, to the benefit of everyone. What has improved since the last inspection? What they could do better: There must be adequate systems in place to ensure that people who are suffering from pressure sores are monitored and seen by a tissue viability nurse for their consultation, advice and support in order to ensure that the best treatment is provided. There should be an up to date copy of the Royal Pharmaceutical Society guidelines kept within the medication areas of the home in order for staff who are responsible for the administration of medication. The chef must hold a current food hygiene certificate in order to ensure that the standards within the kitchen are maintained and that all staff who are involved in the preparation of food are provided with the appropriate training. Please contact the provider for advice of actions taken in response to this Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 7 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. Hill House DS0000019427.V360144.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 Hill House DS0000019427.V360144.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 –5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service at Hill House can be confident that a detailed assessment is carried out prior to admission to ensure their needs can be met appropriately in the home. EVIDENCE: Information about the residents assessed needs is provided by the home. The manager and senior staff carries out the initial assessment, in conjunction with the placing authorities own social worker’s assessment. This process is completed prior to the person moving into the home. All seven care files inspected had an assessment in place. The statement of purpose and service user guide are displayed within the main reception area of the home. These are updated annually and provide a good insight into the current service provided. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 10 Prospective residents can feel confident that the information provided will assist them making an informed choice about both the service required and desired. Hill House DS0000019427.V360144.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 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using the service at Hill House can expect that their health and personal care needs will be set out in care plans for staff to follow which ensures that they receive the care they require and are treated with dignity and respect. However support and advice from the tissue viability nurse must be sought to ensure that people are receiving the necessary treatment in relation to pressure sores, in order to protect and maintain their healthcare needs. EVIDENCE: The manager and staff have worked hard to implement the new care planning system into the home, with approximately 60 of the care plans being completed. The care plans inspected provide a detailed insight and record into the needs of the people living at the home. Individual risks are identified and risk assessments are in place. The home maintains a record of each resident who requires bedrails and there is current risk assessment and consent on each persons file. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 12 Several residents were spoken to during this visit and stated, “Staff are very approachable and always ready to chat”. However one service user did state that on occasions, “they felt like their dignity had been left at the door”. This was fed back to the manager at the end of the inspection. Health needs and visits by the doctor are recorded within the care plan and followed up as required. A four-week dosette system for medication is in place. A check on medication was carried out and we found that an auditing process is in place so that errors are picked up quickly and action taken. The home should obtain an up to date copy of the Royal Pharmaceutical guidelines, in order for staff who administer medication have up to date information on all medication prescribed to people living at the home. There were no gaps seen on the Medication Administration Records (MAR) sheets. The senior staff are responsible for receiving medication into the home and also for the management of the returns medication. A separate running record for the administration of paracetemol is maintained. The drugs trolley was seen to be appropriately maintained and secured during this inspection. The home records the temperature of the drugs trolley and this was up to date on the day of this inspection, which ensures medication is stored safely and remains clinically effective. There must be evidence provided in peoples care plan when they are suffering from pressure sores that professional support and advice has been sought from the tissue viability nurse in order to ensure that the treatment and care that people receive is the most efficient and up to date, to assist with their recovery. The care plans also need to ensure that if a person has more than one pressure sore, the nursing records must reflect the details of each pressure sore individually. Checks carried out on the day of the inspection discovered that one resident had two separate pressure sores but the records only related to one of these. This could put the service user at risk. Hill House DS0000019427.V360144.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 –15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service at the home can expect a range of activities to meet their varying interests. People living at the home can be assured to receive a varied and wholesome diet, which meets their needs. EVIDENCE: An excellent range of activities and leisure activities are provided. There are 70 hours per week, which are divided between a full and part-time worker who have a joint responsibility in implementing the agreed programme. The service is provided over a seven-day period. Activities range from Quiz’s Bingo, reminiscence sessions, late night scrabble, cookery club, church services held at the home, beauty days, hairdressing, board games, arts and crafts as well as a variety of planned celebrations including May day, VE day, Garden parties ‘Tea at the Ritz’. The activity workers also produce a monthly activity newsletter, which outlines a range of interesting facts about the respective months and describes events planned for the whole of the month. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 14 The activity staff should be commended on providing a diverse and interesting activities programme for people living at Hill House and the commitment and enthusiasm in which it is delivered. We joined the residents for lunch, there were two choices of main course, and we saw a variety of alternatives being offered. A new chef manager has recently been appointed, which has had a positive effect on the standard and choices meals provided. The kitchen was inspected and found to be both clean and hygienic, with adequate kitchen equipment and new crockery and utensils have been purchased since the last inspection took place. The atmosphere during the lunchtime meal appeared to be relaxed and informal. Several people required help with their meal and staff were observed to be doing this in a respectful and dignified way. People who required soft and puree diets were offered the same choices and these were also well presented. One person stated that they would like “ a glass of wine occasionally with their main meal.” This request was fedback to the manager who stated that they would consider this as part of their new menu planning. Hill House DS0000019427.V360144.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Hill House and their family’s can be confident that their views, concerns and complaints will be listened to and acted on. EVIDENCE: Staff confirmed they have received training in safeguarding and are clear on how to respond to any allegations made known to them. A complaints procedure is in place and available to all who enter Hill House. There have been 5 complaints received by the home since the last inspection was carried out. One of these complaints is part of a safeguarding adults issue and is currently being investigated by Hertfordshire County Council Adult Care Services. Residents said that they would be confident in taking any concerns to the manager and that they felt that they would be dealt with appropriately. One person stated, “If I had a problem I know I can always speak to the manager” Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 –26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service at Hill House benefit from a comfortable and well maintained environment that meets their needs. EVIDENCE: The general standard of the environment has improved since the last inspection was carried out where there were several pieces of damaged furniture, which required removing from the home as they presented as shabby and unsafe. The manager and maintenance staff have worked hard to improve all areas of the home and have also implemented a daily checklist of health and safety issues around the home, in order to identify repairs and issues at the very earliest stage. All areas of the home appeared clean and hygienic, with infection practices being implemented appropriately. The chef confirmed that the kitchen had been deep cleaned on the 20/2/08. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 17 The home has adequate bathing and toilet facilities and the appropriate specialist equipment. Staff spoken to confirmed that they had received the necessary manual handling training. Each bedroom is personalised and appears homely and comfortable. All areas are attractively decorated and the home was clean and tidy throughout. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private or in their own rooms. The home has extensive grounds to the front and rear of the property and all areas are fully accessible for people to enjoy in the warmer months. Since the last inspection took place a new pergola has been erected and a new garden, with raised borders, for wheelchair access has been started. Also a small area to the rear of the home has been designated as a ‘memorial’ garden and a service was recently held for families of loved ones. The manager and maintenance staff ensures that all fire safety procedures are adhered to. All fire checks were up to date on the day of the inspection. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 –30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Hill House can expect to have their needs met by appropriate numbers of staff that have been appropriately recruited and are adequately trained to ensure that all are safeguarded. EVIDENCE: A thorough check of three staff files provided evidence that there is a robust procedure in place when recruiting staff and all appropriate documents are received prior to a position being offered. Staff spoken to were happy in their job and good teamwork was observed during the inspection. Hill House has an on going training programme and records are kept to ensure staff are kept updated with their skills and there is a designated person who is responsible for implementing this training programme. However on the day of the inspection there was insufficient evidence to confirm that all staff who are involved in the preparation of food held current food hygiene certificates. There are currently 6 staff who are currently doing NVQ level 2 and one person doing NVQ level 3 and the manager is also a NVQ assessor. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 19 Adequate numbers of staff are available to meet the needs of the residents. Regular bank/agency staff are brought in to cover any vacant shifts caused by sickness or annual leave where necessary. There are currently two full time posts vacant and there has been an increase of 20hrs per week in housekeeping since the last inspection was carried out in October 2007. There was evidence to confirm that all staff receives staff supervision and the manager completes staff annual appraisals. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 –38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service at Hill House can feel reassured that the management of the home is improving and that resident’s health and safety is generally better protected. EVIDENCE: The manager and staff have worked hard to improve the running and general day-to-day management of the home. The current quality assurance systems continue to be improved, including more consultation with the residents and their families. The manager carries out his own auditing procedures, which include, daily medication and environmental checks, which are signed and recorded by the manager. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 21 Residents are involved in their own meetings and have the opportunity to discuss any issues about their care. The most recent survey carried out by the home involved sending out thirty-eight questionnaires and a total of twentyfive were returned. Regulation 26 visits are carried out regularly and the reports held within the home. The home has a current insurance certificate valid until the 31/10/08 The comments were generally positive “The staff are always friendly and treat me with respect”.” The manager is always around if you want to chat about something”. There were comments from a few people stating they would like more outside activities and sometimes staff appear “rushed” and have little time to spend “just talking”. One person stated” I would like to have the opportunity to go out to the theatre occasionally”. The health and safety of people living at the home has improved. However there must be consultation with the tissue viability nurse regarding people who suffer with pressure sores, in order to ensure that residents are receiving the best possible treatment in assisting with their recovery. Staff recruitment and selection procedures are strictly adhered to when appointing new members of staff, including the appropriate safeguarding checks. All catering staff must hold a relevant food hygiene certificate. The manager and staff should be congratulated on all their hard work since the last inspection was carried out in improving the service provided to the residents living at Hill House. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 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 3 3 3 3 3 3 2 Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 13(4)(c), 15(1) & (2) & 17(1) Schedule 3 and 4. 13(b) Requirement All care plans must contain all the relevant information in order to ensure the appropriate care is provided to people e.g. pressure sore documentation must be accurate, including the size and the depth. All residents with pressure sores must been seen by the tissue viability nurse for consultation and advice. All staff who are involved in the preparation of food must have a current food hygiene certificate. Timescale for action 10/03/08 2. OP8 06/03/08 3. OP30 18 (1) (c)(i) 31/03/08 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. 2. Refer to Standard OP13 OP14 Good Practice Recommendations Residents should have more opportunities of enjoying trips outside of the home Residents should be offered the opportunity to have a glass of wine/sherry/aperitif as part of their main meals. DS0000019427.V360144.R01.S.doc Version 5.2 Page 24 Hill House 3. OP38 There should be a current copy of the Royal pharmaceutical society guidelines kept within both medical rooms within the home for reference and advice. Hill House DS0000019427.V360144.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Hill House DS0000019427.V360144.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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