Inspection on 20/05/09 for Longview Residential Home

This inspection was carried out on 20th May 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longview Residential Home 09/05/08

Longview Residential Home 15/05/07

Longview Residential Home 08/06/06

Longview Residential Home 02/02/06

Longview Residential Home 04/11/05

Longview Residential Home 17/02/05

Longview Residential Home 14/09/04

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Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Longview Residential Home 66/68 Plymouth Road Plympton Plymouth Devon PL7 4NB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kim Fowler     Date: 2 0 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Longview Residential Home 66/68 Plymouth Road Plympton Plymouth Devon PL7 4NB 01752337203 NOFAX longviewpl7@btopenworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr John Richard Underhay,Mrs Isabel Margaret Underhay care home 15 Number of places (if applicable): Under 65 Over 65 0 15 dementia old age, not falling within any other category Additional conditions: 15 0 The maximum number of service users who can be accommodated is 15 The registered person may provide the following category of service only: Care home only - Code PC to service users of female gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE[E]) Date of last inspection Brief description of the care home Longview is a detached property situated in a residential area of Plympton close to local amenities. The home is registered to provide accommodation and personal care for up to 15 women over the age of 65 for reasons of old age and dementia. Accommodation is provided over 2 floors, offering 11 single rooms and 2 double rooms. A stair lift provides access to the first floor, however there is one step at the top of the stairs and also steps at the main entrance, making access difficult for residents with mobility difficulties. There is a large lounge room and dining room on Care Homes for Older People Page 4 of 27 Brief description of the care home the ground floor, both of which have doors opening onto the patio. There is a garden that is well maintained and attractive. Currently the fees for the home range from 376 pounds to 400 pounds a week but this may vary depending on individual needs. Not included in the fees are the costs of chiropody, hairdressing, transport and residents personal items. Care Homes for Older People Page 5 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: The inspection was unannounced and took place between 10:00am and 3:40pm on the 20th May 2009. The Registered Providers, Mr and Mrs Underhay were present throughout the inspection. The inspector made a tour of the building and spoke to most the people living at the home and the staff on duty at the time of the inspection. Documentation relating to the care planning process and the management of the home were examined. Prior to the inspection surveys had been sent to the care home to allow people who live there to comment upon their experiences. Three surveys were returned to the Commission and two staff surveys were also received. Care Homes for Older People Page 6 of 27 Any comments are in the relevant section of the report. What the care home does well: What has improved since the last inspection? What they could do better: 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 set out 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering admission to this home can be confident that an assessment with be completed before admission to ensure the home can meet their individual needs. Producing a Service Users Guide for the home would ensure that prospective new admission has information they need to make an informed choice on were they live. Evidence: A discussion was held on the homes Statement of Purpose and Service Users Guide. Mr Underhay, the owner of Longview Residential Home stated that he has not produced a Service Users Guide. A completed Service Users Guide would provide information for prospective new admissions. All of the files examined held completed pre-admission assessments and the owner Care Homes for Older People Page 10 of 27 Evidence: confirmed that these are completed prior to admission. The placing authorities care plan that were send to the home prior to admission supported these pre-admission assessments. Completed pre-admission assessment ensures the home is able to meet the needs of individuals before admission and that the care staff are aware of peoples needs. One person living at the home and a visiting relative were spoken with and both were able to confirm that they had visited the home before admission. Other people living in the home returned their surveys to the Commission wrote that their relative had visited the home on their behalf. A prospective new admissions relative called the home during the inspection asking if they could come to look around for their relative. The homes AQAA returned to the Commission states, The opportunity is given for prospective residents to visit and stay for a day if they wish, prior to admission. Longview Residential Home does not provide Intermediate care. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff and manager provide good personal support to people who live at the home. Ensuring the promotion of privacy and dignity at all times. Completed care plan for everyone would ensure the staff would be able to meet the health and welfare needs of people living at the home. Evidence: A visiting health care professional is currently supporting the home in updating and reviewing the format for the homes care plan format. The files of three people currently living in the home were examined. One contained a new completed comprehensive care plan showing information on the person current care needs and how the homes care staff would meet those needs. The remaining two files are yet to be updated and completed in the new format currently being produced. Mr. Underhay confirmed that all care plans would be updated and changed to the new format. These care plans should be completed and reviewed to enable staff to be Care Homes for Older People Page 12 of 27 Evidence: aware the changing needs of people living at the home at all times. The daily care plans are easy assessable for staff on duty and risk assessments are held on individual files for the protection of all people living at the home. Completed care plans will give detailed instructions to all staff as well as information to new staff to ensure intimate personal care is being provided in a manner that meets with the approval of people receiving the care. This is particularly important where people are unable to express themselves verbally. Each person currently being visited by the District Nurse team has a designated file held with the current treatment being carried out. Information was also recorded into individual files that people living at the home are seeing other professionals including a CPN (Community Psychiatric Nurse) and a continence adviser. The care plans give full details and instructions to staff on what health care needs are to be carried out and by whom. Many of the people living in the home were spoken with and some were able to confirm that their health care needs were met and one person said, I see the Doctor regularly. All people living at the home have access to all health care services and this information was recorded into individual files examined. These files recorded that there was input from other professionals including GPs, CPN, chiropodist and consultants based at the local hospital. People have a weight chart held in their individual file. The loss of weight for one person raised concerns and the home confirmed they had arranged a GP appointment to investigate this with loss. The medication system was examined and showed that the home uses the blister pack system to dispense medication and staff were observed administering medication. One staff member was observed dispensing medication at lunchtime, this staff member was able to confirm they had received medicating training from a local pharmacist. Medication errors highlighted in the previous inspection report has now been resolved. The medication system was checked and found to be well recorded and documented. The home does not currently hold any controlled medication and advice was sought from the Commission inspector pharmacist on the correct procedure for recording and holding of one medication. The home immediately followed this advise and changed their currently procedure for holding this medication. Most people living at the home were spoken with during this inspection and some were Care Homes for Older People Page 13 of 27 Evidence: able to confirm that the staff respects their privacy and dignity at all times. Observed during the inspection were staff knocking on peoples doors to promote privacy and shutting the bedroom door when attending to a person personal care needs. One person living in the home said, they shut my door and another stated, The staff help me dress and was able to confirm when asked that this was carried out in private. The homes AQAA returned under what we have improved over the last 12 months states, Soon after the last inspection the deficiencies in medication administration were rectified. Care Homes for Older People Page 14 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. Meals and mealtimes are not rushed making them an enjoyable, social occasion for people. The home welcomes and encourages families and friends to visit. Evidence: People were observed moving freely around the home. Some people remained in their individual bedrooms and one person said, I like to stay in my own room. Staff were seen interacting with people and discussing everyday topics and included assisting individuals when needed showing staff were aware of the needs of people living in the home. The main entrance hall has a notice showing this month activities and visiting entertainment professionals. This included a singer and a relaxation session due. After each visit this information is recorded into the homes daily diary. Mr Underhay, the Registered Provider, also stated that activities are offered as much as possible either by themselves or one of the care staff. Some of the people spoken with were able to confirm that activities are available and offered, though some people Care Homes for Older People Page 15 of 27 Evidence: stated they choose not to participate. Activities mention included, board games, quiz, Bingo and watching a film. A visiting hairdresser was spoken with and confirmed that she visits the home regularly and her services are always very popular and enjoyed by all. Visitors are welcome at any reasonable time and can visit their friend/family in the privacy of their own room. Two visiting relatives were spoken with during this inspection and both were able to confirm they were able to visit at any reasonable time. Also one visitor confirmed that they were able to see their visitor in private if they wised. All family visits and contact is recorded into individual files and daily records examined showed recent family visits for several people living in the home. On person said, I see my son. The homes AQAA records that, Going out of the home with family friends etc is encouraged where safe and practical. All bedrooms visited contained personal possessions and items and one person living at the home said that the home encouraged them to bring in items from home. All people who were able to made positive comments about the food provided. The staff member on duty who was cooking the meal confirmed that the home has all the required fresh ingredients needs and has a 4 weekly menus available and displayed for all to see and this showed a varied and nutritional diet. It was evident from the food seen served at lunch time on the first day, Roast beef, fresh vegetable and a choice of roast or boiled potatoes followed by sponge and custard, that the food was home cooked using fresh products. The meal was well presented and freshly prepared. Staff were observed serving meals individually and asking each person in turn what they would like. During discussion with people about food they said it was excellent and another said, plenty of it! One person was able to confirm that they were able to choose a different meal if they did not like the one on offer. One survey returned to the Commission said of the food, Good variety, very Tasty! Care Homes for Older People Page 16 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. The people who live at Longview and their relatives can be confident that any issues of concern or complaints would be taken seriously and dealt with promptly. Safeguarding training would ensure all staff are aware of new legislation. Evidence: The home has a complaints procedure displayed on the homes notice board and those people who were able to state that they would approach the manager if they had any concerns or complaints. The home has not received any complaints and neither has the Commission. Some of the people living at the home were able to confirm that they were aware the home had a complaints procedure but have never needed it. One person said they would talk to the providers if they had any concerns. One relative also confirmed they were aware the home had a complaints procedure but had not needed to use it and also said the owners were available most day to discuss any concerns. Care staff had not received training relating to the protection of vulnerable adults. One Care Homes for Older People Page 17 of 27 Evidence: staff confirmed they had not received Safeguarding training but would raise any concerns with the providers. Mr. and Mrs. Underhay, the Registered Providers, stated that they are in the home most days and would deal with any issue raised straight away. The Commission would recommend that one of the Registered Providers receive the Local Authoritys Adult Protection training. The homes AQAA records that, We have not had any complaints in the ten years we have run Longview and goes onto say under improvements for the next 12 months, We will arrange for all staff to receive POVA training. Care Homes for Older People Page 18 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. Longview continues to maintain a clean and suitable environment for its stated purpose and the people who live at the home can be assured that they will live in comfortable home that is regularly maintained. Evidence: The home is safe and well maintained and suitable for its stated purpose. It is very comfortable, warm and light home. Several people living at the home confirmed this is usual. One relative commented that the home is, Always clean. A tour of the building confirmed that the home was clean and tidy, with no offensive odours. All bedrooms and communal areas were pleasantly decorated. Bedrooms have not been fitted with door locks and therefore people are unable to lock their doors should they wish for privacy or to secure their belongings when they are not in their room. The lounge area has access to the rear patio area that has a seating area and tubs of flowers. The front garden is attractive but not secure for people with confusion to use unsupervised as it opens directly onto a busy road. Since the last inspection the home has continued to redecorate were needed and has Care Homes for Older People Page 19 of 27 Evidence: benefited from a refurbished bathroom, new windows in some parts of the home, new dinning room furniture and a new hoist for the comfort of people living in the home. During the inspection upgrading work was being carried out on a bathroom and work was being planned to change a further bathroom into a wet room with work commencing next month. The homes AQAA records under, what we could do better, Residents do not seem to have any issues regarding privacy in their rooms but we accept that the facility to lock doors should be available to them so we think that this matter should be addressed and dealt with. Several of the staff confirmed they had not completed any infection control training. The staff were able to confirm that the home provided disposable aprons and gloves for their protection. Infection control training would ensure staff are aware of new legislation and how to manage infections within the home. One survey return to the Commission stated when asked if staff listen and act on what you say Yes, very attentive. Care Homes for Older People Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are employed in sufficient numbers to meet the needs of those currently living at Longview. Regular staff training would ensure that only suitable qualified, competent and experienced staff are working in the home. Evidence: The homes rotas and the staff confirmed that there is sufficient staff employed to care for the number of people currently living at the home. On the day of the inspection there were 13 people living in the home and on duty were the Registered Provider, Mr Underhay, 3 care staff and one domestic. Thus providing evidence that the home had sufficient staff to support people currently living in the home. Some of the staff on duty during the inspection were spoken with and some confirmed that they hold a NVQ qualification. The manager confirmed 9 of the staff eleven staff employed within the home currently hold this qualification. Examination of staff files showed that most staff had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as Care Homes for Older People Page 21 of 27 Evidence: possible unsuitable staff are not employed. Many of the care staff employed at the home are long serving staff members having worked at the home for a number of years therefore have a great deal of experience working with older people. Several people living in the home and a relative were able to confirm that the care they received is very good. Several staff members were interviewed during this inspection and none had completed the local authorities Safeguarding training or Infection control training. A 1st Aid course and Dementia training had recently been undertaken. All staff would benefit from Safeguarding and Infection control training. No formal Induction is provided by the home. The homes AQAA states, We provide suitable staff experienced in the care of the elderly who are caring and communicate and empathies well with the residents. One staff member said, Very happy working here. The people living at the home said of the staff Couldnt be looked after better and another saying The staff are excellent and a family member said of their relatives care, Couldnt have picked a better home. Care Homes for Older People Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The owners and their staff team strive to provide a homely, stimulating environment that respects people who live at the home. Evidence: Mr and Mrs Underhay have owned the home for a number of years and are in the home most days. It was clear from discussion with the person living and working in the home that Mr and Mrs Underhay are well thought of. As previously stated in the last inspection report there is currently no formal recorded quality assurance process at Longview to enable the Registered Providers to demonstrate how they consult with people living at the home about the quality of services provided. Many people confirmed that they speak to the providers most days and are able to raise issues and that they are dealt with by Mr and Mrs Underhay. However the providers have confirmed that they have started a formal process with a Care Homes for Older People Page 23 of 27 Evidence: outside agency coming into the home later this week to undertake quality assurance survey. Supervision is still carried out informally with the providers stating no records are held. However the staff interviewed felt they were supported by the providers and were able to approach and discuss any issues. Most of the people living in the home have their money held by family members. The home only holds a small amount of petty cash to purchase everyday items like toiletries. The money held was checked and found to be correct with a clear audit trail of income, expenditure and receipts held. The AQAA states under what we could do better, We should have in place a quality assurance process. Sampling of records indicated equipment is serviced regularly and maintained in good order. Health and Safety is a priority in the home and records examined showed fire safety training and fire protection is in place and up to date. The accident records were accurate and files examined showed that information is recorded onto accident forms and also written into peoples daily records with appropriate action taken when needed. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15 All care plans must be in 31/08/2008 place and reviewed regularly to ensure service users needs in respect of his health and welfare are met. Care Homes for Older People Page 25 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 7 15 All care plans must be completed in full, reviewed and updated. This requirement was carried over from the last inspection. This will ensure that staff are aware of and able to meet the needs of people living in the home. 31/08/2009 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 1 The home should have a Service Users Plan in place. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!