Inspection on 05/09/07 for Orrell Grange

This inspection was carried out on 5th September 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

Orrell Grange 15/07/08

Orrell Grange 01/12/06

Orrell Grange 23/02/06

Orrell Grange 18/11/05

Orrell Grange 18/03/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Orrell Grange 43 Cinder Lane Bootle Liverpool Merseyside L20 6DP Lead Inspector Ms Lorraine Farrar Key Unannounced Inspection 5th September 2007 10:40 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 Orrell Grange DS0000061714.V345659.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. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orrell Grange Address 43 Cinder Lane Bootle Liverpool Merseyside L20 6DP 0151 922 0391 0870 7059966 orrellgrange@orrellgrange.plus.com 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) 1st Care Ltd Mrs Shiela Victoria Harrison Care Home 36 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (36) of places Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 36 (OP) and up to 6 DE. One named female out of category service user under pensionable age. The variation applies to the named service user only, should she leave the Home, then the variation will cease to apply. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 1st December 2006 3. Date of last inspection Brief Description of the Service: Orrell Grange is a purpose built care home designed to provide accommodation and nursing care for thirty-six older people. It is situated in a residential area of Bootle with nearby facilities including shops, pubs and public transport. Twenty-six of the bedrooms are single and there are also five double bedrooms. Four of the single rooms have en-suite facilities and all other bedrooms have washbasins. Where there are shared rooms, screens are provided for privacy. Bedrooms are on both the ground and first floor with access available to the first floor via a lift. Downstairs there is a small dining room that people can use, they can also choose to eat in their room or the lounge, as they prefer. On the ground floor there is a large lounge with different seating areas. A small separate lounge has recently been created for people who smoke. There are staff available twenty four hours a day to support people with their personal and health care. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this inspection was gathered in a number of different ways. This included an unannounced site visit on 5th September 2007 where time was spent reading records and looking at the building. ‘Case tracking’ was used as part of the visit. This involves looking at the support a person gets, including their care plans, medication, money and bedroom. Case tracking was used to look at life in the home for three of the people living there. Discussion also took place with five of the people living in the home, a visitor and three members of staff. In addition time was spent observing daily life at Orrell Grange. Comment cards were sent out before the inspection to residents, their relatives and health and social care professionals. Of these ten residents, three of their relatives and five health and social care professionals completed and returned the cards. Their replies and comments have been incorporated within this report. The Manager had the opportunity to contribute information by completing a pre inspection assessment of the service, information from which has also been taken into account in completing this inspection of the service. Current fees for living in the home range from £365 to £471.50 each week. What the service does well: The people who live at Orrell Grange said that there are always enough staff to help them and that they always receive the support and care that they need and expect. Their comments included, “I like the staff here “ and “we’re well looked after”. Relatives expressed similar views with one explaining, “The family as a whole are delighted with the care (our relative) is receiving. There are always staff about, they always comment on how she has been during the past few days. They also sit and talk to residents, lots of activities take place.” During the site visit staff were seen to spend time talking and engaging with the people who live there as well as responding quickly and positively to requests for support. Staff respect peoples privacy and one of the people Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 6 living there explained, “they never make you feel embarrassed” when being supported with personal care. Information about how to raise concerns about the service is easily available and the people living there and their relatives said they know how to raise concerns and are confident they would be dealt with. Relatives and friends are welcome to visit the people living at Orrell Grange at all reasonable times and said that they are made to feel welcome. There are some activities arranged during the afternoons and the occasional trip out, to which relatives are invited, also takes place. In addition parties with entertainers are arranged for special birthdays and again relatives are welcomed. Different religious services take place that people can attend as they choose. Orrell Grange is a warm and clean home that has aids and adaptations to meet the mobility needs of the people living there. People can personalise their own bedrooms and choose where to send their time. What has improved since the last inspection? What they could do better: Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 7 Care plans and assessment relating to people health should be reviewed more frequently. At present not all plans and health assessments are reviewed monthly and this could lead to changes in peoples support needs and choices not being noted as quickly as they could be and therefore acted upon. Medication that is labelled as belonging to one person must never be given to another person even if they are prescribed the same medication. This will help to reduce the risk of errors occurring and provide a clearer way of auditing medication held in the home and dispensed to people. 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. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient information is provided to and obtained about new residents to enable everyone to decide if Orrell Grange is the right place for them to live. EVIDENCE: A care file for a new resident showed that before she moved into Orrell Grange staff obtained a copy of the assessment carried out for her by Social Services and met with her to carry out their own assessment. A relative of one of the people living there explained that the family were invited to look around the home to see if they thought it would be suitable and were provided with brochures and information about the service provided. Their relative was then visited by staff whilst she was in hospital to assess her support needs. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 10 She was then invited to visit Orrell Grange for a meal before deciding if she would like to move in. This assessment process helps to ensure that the service can meet the persons needs and their choices and is a suitable place for them to live. Orrell Grange does not provide an intermediate care service. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s health and personal care needs are recognised and met within the service. However improvements to the way in which people’s medication is managed would lessen the risk of mistakes occurring. EVIDENCE: Residents and relatives who completed comment cards all said that people always get the help and support they need at Orrell Grange. Relatives’ comments were very positive and included, “My father is always well fed and clean, and is always helped in any way he needs by all staff” and “I am very happy with the care and support my mother gets at Orrell Grange. They understand my mothers needs and are always helpful and friendly”. Health professionals said in their comment cards that the service always or usually seeks advice when needed and meets people’s health needs. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 12 These views were repeated during the site visit and discussions with some of the people living at Orrell Grange. One person explained, “we’re well looked after” and another that “they take great care, you only have to ask if you want something, they can’t do enough for you”. Individual care plans are in place for the people living at Orrell Grange. A series of assessments are carried out to identity any areas of support the person may have, these include their mobility, their nutrition and the condition of their skin. Where the assessment identifies a need for support a care plan is in place with written guidance for staff to follow. Care plans are also in place with guidance for staff on how to support the person with their health and their personal care. These plans had been reviewed by staff, however not all of these reviews had taken place in the past month. If plans and assessments are not reviewed regularly changes to the persons support needs may not be noted and therefore acted upon as quickly as they could be. The people living at Orrell Grange said that if they need advice on their health care or to see a GP this is arranged quickly. Records contained evidence that staff act on any health care issues by seeking advice and putting short term plans into place to support the person and if possible resolve the issue. People said that if they use their call buzzer they never have to wait long for someone to help them and this was seen to occur during the visit with staff responding quickly to call buzzers and requests. One lady explained, “staff don’t just walk in they knock” and another that “they don’t make you feel embarrassed” when supporting her with personal care. Medication is stored in a locked cabinet with fridges and controlled drug storage also provided. A clear system is in place for recording medication received and given to residents. Medication checked was generally stored correctly and tallied with the audit, records and stock held. However several people had been prescribed the same medication for their bowels and although individual bottles had been provided, only one bottle was in use and was being used to dispense for everyone one. This practice means that a clear audit trail is not in place and that people are not being given the medication labelled and provided for them and could lead to errors occurring. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Orrell Grange are supported to make choices about their everyday lifestyles. EVIDENCE: One of the people living at Orrell Grange explained that there are some activities arranged by the home such as quizzes and bingo and that they have recently enjoyed a day trip to New Brighton. She also explained that birthdays are celebrated with “a good meal” and often an entertainer. During the site visit staff were seen to sit and chat with people and to spend time discussing their interests. For example one member of staff was reading a magazine with a resident whist another was planning the following days quiz with another resident. There are Catholic and Church of England services held regularly in the home that people can attend as they choose. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 14 Visitors were seen to come and go throughout the day and the relative of one resident explained that they are always made welcome and there are no restrictions on their visiting. Comments from people regarding meals were mixed with some people saying they always like the meals and others that they sometimes like them. However everyone spoken with said that they have a choice at meal times and that if they do not like the choices available then they will be provided with something different. The cook was able to explain how she caters for the different diet needs people have and one lady explained that she prefers a softer diet and this is always catered for with food she enjoys. Drinks were seen to be served throughout the day and a resident explained “they bring you drinks whenever you want”. People are encouraged to personalise their bedroom with their own possessions and are able to make choices about how to spend their time, decide where to see visitors and to manage or have their family manage their money. This helps people to retain as much of their independence as possible and supports them to live their life as they choose. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Orrell Grange are confident that any concerns or complaints they have will be listened to and acted upon. EVIDENCE: The people living at Orrell Grange said that they know who to talk to if they have any concerns. They said they would raise them with the manager with one explaining, “she’s helped me a lot” and another “she’s very good, she sorts things”. There is a policy in place for dealing with any complaints and information about how to do this is displayed in the hallway and given to people as part of the brochure. There is also a policy in place for dealing with any adult protection issues that have arisen and staff have had training in this area. This helps to ensure that the people living at Orrell Grange are safe and any issues can be quickly identified and dealt with. There has been one complaint received about the service since the last big inspection. This was investigated by the organisation and responded to appropriately. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Orrell Grange provides a safe, warm and comfortable home for peoples to live in that caters for their needs. EVIDENCE: The people living at Orrell Grange said in their comment cards that the home is always fresh and clean and this was observed during the site visit when all areas visited were clean, tidy and warm. Bedrooms are personalised with people’s own possessions and equipment is provided to meet their needs. This includes adapted baths and toilets, a lift, hoists, bed rails, cushions and call bells. The majority of bedrooms do not have en-suite facilities however all are provided with washbasins and there are bathrooms available on both floors. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 17 Shared space includes a small dining room and large lounge. This lounge has been arranged into separate seating areas so that people can choose whether to watch TV or sit with visitors etc. At the back of the lounge a separate, small, enclosed room has been created, this is for use by people who live there and smoke. Some rooms have been recently redecorated and there are plans in place to decorate all corridors and hallways. There is a separate laundry room equipped with, 2 industrial washers, an industrial dryer and sluice. A member of Staff is employed to work in there and it was noted that peoples clothing looked well cared for and bedding was ironed and in good condition. A system is in place to prevent cross infection and equipment to help with this is provided, including disposable gloves and aprons and colour coded bags for potentially infected waste or laundry. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Orrell Grange are supported by a staff team who are able to meet their needs and choices. EVIDENCE: One of the people living at Orrell Grange explained that, “I like the staff here “ and another said that there are always enough staff to help her when needed. This was observed during the site visit when staff were seen to respond quickly to requests for help and to call buzzers. Relatives said that staff always have the skills and experience to support people properly, with one describing staff as, “always very helpful, polite ad attentive”. The staff rota shows that there are always two registered nurses working during the day and that the number of carers alters according to the times of the day that the people living there have more support needs. Records showed that staff are able to and do take part in a variety of training to help them understand their role and how to best support people. This ranges from fire safety and food hygiene to the protection of vulnerable adults Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 19 and more specialist training to meet peoples needs such as diabetic foot care, supporting people with dementia and falls prevention. Some staff have achieved a national care qualification (NVQ) and others are undertaking this at present. However nationally there is an expectation that 50 of care staff will hold a care qualification and this is not met within Orrell Grange. This qualification helps to ensure that staff have a good understanding of how to support people safely and respectfully and in line with current good practices within care. New staff undertake an induction programme, which introduces them to the service and also to basic care practices and values. This helps to ensure that they have a good understanding of their role and the way they should carry it out for the benefit of people living there. Before new staff start work at Orrell Grange a series of checks are carried out on them. This includes checking the protection of vulnerable adults list and a Criminal Records Bureau (CRB) check as well as obtaining two written references. These checks help make sure that new staff are suitable and safe to work with the people living at Orrell Grange. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Orrell Grange is a well managed home that reviews and works to improve the service offered for the benefit of the people living there. EVIDENCE: Mrs Sheila Harrison is the registered Manager of Orrell Grange. She is a registered nurse with many years experience of supporting and managing care services for older people. Mrs Harrison keeps herself up to date by attending training relevant to the support provided at Orrell Grange. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 21 Orrell Grange arranges for a quality audit to be carried out each year by an external company. This was last carried out in April 07 and the home received a 4 star rating out of a possible 5 stars. This involves the Auditor spending time with Residents, Relatives and Staff and sending out questionnaires seeking their opinion of the service offered. In addition a manager from within the larger organisation visits the home regularly and carries out visits and audits of the service, this includes talking with the people living there and staff and examining a selection of records. These audits help to ensure that Orrell Grange is providing a good quality service for people and any areas for improvement are quickly noted and acted upon. The service encourages the people living there to manage their own money with support from relatives or friends of needed. They will act as appointee for peoples benefit money, only when no one else is available. A safe is provided for storing small amounts of peoples money and written records are kept of their income and outgoings. A check was made on some of the records and money held for people and these were found to be in order. A sample of records relating to health and safety including the gas, electrical and lift certificates and fire book were checked. These were in date and satisfactory. As well as obtaining checks and satisfactory certificates from outside contractors the service also carries out regular checks on the fire system and water temperatures within the home. These checks all help to ensure that Orrell Grange is a safe place for people to live and work in. Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 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 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(2)(b) Requirement A system must be put into place to ensure all care plans and health assessments are reviewed at least once a month. This will help to ensure that any changes to a persons support needs and choices are quickly identified and acted upon. Medication must not be given to people that is clearly labelled for use by others. This will help to prevent medication errors occurring. Timescale for action 30/10/07 2. OP9 13(2) 10/10/07 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 OP28 Good Practice Recommendations The registered person should support Staff to obtain an NVQ level 2 qualification in care. This is a previous inspection recommendation Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Orrell Grange DS0000061714.V345659.R01.S.doc Version 5.2 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. 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