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Inspection on 14/09/07 for Pine View Care Home

Also see our care home review for Pine View Care Home for more information

This inspection was carried out on 14th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The medication system in use has changed, which has included the provision of a medication trolley.

CARE HOMES FOR OLDER PEOPLE Pine View Care Home 418-420 Hinckley Road Leicester Leicestershire LE3 0WA Lead Inspector Linda Clarke Unannounced Inspection 14th September 2007 09:15 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 Pine View Care Home DS0000064266.V340308.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. Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pine View Care Home Address 418-420 Hinckley Road Leicester Leicestershire LE3 0WA 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) 0116 2855868 0116 2547343 pineviewcarehomes@ntlworld.com Pine View Care Homes Ltd Mr Dinesh Raja Care Home 15 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (15) of places Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No Service users in the category DE(E) shall be admitted to the home where there are already four service users in this category accommodated there. 6th June 2006 Date of last inspection Brief Description of the Service: Pine View is a care home providing personal care and accommodation for up to fifteen older persons, of which 4 placements are for service users with a diagnosis of Dementia. Pine View is sited on a main road in to Leicester, and benefits from a small car park to the front. There are good public transport links into the City Centre. Communal rooms include two lounges, and a dining room leading into a conservatory. There are nine single and three shared bedrooms, of which some have an en-suite facilities comprising of a toilet and wash hand basin. Bedrooms being located on the ground and first floor. Access to the first floor is via a stairwell fitted with a stair lift, in addition there is a passenger lift. Toilet and bathing facilities are located on the ground and first floor. The rear of the property has a courtyard and large rear garden. Information is located on site detailing the range of services offered, which includes the Statement of Purpose and Service User Guide in addition to this Pine View provides prospective service users with a summary of the Commission of Social Care Inspections, Inspection Reports, which are available upon request. Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process consisted of pre-planning the inspection, which included viewing the previous Inspection Report, reviewing of the Annual Quality Assurance Assessment (AQAA), and Comment Cards sent to service users and their relatives by the Commission for Social Care Inspection, six service user and six relative Comment Cards were returned. The unannounced site visit commenced on the 14th September 2007 and lasted 1 day. The focus of the inspection is based upon the outcomes for the service users. The method of inspection was ‘case tracking’. This involved identifying service users with varying levels of care needs and looking at how these are being met by the staff at Pine View. Three service users were selected and discussions were held with two of them, additionally two service users who were not part of the case tracking process were spoken with. The method of case tracking included the review of service users’ individual care records, discussions with staff of various delegated responsibilities within the home and reviewing the records, training records and the minutes of service user meetings. What the service does well: Individuals considering residency at Pine View are supplied with written information as to the services offered, and are encouraged to visit the Home. Care plans are well written and provide a holistic approach to care, and focus on service user abilities, providing written information as to the support they require from staff in order to maintain their independence. The Commission for Social Care Inspection (CSCI) sent out surveys to a number of service users and relatives when asked what the home does well the following comments were made: • • Most things The staff always listen to what I say about my mother and act on it. The meals given to my mother seem very nice and my mother appears happy with them. They are very kind and helpful Respects patients dignity, clean and well fed. All round care. • • • Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 6 • Up to now we as a family are happy with the care our mother receives. The staff are always helpful and take note of everything we say to them. The staff are also very friendly. Everything is fine, very happy. I cannot find any fault with the home or staff they are caring to all the patients needs. • • 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. Pine View Care Home DS0000064266.V340308.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 Pine View Care Home DS0000064266.V340308.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 and 3. Standard 6 is not applicable, as the Home does not offer Intermediate Care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that the information supplied by the Home, and their needs assessment will enable them to make an informed choice as to where they receive care, and can be confident that the Home can meet their needs. EVIDENCE: Information is provided to prospective and existing service users in the Homes’ Statement of Purpose and Service User Guide. The range of information includes a description of the Home, its aims and objectives, details the facilities and services offered, information as to staffing and their training, activities offered and includes how service users are consulted and how concerns should be raised and how they are dealt with. Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 9 Prospective service users and their relatives are encouraged to visit Pine View, to look around and meet the existing service user group and staff on duty. Individuals who are funded by a Local Authority have an assessment of their needs determined by a Social Worker, the individual, the service users and their relative if appropriate in conjunction with the Registered Manager will establish as to whether the needs of the individual can be met by the staff and facilities of Pine View. The Registered Manager confirmed that the Care Manager of Pine View undertakes an assessment of service users who are funded by the Local Authority and those who fund their own care. The assessment of the service users whose records were viewed as part of the case tracking process were detailed, and reflected the needs of the individual at the time of their admission into the Home. Pine View Care Home DS0000064266.V340308.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are well cared for having their tailored health and daily care needs met through personalised care. EVIDENCE: Care plans and records of three service users were viewed, care plans provide information as to the support an individual requires with regards to their physical health and well-being. Care plans included a brief outline as to a service users life prior to admission in to care, the care and support they require, and details the goals in relation to their care, such as promoting the independence of an individual with regards to daily living tasks. Currently there is a book which details the visits of General Practitioners and District Nurses, the Registered Manager advised that this practice was currently being reviewed, and that a record sheet was being devised to record visits from health care professionals. The practice of recording information Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 11 about more than one service user in one place is not good practice as this presents concerns to individual confidentiality. Records confirmed that service users have access to health care professionals, include domiciliary visits by Chiropodists and Dentists. The medication and medication records of two service users residing at Pine View were viewed and were found to be in good order, staff responsible for the administration of medication receive training. Service users have access to a telephone, and by private arrangement can have a phone line installed in their bedroom. Service users spoken with confirmed that they receive their mail unopened, but acknowledge in some instances relatives deal with their correspondence. Staff were observed speaking courteously with service users, there was an easy rapport between service users and staff sharing jokes and humour. Pine View Care Home DS0000064266.V340308.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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have access to activities offered at Pine View. There are limited choices available to service users at mealtimes. EVIDENCE: Pine View has a group of service users who were observed laughing and talking with each other in one of the lounges after lunch. Service users are offered a range of recreational and social activities, which is detailed with information supplied to prospective and existing service users that states: • • • • • • • • Bingo Music and Movement classes every fortnight Sing a longs Hairdresser every week In house monthly Church Service Video film afternoons Games afternoon Pub meals DS0000064266.V340308.R01.S.doc Version 5.2 Page 13 Pine View Care Home Service user spoke favourably about the bingo, music and movement classes and floor games, which included skittles. Service users said that they had family and friends visiting, one service user spoke of their surprise visit from one of their children who they had not seen for many years as they’d emigrated. One service user said that their son visited every week, whilst another service user said that their daughter visited frequently. There is a four weekly menu in place, for the main meal and teatime. The menu viewed did not reflect choices, with one option of main meal and dessert being available. Service users confirmed that there is a choice for breakfast, being cereal, toast or a cooked breakfast. On the day of the visit service users were supported to the dining room, where fish, chips and peas were served, followed by fruit pie, the menu stated cheesecake. One service user chose not to eat their meal, and a sandwich was offered, however they were not asked what they wanted as a filling, the service user did eat their sandwich. There is a menu board in the dining room, however the information is about the range and types of meals available as opposed to detailing the menu for the day. The Senior Carer on duty was asked whether consideration had been given to food being placed into serving dishes for service users to serve themselves, as opposed to their meals being ready plated, the Senior Carer said that in their opinion they didn’t believe that a majority of the service users would be able to serve themselves. Service users after lunch were asked their views as to the meals provided; in the main the comments were positive, one service user said, “it’s nice not having to cook for yourself”. “I find the meals hear are nice.” “The meals are okay.” Pine View Care Home DS0000064266.V340308.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by a robust and accessible complaints procedure; additional staff training in the area of protecting adults from abuse would further protect service users. EVIDENCE: Documentation supplied by the Registered Manager prior to the site visit detailed that Pine View has not received any complaints or concerns in the last twelve months. The Commission for Social Care Inspection (CSCI) in the last twelve months has not received any complaints or concerns with regards to Pine View. Information as to how concerns and complaints can be raised and how they will be handled is provided in documentation supplied to prospective service users, and displayed on the notice board in the Home. Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 15 Staff as part of the National Vocational Qualification are made aware as to the types of abuse, which individuals may experience, and their role as a care worker in directing any concerns with regards to service users welfare to the appropriate person. It was noted that staff have not benefited from training in dealing with adult protection issues, for sometime, the most recent training being in 2005, the Registered Manager was advised that staff need to receive training to update their skills and awareness. Pine View Care Home DS0000064266.V340308.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, 20, 21 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a warm, safe, clean, comfortable and wellmaintained environment suitable for their needs. EVIDENCE: Pine View has two separate lounges to the front of the property, a majority of service users in the main choose to sit in one of the lounges, which does reduce the space, however service users are very well practiced in leaving the lounge with the support of their walking aids. The dining room is to the rear of the property and provides four dining tables, the dining room leading into the conservatory and the kitchen. Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 17 The Registered Manager advised that the carpets in both lounges were to be replaced; the carpet of the corridor leading to the dining room was stained, and would benefit from being replaced. The bathroom and toilet facilities are located on the ground and first floor; the bathroom of the ground floor is currently being altered to provide a walk-in shower for service users. On the day of the site visit the Home was clean and tidy, and service users felt that Pine View was ‘homely’. Pine View Care Home DS0000064266.V340308.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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff that are experienced meet service users needs, service users would benefit from staff receiving additional training in areas specific to their individual needs. EVIDENCE: Discussions with the Registered Manager and the staffing rota detail that there are two members of care staff on duty throughout the day, with one member of staff being on duty during the night. There is a Cook and Domestic Assistant on duty in the morning. Pine View has thirteen care staff employed, of which eight have attained a National Vocational Qualification in Care representing 62 of the staff team. A significant number of staff having worked at the home for many years, which supports consistency of care, and enables service users and staff to build positive relationships. The staff files of three members of staff were viewed, all were found to contain a completed application form, two written references, confirmation of their identity and a Criminal Record Bureau (CRB) disclosure. Discussions with the Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 19 Registered Manager confirmed that staff do not commence work until the appropriate checks as to their suitability have been attained. Staff spoken with, and staff files viewed confirmed that staff have received training in a variety of topics related to health and safety which include Food Hygiene, First Aid and Moving and Handling. The Registered Manager advised that staff have also attended training in Dementia Care, as was confirmed by one member of staff, however other staff spoken with said they had not received training with regards to Dementia Care, staff files did not contain a Certificate to confirm they had received training. The Registered Manager acknowledged that the training in Dementia Awareness was held in 2005. The care plans and records of service users in some instances highlight specific health care needs and conditions in addition to Dementia or Alzheimer’s such as Parkinson’s disease. To ensure service users are supported by staff that have an understanding of their needs, as documented within their care plan staff should receive the appropriate training. A requirement has been made that a training plan be organised which provides training for staff in topics relevant to the health, care and welfare of service users. Pine View Care Home DS0000064266.V340308.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, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Registered Manager manages the day-to-day operations of the Home. Whilst service users are consulted, outcomes and future developments are not planned. EVIDENCE: The Registered Manager, Mr Dinesh Raja, has been in post since January 2006. Mr Raja confirmed that he has nearly completed the National Vocational Qualification at level 4 and the Registered Managers Award. Service users have access to a quality assurance survey, which they are asked to complete annually. The Registered Manager advised that the results of the Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 21 surveys are discussed as part of the staff team meeting, and any actions including who is responsible for undertaking them are discussed and recorded. It is recommended that the results of the quality assurance process are collated and a report produced which incorporates any actions the Registered Manager will introduce to address the issues identified, and a copy of the report to be made available to all participants and interested parties. The Registered Manager prior to the site visit completed an Annual Quality Assurance Assessment, which is a self assessment detailing how the outcomes and needs of service users are being within their service, very limited information was provided as to how the service could improve and its plans for improvement in the next 12 months. Service user meetings take part six monthly providing an opportunity for service users to raise issues they feel relevant, the Registered Manager advised that he visits the Home most days, and is available should service users wish to talk with him. Staff meeting minutes were not viewed, conflicting information was given by staff as to the frequency of staff meetings, staff in some instances felt that they would benefit from additional staff meetings being held. The Registered Manager confirmed that in most instances service users or an appointed person manages service user finances, which in many instances is a relative. Mr Raja confirmed that Pine View does not hold service users money on the premises, and should service users require money to purchase items this is done so out of monies available to the staff at the Home. Invoices are then sent to individuals responsible for handling service users money. Care staff are supervised performing care tasks by a Senior Care Worker on a regular basis, to ensure that their care practices are appropriate. Staff receive an annual appraisal. It is recommended that the supervision of staff includes discussions, which are recorded, the supervision to include their training needs, issues with regards to service users, and any other aspects relevant to their role. Information submitted prior to the site visit detailed the regular maintenance of health and safety systems within the home, including fire systems and equipment, environmental health visits, central heating systems and emergency call systems. Pine View Care Home DS0000064266.V340308.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 3 X 3 X 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 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 3 3 2 X 3 Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP18 Regulation 13 (6) Requirement Timescale for action 13/12/07 2 OP30 18 (1) The Registered Person to ensure that a training plan is developed which ensures all staff responsible for the welfare of service users receives training in safe guarding adults from abuse. The Registered Person to ensure 13/12/07 that a training plan is developed which ensures all staff receive training relevant to the individual and collective needs of service users, which is to include Dementia Awareness and other conditions associated with the service user group. 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 OP33 Good Practice Recommendations It is recommended that following a quality assurance audit a report summarising participants views is produced, DS0000064266.V340308.R01.S.doc Version 5.2 Page 24 Pine View Care Home 2 OP36 which includes an action plan as to how the service will address the issues addressed and continually improve its service, the report being circulated to all participants and interested parties. It is recommended that the format of staff supervisions be reviewed, to include a one to one discussion, which is recorded. Supervisions to include topics such as staff training needs, service user care, and all aspects relevant to the employees’ role in the Home. Pine View Care Home DS0000064266.V340308.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Pine View Care Home DS0000064266.V340308.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. 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