Inspection on 17/04/07 for Oak House

This inspection was carried out on 17th April 2007.

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

Oak House 29/11/05

Oak House 27/06/05

Oak House 09/12/04

Oak House 01/06/04

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 Oak House 103 Corringham Road Stanford Le Hope Essex SS17 0BA Lead Inspector Ms Vicky Dutton Unannounced Inspection 17th April 2007 08:00 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 Oak House DS0000018092.V336145.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. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak House Address 103 Corringham Road Stanford Le Hope Essex SS17 0BA 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) 01375 673104 F/P 01375 673104 Christian Care Homes Mrs Lesley Venables Care Home 13 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (13) of places Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Oak House is owned and managed by Christian Care Homes, a Registered Charity. The home is registered to provide care and accommodation for thirteen older people, of whom, up to ten may have dementia. Day care is provided in a separate lounge area and is not part of the registered establishment. However, some residents do enjoy joining up with the day centre clients for activities or meals. The home has the use of two mini buses, trips out and holidays for residents are arranged throughout the year. Oak House has seven single rooms and three shared rooms on two floors with passenger lift access. There is a large lounge/dining room and a pleasant garden. The hallway area of the home provides a wealth of information for residents, relatives and other visitors. Copies of the homes Statement of Purpose and Service Users Guide were available in addition to the most recent CSCI inspection report and a report following a contracts monitoring visit undertaken by the Local Authority. The current scale of charges as quoted in the home’s Pre Inspection Questionnaire and confirmed at the site visit are £375.69 as a contract price and £420.00 as a private rate. Additional charges to residents include chiropody, hairdressing and holidays. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced ‘key’ site visit. The visit took place over a six and a half hour period. At this inspection all the key standards were considered. The home had no previous requirements. Prior to the site visit the home had submitted a pre-inspection questionnaire (PIQ), and provided additional information that assisted with the inspection process. At the site visit a partial tour of the premises took place, care, staff, medication and other records and documentation were selected and various elements of these assessed. A staff ‘handover’ session was attended. During the site visit residents, visitors and some of the home’s staff were spoken with. As part of this key inspection questionnaires were sent out in the post to health and social care professionals. Visitors, staff and residents’ questionnaires were made available at the home. The views expressed at the site visit and survey responses have been incorporated into this report. The inspector was assisted at the site visit by the registered manager and other members of the staff team. Feedback on findings was given throughout the visit, and summarised at the end. The opportunity for discussion or clarification was given. A feedback card on the inspection process was sent to the home after the site visit. The inspector would like to thank the manager, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: Oak House continues to provide a high level of care and support to residents. Relatives were highly complimentary about the service offered. One said ‘Oak House is an excellent care home and is run to an extremely high standard,’ another: ‘we highly commend the staff and running of Oak House. There is a happy family atmosphere and the manager is professional and caring.’ Residents were also positive about their life at Oak House. One commented, ‘It may not be a palace but we have got the best home here.’ Another said that they ‘would not change anything.’ Residents feel well cared for at the home. One said ‘since living at Oak House my general health has improved and my depression has gone. I am very happy and well cared for.’ The entrance hallway at the home is used to display a wide range of information for residents and visitors. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 6 The home is well managed and has a stable and well trained staff team. This ensures that residents receive a consistent quality of care provided by staff that they know. The manager is proactive in their approach and is continually reviewing and seeking ways to improve and develop the service offered by the home. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 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 Oak House DS0000018092.V336145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their families are given sufficient information about the home to help them to make informed choices. Staff are well trained and have the skills to meet residents’ needs. EVIDENCE: The home has a Statement of Purpose and Service Users Guide in place. The service users guide is currently being reviewed to include photographs of different aspects of the home, and a frequently asked questions section. The manager was advised that changes in Regulations require that fees and additional charges are also included in the text. The manager undertook to address this. Copies of the service Users Guide were available, and a relative confirmed that they had been given written information about the home. Many residents living at Oak House had previously attended day care at the home, so had a good awareness of the home. The home is keen to give people the information they need and assist so that they can make decisions. A relative Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 9 said that ‘Oak House was the only home that allowed me instant access without an appointment, gave me a tour of the house and allowed me to talk to residents.’ Files of recently admitted residents showed that their needs were assessed before they moved into the home. As previously stated many become resident at Oak House after attending day care services at the home. This means staff are already aware of their needs to a degree, and can assist them more effectively in their move to residential care. Christian Care Homes are consistent and proactive in providing staff training and support to a good level. Staff demonstrated a good knowledge of residents’ care needs. All staff at the home have received training in dementia care. Intermediate care is not provided at Oak House. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents at Oak House receive excellent health and personal care based on their individual needs. EVIDENCE: All those spoken with and feedback on surveys was unanimous that the care provided at Oak House met residents’ needs and was excellent. ‘The love and care my relative receives is superlative,’ ‘I am very satisfied with the level of care,’ ‘the care and support my relative receives is 100 ’ were just a few of the many comments received. A visiting professional felt the home was good at ‘promoting the individuality and independence of residents.’ Care planning at the home is based on a person centred approach and provides a good basis for care to be delivered to residents. Care plans viewed were of a good standard. Observations, discussion with staff and a staff hand over attended showed that staff have a detailed knowledge of all individual residents’ needs. The manager outlined how residents and relatives are encouraged to be involved with the care planning process. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 11 It was discussed with the manager that some adjustments to care planning may be needed to ensure that staff are aware of how to consistently assist residents with behavioural needs, and to ensure that care planning information identifies all potential health/care needs. The manager had already been reviewing care planning and was considering the use of a different format that might assist this process. Records viewed and discussion with residents showed that the home is proactive in managing residents’ healthcare needs. Relatives spoke of times when residents had experienced periods of illness. They said how well the home had managed these episodes, and of the support, including staff visiting residents in hospital, given at these times. Two residents who had recently been in hospital also said that the home were excellent getting them appropriate medical support when needed. Both said that when in hospital they ‘couldn’t wait to get back home again.’ Medication at the home is mostly managed through a monitored dosage system (blister packs.) Aspects of the system sampled at the site visit were satisfactory, and showed that medication is managed safely to protect residents. Staff administering medication have received a good level of training and their practice is monitored. Minor points of best practice such as double signing handwritten entries on medication administration records were highlighted to the manager. During the site visit staff were observed to treat residents with courtesy and respect. Dignity was preserved when personal care tasks were being undertaken. Residents said that staff always treated them in a sensitive manner. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff to make individual choices about their daily life. Opportunities for activity and occupation are provided that meet residents’ needs and expectations. Families are made welcome. EVIDENCE: As care planning at the home is person centred, residents’ choices and preferences are well documented and followed by staff. Routines of the day observed and residents spoken with confirmed that individuality is respected. A part time activities person and a pastoral worker are employed by the home. Residents at Oak House also have the option to join in activities being undertaken by people attending day care at the home. The home has a strong key worker system in place. As observed at the site visit key workers also undertake individual resident led activities/tasks with residents. Residents spoken with were happy with the level of activity/occupation offered. A relative said ‘they are always trying to involve the residents in activities and there are outings and holidays arranged during the year.’ This year two holidays are planned involving most residents, as 5/6 residents will go on each trip. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 13 Visiting at the home is very open. Relatives spoken with said that they were always made welcome and offered a drink. The home feels that it is very much part of their role to create a family environment at Oak House. They try to work closely with families in caring for residents, and to offer whatever help and support is needed. This was confirmed by comments from relatives. Tellingly one relative also said ‘at Christmas parties and other functions we meet relatives of deceased residents that still feel part of the family of Oak House.’ Feedback from visiting professionals also said that they were always made welcome at the home. Residents’ bedrooms were very personalised showing that they are able to bring in personal possessions. Information on advocacy services was available. The manager said that these services had been used by the home and that an advocate was currently being arranged for a resident. Residents spoke well of the food offered by the home. Menus viewed showed that a good variety of foods and level of choice is offered. Lunch on the day of the site visit looked appetising. The cook has attended training and is aware of the nutritional needs of elderly people. This has led to all residents being offered an aperitif before lunch to stimulate their appetite. The cook also said that, as well as daily feedback, they hold regular meetings with residents to see what they would like on the menus. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 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. 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. Residents at Oak House are able to raise concerns and have access to a clear complaints procedure. Residents are protected from abuse. EVIDENCE: The home has a complaints procedure in place which is on display and available to residents and others. The manager was advised that the procedure should be revised in the light of guidance given in a previous CSCI newsletter. This relates to who should investigate complaints. No complaints had been received by the home or CSCI since the previous inspection. Many compliments had been received and recorded. Residents and relatives said that they knew how to raise concerns and would feel confident in doing so. Staff at the home have received training in adult protection and in managing challenging behaviour. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 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. 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. Residents live in a comfortable, clean and well maintained home that meets their needs. EVIDENCE: Oak House is situated in a residential area. The home provides a good quality of accommodation for residents, which is well furnished, decorated and maintained. The property is an older building and some areas, such as bathrooms/toilets would benefit from refurbishment. Residents spoken with were happy with the accommodation provided. Bedrooms were personalised and homely. The home has a pleasant garden. Last year Oak House was awarded a silver and silver gilt award in the Thurrock in Bloom scheme. Residents enjoy the garden. One resident told the inspector about growing plants from seed this year. Residents have all just planted individual sunflowers. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 16 On the day of the site visit the home was clean and odour free. Feedback from residents was that the home is always fresh and clean. Staff have received training in Infection control, and were noted to use protective equipment appropriately when caring for residents. The home’s laundry is situated off the home’s main living area. This is not ideal as laundry is then carried through the lounge/dining room. However this is done in a hygienic manner, and the laundry area has suitable equipment for the number of residents accommodated. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at Oak House are recruited safely, and well trained to support the needs of residents. EVIDENCE: Residents and relatives gave very positive feedback about staff at the home. Comments such as ‘the manager and all the staff are kind and totally dedicated to the quality of life of those they care for so wonderfully’ were frequent. Staff rota’s indicated that the home was maintaining staffing levels at three staff on duty during the day, and one awake and a sleep in member of staff at night. The manager’s hours are supernumerary to this. The manager and staff felt that these levels were currently sufficient to meet residents’ needs. During the site visit it was observed that there were staff interacting with and available to residents at most times. Residents felt that staff were attentive, and around when they needed them. In addition to care staff the home employs a cook, activity person, pastoral worker, a domestic and a handy man who works across all three homes managed by Christian Care Homes. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 18 A wide range of training is provided to the staff, who are encouraged to continue learning and developing skills throughout their employment. Nine staff at the home hold a National Vocational Qualification (NVQ) at level two or above. A further six staff are starting NVQ training. The home employs 25 care staff, many of who are part time. The home has therefore nearly reached the recommended 50 of care staff trained to NVQ level two or above. Staff spoken with and on surveys confirmed the good level of training offered by the home. The files of two more recently recruited members of staff were viewed. These showed that staff are recruited safely, with all relevant checks carried out so that residents are protected. To assist staff in caring for residents all new staff go through a comprehensive induction training programme. The induction programme is in line with current Skills for Care Standards. Staff confirmed that ongoing training is very much encouraged at the home. One said ‘we are given every opportunity to undertake training and updates. New information/updates are shared with us by our training manager.’ Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 19 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, 32, 33, 35, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Oak House is managed effectively by a competent and qualified manager. Management is based on openness and respect. Quality assurance systems are in place. EVIDENCE: The registered manager at Oak House is very experienced and has completed appropriate training. Findings in this report evidence that the home is managed very effectively for the benefit of residents. Residents, relatives staff and visiting professionals felt that the home was well managed. Oak House promotes an open and inclusive atmosphere. Residents felt that they were listened to and that staff acted upon what they said. Staff felt that Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 20 management at the home was very approachable. Regular staff and residents meetings are held. Staff felt that they were listened to. One said ‘I have often made suggestions and they have been listened to and acted upon. I have no problems with talking to my manager or anyone within the management team.’ Staff felt that they could go to the manager at any time for support or discussion. Strategies are in place to monitor quality at Oak House. The home completed an exercise in quality assurance last year by sending out surveys to all relatives. It was seen that feedback provided was being acted on and relatives informed of actions. Residents are spoken with on a one to one basis, and can express their views on the service within residents’ meetings. The registered provider carries out monthly visits to the home (as required by Regulation) to monitor the quality of the service. The home is starting to develop other internal quality tools such as regular medication audits. The home has regular ‘link’ meetings with other authorities involved with the home such as the PCT and Thurrock Council. It was advised that to tie all these pieces of activity together management should aim to develop an annual development plan for the home. Oak House is part of the Investors in People Scheme. This shows the organisation is committed to maintain their high standards and improve where necessary the service it provides. The home does not manage any finances for residents; these are managed by families or via The Court of Protection. The home does however hold some personal allowances for safekeeping. These were sampled. Records were accurate and monies balanced. The pre-inspection questionnaire completed by the home showed that systems and services are regularly checked and maintained. So that residents are cared for safely, risk assessments are in place. As the home is registered to care for up to ten residents who have dementia it was advised that the risk assessment process be extended to look at such areas as storage of disposable gloves, that could present a potential hazard. Staff training in important core areas such as moving and handling was seen from records to be up to date. Oak House DS0000018092.V336145.R01.S.doc Version 5.2 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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 4 3 3 X 3 X X 3 Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations Care planning should identify all potential care needs and give staff strategies to assist residents with these in a consistent manner. Best practice issues relating to medication practice such as signing hand written entries and dating boxed/bottled medication should be actioned. To ensure a safe environment for residents with dementia, the premises should be audited and risk assessment undertaken as appropriate. 2. OP9 3. OP38 Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Oak House DS0000018092.V336145.R01.S.doc Version 5.2 Page 24 - 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. 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