Inspection on 28/11/05 for Hillcrest House Limited

This inspection was carried out on 28th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Hillcrest House Limited 02/10/07

Hillcrest House Limited 30/10/06

Hillcrest House Limited 07/06/05

Hillcrest House Limited 01/12/04

Hillcrest House Limited 15/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Hillcrest House Limited Hillcrest House Barbican Road East Looe Corwall PL13 1NN Lead Inspector Kerensa Livingstone Unannounced Inspection 28th November 2005 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 Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 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. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hillcrest House Limited Address Hillcrest House Barbican Road East Looe Corwall PL13 1NN 01503 263489 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) www.hillcrestlooe.co.uk Hillcrest House Limited Ms Sharon Jane Keast Care Home 88 Category(ies) of Dementia - over 65 years of age (31), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (31), Old age, not falling within any other category (57), Physical disability (57), Physical disability over 65 years of age (57), Terminally ill (57), Terminally ill over 65 years of age (57) Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: Hillcrest House offers care and accommodation to service users in need of care by reason of old age. The home has two units, the General Unit that provides nursing care for up to 57 people and Trevena which provides care for up to 31 older people who have mental health problems or dementia. The home is situated on the outskirts of Looe and has scenic views over the surrounding countryside and sea. There is a small group of shops within walking distance of the home. The home is a modern building, purpose built to provide care and accommodation. There is a large car park to the front of the home. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted over one day by two Inspectors. The Inspectors had the opportunity to meet Service Users, relatives, staff, the Registered Manager and senior staff. Service User documentation, Policies and Procedures, record keeping and the environment were inspected. All the service users and visitors spoken with at the time of the inspection were very happy with the quality of care that they are offered, the staff and their environment. The Service Users spoke of the individualised care that they receive, which is all the more commendable given the relatively large size of the home. Management structures are clearly defined and the comments of service users and visitors reflect effective everyday management and communication. What the service does well: What has improved since the last inspection? The Registered Manager continues to ensure that Service Users are offered a high standard of care in an individualised way, unusual in a larger home. The environment is comfortable, clean and well cared for. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 6 What they could do better: 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. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 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 Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 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. Prospective Service Users are provided with the information that they require to ensure that they are able to make a choice about where to live. Service Users are given terms and conditions which form the basis of their contract with the home. EVIDENCE: The Statement of Purpose is comprehensive. A service user’s guide was available within the reception areas. This is clearly written and an attractive document, providing details of the environment. This document is provided to all prospective Service Users including qualitative information and a copy of the most recent inspection report. These documents are kept under review. The Inspectors were informed that all Service Users are provided with a statement of terms and conditions at the point of moving into the home. This document should include the rights and obligations of the Service User and Registered Provider and who the fees are payable by e.g. Service User, social services, other and health. This information is currently provided on a separate sheet. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 9 Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 10 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, 10 & 11 The Inspectors believe that the Service Users health, social and personal needs are being comprehensively met. Service Users confirmed their satisfaction with the care that they are receiving. Service Users and/or their representatives must be involved in the drawing up of the Service Users plan. Policies and Procedures relating to ageing and dying should be developed further. EVIDENCE: Each service user has a detailed care plan, based upon the pre-admission assessment and risk assessment. The care plans incorporate the health, personal and social needs of the Service Users. The Registered Manager must ensure that the plan demonstrates that the Service User is involved in the drawing up of the care plan, recorded in a style accessible to the Service User, agreed and signed by the Service User whenever possible and/or representative (if any). Risk assessments are full and detailed, identify risks/problems and an action to reduce the risk. There is evidence that these are kept under review. There is a computerised Patient Care System utilised for documentation. On the day of the inspection, the Inspectors discussed with the Registered Manager that entries appeared to be being made using other staff accounts, the Registered Manager agreed the need for this to discontinue, as this invalidates the unique identifier and password, which will clearly identify Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 11 who made the entry. The Nursing and Midwifery Council confirm that computerised record keeping is the way forward, stating they must be patient focused, secure, confidential and accessible. The unique account for each staff member could be seen as a signature to identify the originator of the record. On the day of the inspection the daily record for Service Users for the last week on one unit or two weeks on one unit were not available at inspection. The implications of this were discussed. The records are written by qualified nurses, the Inspectors discussed the Carers role in record keeping with the Registered Manager. Multi disciplinary specialist input is sought on an individual basis. The home enjoys a good working relationship with local Primary Health Care team members. The services that are provided included the audiologist, chiropody, physiotherapy, mental health services, General Practitioner, dentist and hairdresser. An activities organiser is employed providing specialist input into activities aimed at service users with dementia. There is evidence that a comprehensive range of assessment tools are utilised including moving and handling, nutritional assessment and dietary requirements. Service Users spoke highly of the care that they received and the staff without exception. Service users feel they are treated with respect and their right to privacy is upheld. Staff were observed to treat service users with respect and the Service Users confirmed this. Respect for the service users was evident throughout and in all aspects of the inspection. Family and friends are encouraged to visit service users at any time. There is evidence that care and comfort is given to Service Users and their families when they are dying. Service Users wishes concerning death and dying need to be discussed and recorded, to include the changing needs of the Service Users with deteriorating conditions or dementia. The Service Users family and friends should be involved (if that is what the Service User wants) in planning for and dealing with increased infirmity, terminal illness and death. There are up to date Policies and Procedures relating to expected deaths and death of a service user. The Registered Manager should develop these Policies and Procedures to include ageing and care of the dying. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 12 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): 15 Service Users receive a varied, nutritious, balanced diet in comfortable surroundings. Individual wishes and requests are usually met. EVIDENCE: Service Users are offered a six weekly rotational choice of menu for all meals. A cooked breakfast is offered twice weekly and a roast meal three times a week. There is a separate menu for vegetarians. Salads are available; one Service User informed the Inspector that they enjoyed these. Service users were aware of the choices for lunch on the day of the Unannounced Inspection. Individual requests for snacks or meals are met, if at all possible. Baskets of fruit are available within the home for Service Users to help themselves. Service Users informed the Inspectors that they enjoyed the meals that are offered and can choose whether to join other Service Users in the dining room or to remain in their own room. Staff are in the dining room to provide assistance as required. Food was observed to be attractively presented. Weekly cleaning schedules are maintained and fridge temperatures maintained. The Inspectors were impressed with the enthusiasm and pride that was apparent within the catering team. This was confirmed by Service Users. One Service User recounted how the chef had visited them to discuss their dietary requirements. Nutritional assessments are undertaken, records are kept of the food on offer and Service User records of what is eaten. A variety Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 13 of drinks are offered to the Service User. Cake and/or biscuits are offered with drinks provided at 07.30, 10.30, 14.30 and 20.30. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 14 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 & 18 Service users and visitors confirmed that they would feel able to approach the staff or the management of the home if they had a concern. EVIDENCE: Service Users informed the Inspectors that they knew who to speak to if they had any concerns and were confident that action would be taken. There is a clear complaints procedure for the home, this includes stages and timescales, this has been reviewed since the inspection and states the complainant can contact the Commission for Social Care Inspection at anytime, this must displayed within the Service Users Guide and in the home. A record is kept of all complaints made, including the investigation and the action taken. There are policies and procedures in the home regarding Whistleblowing and types of abuse. These subjects form part of induction training for all staff. Protection of Vulnerable Adults policy and procedural information is included in the Whistleblowing documentation. The Protection of Vulnerable Adults Procedure has been reviewed and includes local contact details for the key agencies. Two staff have attended external training in this area. Further staff are due to attend the Social Services Protection of Vulnerable Adults training. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 15 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, 21, 22, 23, 24 & 25. The environment meets the needs of the Service User in a homely, hygienic and comfortable way. The Service Users benefit from well maintained and personalised accommodation that they value. Specialist equipment is sought on an individual basis for the Service Users. EVIDENCE: Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 16 The home is accessible, decorated in a homely manner and well cared for. It is located on the outskirts of Looe. The home is purpose built and therefore the layout of the home is suitable for its stated purpose. Many rooms have super views into the valley and of the river. The Provider has ensured that there is a programme of redecoration and refurbishment. There is a maintenance record book. The grounds were tidy. There is a large car park to the front of the home. The home complies with requirements of the Fire Officer and Environmental Health Officer. There is wheelchair access to the home. There is adequate office space for support services, managerial and clinical staff. The home provides a range of communal facilities. The general unit has a large lounge and separate dining room, whilst Trevena has a large lounge with a dining area. Trevena is a locked unit, where access is gained by a numbered keypad. There is a reception area with staff to receive visitors to the home. The furniture in communal areas is of a good standard. There is natural light and opportunities for ventilation within both. There are five double rooms in Trevena, a screen is provided. The Inspectors were advised that all rooms are ensuite. Additional bathroom and toilet facilities are provided near to communal areas. There are adequate facilities for the needs of the Service Users. A large range of equipment is provided to assist in the care of Service Users, this includes suitable beds, portable hoists, handrails, moving and handling aids, special mattresses etc. Individual Service Users needs are assessed and the equipment required is provided. There is a lift to the first floor. Service users’ rooms generally contain the furniture and fittings required. All doors have a lock and this can be overridden from the outside. Screening was provided in double rooms. The majority of the rooms have adjustable hospital type beds. Service users were very satisfied with their rooms, informing the Inspectors that they were able to bring in personal belongings and furniture. Service Users rooms are carpeted as a rule. When required special flooring is used but this based upon risk assessment and carpet replaced for a new Service User. All hot surfaces are covered, hot water regulated and windows restricted. Environmental risk assessments are undertaken for all risk factors within the home. The premises were clean and generally free from odours. Alcohol solution is provided at the entrance to all units and visitors are encouraged to use this before entering. There is an active maintenance programme with two maintenance staff employed by the home. There is allocated storage space within the home, which meets the needs of the home. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 17 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): These standards were fully inspected at the previous inspection and met the minimum standards. EVIDENCE: Staff spoke freely with the Inspectors about the support and training that they are offered. The Inspectors observed that staff were enthusiastic and motivated in their work. Staff value the clear leadership and managerial support that is offered. Service Users, without exception, spoke highly of the staff and management team, for example ‘nothing is too much bother’ and ‘staff are very kind’. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 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, 34, 35, 37 & 38 Service users benefit from living in a home which is managed by an experienced Registered Manager, who operates this established home in an organised manner demonstrating clear leadership. There is a clear managerial hierarchy and systems are in place to enable the smooth running of the home. EVIDENCE: The Registered Manager has been at the home since 1987, is a registered nurse and has completed the NVQ Level 4 management diploma. The Registered Manager is involved in the day-to-day running of the home and there is evidence of clear and strong managerial leadership. The organisational structure of the home demonstrates how responsibility is delegated to Heads of Departments, this is displayed and provided to all service users and representatives. A further three staff have completed the NVQ Level 4 management diploma. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 19 An annual quality assurance questionnaire is circulated annually. Following the last inspection the findings of the quality assurance questionnaires have been published and a copy was provided at this inspection. This was for 2004, a further survey is planned, and this should include feedback from families and stakeholders in the community on how the home is achieving goals for Service Users. A copy of the report resulting from any further reviews conducted within the home shall be forwarded to the Commission. As a limited company suitable accounting and financial procedures are in place. There is clear evidence of reinvestment into the home. Records of all transactions are kept. Employers Liability insurance is in place. There is an annual business and financial plan for the establishment, which was not inspected at this inspection. Evidence of financial viability has been formally provided following the inspection. Service Users and their family/or representative are encouraged to maintain control of their money in almost all situations. Written transactions are maintained, receipts provided and invoices issued for all dealings with Service Users monies. The Safe Handling of Service Users Monies Policy and Procedure has been updated to reflect the practices. The Registered Manager is the appointee for one Service User. No monies are held for Service Users. There is a facility for the safe keeping of valuables on behalf of the Service User, a receipt is provided. Record keeping was observed to be of a very high standard, a Visitors Book is situated in the reception area of the home. The Registered Manager is addressing the issues raised earlier in the report regarding the daily record. Notification under Regulation 37 regarding a recent issue was discussed. Accidents are recorded in an accident book that complies with data protection legislation. Emergency lighting in the home is tested and a record kept. Legionella checks are made and recorded, water samples were sent away eighteen months ago and currently under review. The Inspectors were informed that all water is regulated, all hot surfaces covered and all windows restricted. There is evidence that regular servicing and maintenance is undertaken e.g. hoists. Evidence is kept on file e.g. PAT testing, gas certification (23.5.05). There are two maintenance staff and a vacant third post. The maintenance personnel were evident on the day of the unannounced inspection. There is a designated Health and Safety person. There is a designated Moving and Handling trainer and there is a designated Fire trainer. Full records are kept of training to promote safe working practices. The Environmental Health Officer visited the home on the 3rd August 2005 and the Fire Officer visited in 17th November 2005. COSHH assessments are completed and kept under review. Infection control Policies and Procedures have been updated and developed. Health and Safety Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 20 Policies and Procedures are available in clinical settings, the office and reception. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 21 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X 3 3 X 3 3 Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 15 Requirement The Registered Manager must ensure that there is evidence that the Service Users plan is drawn up with the Service User or a representative unless it is impracticable. The Service User should be notified of any revisions. Timescale for action 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP2 Good Practice Recommendations For the home’s written contract/statement of terms and conditions to refer to the accompanying document that include the rights and obligations of the Service User and Registered Provider. For the daily record to be accessible to all members of staff and entries to made using a unique identifier and password, which will clearly identify whose made those entries, as a signature to identify the originator of the record. For Service Users wishes concerning death and dying to be DS0000046312.V254602.R01.S.doc Version 5.0 Page 23 2. OP8 3. OP11 Hillcrest House Limited documented. The Service Users family and friends should be involved (if that is what the Service User wants) in planning for and dealing with increased infirmity, terminal illness and death. The Registered Manager should develop Policies and Procedures to include ageing and care of the dying. Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Hillcrest House Limited DS0000046312.V254602.R01.S.doc Version 5.0 Page 25 - 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!