Inspection on 19/06/07 for Pennhaven

This inspection was carried out on 19th June 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pennhaven 16/07/09

Pennhaven 01/02/06

Pennhaven 11/11/04

Pennhaven 01/07/04

Pennhaven 12/04/04

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

CARE HOME ADULTS 18-65 Pennhaven 36 Powderham Crescent Exeter Devon EX4 6BZ Lead Inspector Stephen Spratling Key Unannounced Inspection 19th June 2007 09.50 Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 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 Pennhaven DS0000022006.V335864.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 Adults 18-65. 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. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pennhaven Address 36 Powderham Crescent Exeter Devon EX4 6BZ 01392 255588 01392 255588 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) The Parkview Society Ms Sarah Emilia Carcillo Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: Pennhaven is a home for eight people who have had mental health difficulties. It is situated close to the centre of Exeter in a quiet residential area of the town. It has nothing to distinguish it as a residential home. The building has three storeys, which include a large kitchen, comfortable lounge room, eight single bedrooms and a cellar where the laundry is situated. It has a pleasant garden and patio area to the rear. Staff are available 24 hours a day. Though some people have lived at the home for several years it is not intended as a home for life and aims to support residents to develop their abilities to move on to more independent living. Inspection reports are available from staff at the home on request. The current range of fees is between £411 and £800 per week. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparing for the inspection we sent questionnaires, asking about the quality of this service, to 20 people. Residents returned three, five were returned by staff and three by health and social care professionals who have contact with people who live at this care home. This inspection site visit started at 9:50 am and finished at 4:45 pm on the 19th June 2007. A follow up visit at the offices where staff recruitment files are kept was made on the 11th July 2007. There were seven people resident at the home and at the time of the inspection site visit and we spoke with six of them. We also spoke with the home manager and three members of staff. Looked around all the shared areas of the home and at two residents’ private rooms. Read the care records for three residents and at some other records kept by the home. What the service does well: What has improved since the last inspection? To make the home more comfortable and pleasant to live in work is ongoing to improve the home’s kitchen and bathrooms. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People thinking of moving to the care home can be confident that the home’s good assessment and admissions practice will help to ensure that their needs can and will be met. EVIDENCE: People who live at the home confirmed, that they are given opportunity to visit the home and meet residents and staff before deciding to move in. The manager said people often visit several times and can come for an overnight stay before they make a final decision. All staff who returned Commission questionnaires confirmed that they are told about “any particular needs which service users have” “before” they begin working with them. Records contained detailed information about people who live at the home including medical/social histories, the individual’s personal goals and what support they require to help them work towards those goals. This information had been gathered from the people themselves and from health and social care professionals involved with their care prior to admission. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who live at this home can be confident that they will receive support to achieve their personal goals and to live life how they choose. EVIDENCE: People living at the home told us that they are free to spend their time as and where they choose. They confirmed that they are invited to take part in developing and reviewing their care plans. Care plans clearly reflected information gathered through the homes assessment process. They were based on goals that had been identified by the person concerned and went on to describe actions that staff and the person should take to work towards these goals. One person spoke with us about one of their personal goals, what they were doing to achieve it and how staff supported them. This goal and set of actions were reflected in their care plan. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 10 All care plans showed evidence of regular monthly review, which provided detailed description of progress and barriers to progress. Where appropriate, reviews had resulted in changes to care plans. Care plans and reviews were mostly signed by staff and the person they concerned. Where they were not signed it was clearly recorded why not; for example that the person using the service had declined. Care records contained detailed personalised risk assessments, which sought to identify dangers, and then described interventions to support people to minimise those risks. For example one provided clear description of what may trigger a particular person to self-harm. Then went on to provide detailed description of what staff should do in response to identified triggers, to help the person find safer ways of responding to stressful events and to take responsibility for this. Personalised risk assessments regarding people using equipment around the home such as the cooker and their awareness of food hygiene principles were also in place. All risk assessments identified ways of managing risks appropriately balanced against the need for people to retain and regain independence. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at this home benefit from the support they receive to be active, independent, to maintain important personal relationships and to eat well. EVIDENCE: People living at this home told us that they have free access to the kitchen and that everyone has responsibilities for keeping the home clean and for preparing meals. They take it in turns to shop and cook for each other and are supported by staff to do this. They said that food is usually good and confirmed that alternatives are offered where they do not like the main meal on offer. They confirmed that responsibilities and menus are discussed at weekly house meetings. People told us about varied social and educational activities they are involved with. On the day of the site visit one person was on their way Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 12 to a college course. Another person spoke of enjoying the regular/frequent opportunities to get out accompanied by staff. And another person showed us art work they do at the home and with a local club. Care records reflected these activities and the goals of the individual people living there. Staff showed a detailed awareness of peoples’ interests and could describe their roles in supporting them to be active. Examples ranged from prompting them to do attend educational placements independently to accompanying and supporting them out of the home at specific times or to specific events. People spoken with confirmed that they are free to see who they choose and that guest are welcomed at the home. Staff showed an awareness of peoples’ significant relationships and the importance of supporting them. A health care professional who returned a Commission questionnaire wrote that they believe that the “service adopts a non-judgemental attitude to individuals life choices”. The other two professionals who responded both confirmed that the service “supports individuals to live the life they choose.” Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home can be confident that they will receive medications safely and the help and support they need to be physically and mentally well. EVIDENCE: None of the people currently living at the home need physical help to maintain their personal hygiene. Where prompting and encouragement is needed this was described in care plans and staff showed a good awareness of these plans. Medical histories and health care needs were clearly recorded in care records. Care records also contained evidence of regular consultation with health care professionals including, GPs, community psychiatric nurses and psychiatric consultants. Advice from these people was seen to be incorporated into care plans. People at the home confirmed they are supported to access health care services. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 14 Professionals returning Commission questionnaires confirmed that that they believe “individuals health care needs are met by the care service”. They also indicated that medications are safely managed. One person asked about how the home supports people with medications, wrote that the homes approach is “ creative” and “sensible”, adding that they and people at the home are always consulted. We saw that medications are safely stored and that clear and proper record of receipt, administration and disposal of medications is kept. Each person’s record file contains detail of the medications they are prescribed together with detailed information about its purpose and potential side effects. Some people manage their own medications and have lockable storage in their rooms. Basic risk assessments for people wishing to manage their own medications had been completed though developments to these were recommended. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home can be confident that concerns and complaints will be listened to and acted upon and that staff would act to protect them if they were being mistreated. EVIDENCE: The three people who returned Commission ‘service user’ questionnaires confirmed that they would know who to speak to if they were not happy or if they wanted to make a complaint. People spoken with during this inspection also confirmed this, expressing confidence in staff and the manager to act on their concerns. The homes complaints procedure provides potential complainants with the information they would need including how to contact the Commission. It is posted clearly on the homes notice board. The home manager told us that no formal complaints have been received during the past twelve months and none have been received by the Commission during this time. We saw the homes complaints recording system, which prompts the user to record the issue, action taken as a result and the outcome to any investigation. We saw the homes policy regarding detection and reporting of abuse of vulnerable people. It provides appropriate up to date information having been reviewed in September 2006. Staff told us that they had attended Protection of Vulnerable Adults (POVA) training within the past year and showed a good understanding of their responsibilities to identify and report abuse of vulnerable adults. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at this home benefit from the comfortable, homely and clean accommodation. EVIDENCE: On the day of the site visit we saw that the homes kitchen and bathrooms were being refurbished. Appropriate steps had been taken to ensure people could get food and drink and access to washing facilities when they wanted. Five of the people living at the home said they were happy with cleanliness in the home; two people were dissatisfied, with one person saying they never felt it was clean. On the day of the site visit we saw that all the shared areas of the home were clean and generally tidy. We saw two private bedrooms; both reflected the individuals who occupied them. People living at the home said they were happy with their private bedrooms, which are comfortably furnished and equipped with appropriate privacy locks. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can be confident that staff are on duty in sufficient numbers and that they have the qualities and skills needed to provide a good quality service. Before people can be fully assured that new staff are suitable to work with them, the service must make sure that pre-employment checks are always done before staff start work. EVIDENCE: Care staff told us that there are always at least two of them on duty and that staffing levels are sufficient to allow them to spend uninterrupted time with people in and out of the home. People living at the home confirmed that staff are always available when needed. People living at the home described staff in generally positive terms, describing them as “nice” and “respectful”. One person did tell us that they find some staff “bossy”, though they also said that being at the home had helped them become more independent. Another person said that they thought some staff were not always firm enough with other people living there, but went on to Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 18 speak very highly of the support they receive from their key worker and some other staff. The home operates a ‘key worker’ system, where a staff member takes particular responsibility for the support and wellbeing of a named person. Staff demonstrated a clear understanding of their responsibilities as key workers and a detailed knowledge of the support needs of people we asked them about. Professionals responding to Commission questionnaires indicated that they believe staff have appropriate skills and experience. Staff told us that they have access to a variety of training. All three spoken with confirmed they have received updates to their basic health and safety training (see conduct and management). All had also done some training about caring for people who have mental health problems. Two of them had attend ‘support time and recovery’ (STR) training run by the local mental health trust in the past year. This course provides staff with knowledge and skills about how to support people with mental health problems recover their independence. The manager showed us copy of the home’s staff training plan, which identified what staff have done and when specific training needs to be updated. We looked at the recruitment files for two members of staff, employed since we last viewed the homes recruitment processes in 2005, when recruitment process were found to be satisfactory. One contained records that all appropriate pre-employment checks had been carried out before the staff member started in post. The second contained all the required employment checks but the references were dated as having been received after the person had started in post. Although a check on the protection of vulnerable adults list (POVA first) had been received prior to employment, a full Criminal Records Bureau (CRB) check had not been received prior to employment. Though it is acceptable to employ someone before receipt of a full CRB they must not work unsupervised and all other checks should be in place. The manager told us that the staff member did not work unsupervised prior to the receipt of their CRB and the file contained record of requests for references being made in good time before employment commenced. She told us that she had chased referees and obtained a verbal reference from the staff members last employer prior to them starting in post. The homes telephone diary indicates that this call was made by the manager to this employer though there is no record what information was requested or provided. The manager said that she also obtained verbal references from two other current staff members who had previously worked with the applicant before employing them. Record of these verbal references being made was also not recorded at the time. The manager Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 19 also told us that she had seen copy of the applicants CRB check obtained by their previous employer. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at this home can be confident that it is effectively, efficiently and safely managed. People’s views about the service are listened to and work is ongoing to monitor and continually improve the service being provided. EVIDENCE: People living at the home spoke highly of the service manager, confirming that she listens and acts on their concerns and ideas. Care staff echoed this view and described the Parkview Society as an organisation that values and listens to its staff. Staff described the staff group as stable, saying that they work well as a team. The manager reported and staff confirmed that no staff have left or been recruited during the past year. Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 21 One professional who returned a Commission questionnaire described the service provided at this home as “impressive” and another wrote, “we do need more resources like Pennhaven…” Care staff said that they receive regular supportive supervision, usually every six to eight weeks, from their manager. Records were available of these meetings. The manager and the Society have developed comprehensive policies and systems to guide staff in their work. We saw that policies are regularly reviewed and updated/developed. The manager reported that a ‘trustee’ visits the service regularly (regulation 26 visits) to monitor the quality of the service. Reports of these visits were available. The views of people living at the home are invited regularly through the homes weekly meeting and quarterly surveys. People confirmed that the meetings happened regularly and though one person said nothing changed as a result, others said they did. An example of one change is that that the manager has agreed to discuss any visits that prospective new people may make with current people living at home at the weekly meetings. An ‘annual plan’ for the service is available which includes description of how the quality of the service is reviewed. As mentioned earlier, staff are kept up to date with training on health and safety topics. Records indicated and staff confirmed that up date training about fire safety, food & hygiene and first aid had been provided over the past year. Maintenance records confirmed that fire alarms, gas appliances and portable electrical appliances (PAT) have all been serviced/professionally-safety checked within the past twelve months. The home’s fire risk assessment had last been reviewed in May 2006, the manager was aware that this was again due for review. Fridge temperatures were being monitored daily as recommended. Walking around the home no unmanaged threats to the health and safety of people at the home were observed. Pennhaven DS0000022006.V335864.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 Adults 18-65 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 23 no Are there any outstanding requirements from the last inspection? 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 YA34 Regulation 19 Schedule 2 Requirement To ensure people living at the home are properly protected from staff unsuitable to work with them, all employment checks must be done before staff start working in the home. A person may be employed in the home prior to receipt of full CRB as long as a all other checks, as described in the schedule 2 of the Care Homes Regulations, are in place. • Two written references must have been received before staff start work. Where it is not possible to obtain reference form last employer the reason for this should be recorded and written references from two other suitably placed referees should be sought. (Full written record of any verbal references should be kept and be available for inspection.) Timescale for action 19/08/08 Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Pennhaven DS0000022006.V335864.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!