Inspection on 10/02/09 for Rockrose

This inspection was carried out on 10th February 2009.

CSCI found this care home to be providing an Good service.

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

Rockrose 25/09/09

Rockrose 07/07/09

Rockrose 12/02/08

Rockrose 27/04/07

Rockrose 02/06/06

Rockrose 21/10/05

Rockrose 03/06/05

Rockrose 01/02/05

Rockrose 02/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rockrose 10 Kingsfield Road Herne Bay Kent CT6 7EA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Eamonn Kelly     Date: 1 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Rockrose 10 Kingsfield Road Herne Bay Kent CT6 7EA 01227740549 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Sookdeo Sawock,Miss Uyjayantimala Aubeeluck Name of registered manager (if applicable) Miss Uyjayantimala Aubeeluck Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Rockrose provides support for up to 7 people. Currently, the registered providers live on the first floor of the premises. There is good access to public transport and car parking is available at the front. Residents bedrooms are single occupancy and are all ground floor rooms with en-suite facilities. Residents have access to two lounge areas and to a garden that is suitable for use by frail people. Information about weekly fees and other charges is available from the registered providers and information about services and facilities is contained in the guide to the service. 0 Over 65 7 care home 7 Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place on 10 February 2009. The methodology used to produce the report includes reference to the AQAA (annual quality assurance assessment) submitted by the registered providers, meetings with the manager and members of staff and meetings with five residents. The AQAA outlined some of the areas that have been improved for the benefit of residents and areas of practice where further further development is planned by the providers. The profiles of three residents were assessed in some detail and the relevant care plans were seen. The inspection included a visit to most parts of the premises. Some records used for supporting residents were checked. Care Homes for Older People Page 5 of 27 The outcomes of the previous inspection report were checked. Checks were also made of information known to the Commission about the service, for example, progress it is making in complying with Social Services contractual obligations. The previous report contained three requirements. These related to the need for a better induction procedure, an annual development plan and a more consistant staff supervision procedure. Social Service contracts officers have helped the service to improve in these areas and progress continues to be made. This report contains no requirements or recommendations. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their supporters receive initial advice and guidance to help them assess the facilities and suitability of the home. This includes provision of a residents guide that describes services and facilities. Evidence: Prospective residents and their representatives receive assistance and guidance to help them decide if the home is able to meet their support needs. They receive a written guide that contains information about services and facilities. The registered providers carry out an assessment of prospective residents support needs with assistance where necessary from Social Services care managers. New residents receive a contract that contains information on the rights and responsibilities of both parties. Care Homes for Older People Page 9 of 27 Evidence: Some residents have support needs associated with the on-set of dementia as well as substantial mobility problems and other disabilities. Three care plans seen showed that, at this stage, the support needs of the prospective resident are identified together with how these needs would be addressed after admission. The registered provider was advised to make these records clearer as review information did not clarify the current needs of each resident. Good information about residents background was seen to be obtained at this stage. Potential residents visit the home prior to taking up residence as part of the admission procedure. The home occasionally admits residents for respite care. The registered provider was advised that care plans in such circumstances should be completed fully with support needs identified and a plan of care developed. Two sets of visitors said that residents were well cared for. The AQAA stated that questionaires given to relatives produce positive comments about how residents are supported. It also states that residents receive value for money because of the dedication of the providers, competitive fees and the fact that there is a small group of residents who receive individual attention. The AQAA stated that, as part of improving admission procedures and ongoing support for residents, the impact of the Mental capacity Act is being assessed and it is intended that one or both registered providers will obtain formal training. Care Homes for Older People Page 10 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive good healthcare support. Evidence: The stated intention of the registered providers is to obtain an outline profile of the prospective resident followed by a more detailed profile with the participation of the resident, family members and, in some instances, care managers. Care plan records seen for three residents contained good personal profiles of residents. Each resident has a personal file containing support plans, risk assessments, daily notes and information on contacts with healthcare services. The providers are working closely with Social Services contracts officers in developing the quality of support plans, risk assessments and daily notes. Some of the information about residents health in the support plans seen was not up-to-date in comparison to their current state of health. The provider showed how he was updating these and following advice from Social Services officers to ensure that the records contributed to the care of residents. There is continuing improvement, with advice from Social Services, about the need to update risk assessments and the provider outlined how he is undertaking these Care Homes for Older People Page 11 of 27 Evidence: improvements. During the inspection visit, members of staff (registered provider and agency carer) treated residents with understanding and respect. Discussions about the profiles of three residents and how they are supported indicated a good level of understanding of and respect for clients. Where difficulties occur in the continuing support for some residents, there was evidence that care managers and family members are involved in reviews and changes that may be necessary. A former resident has recently moved to a care home with nursing because the appropriate level of support could no longer be given. Support plans showed that GPs visit as necessary. Residents have good access, according to profiles of residents discussed during the inspection and records checked, to local NHS community services. The services of district nurses are routinely obtained. A resident explained how dressings for a wound are changed regularly by district nurses. In two instances it was evidenced from care plans and resident testimony that good support from chiropodists is obtained. Three residents said they received good healthcare support particularly when they were feeling most vulnerable. They also said that the providers have a good understanding of the difficulties faced by residents and are skilful in providing the personal support needed. They referred to their good access to dentists, district nurses and chiropodists and this support was evidenced in their care plans. The registered provider explained how medications are administered and how unwanted medicines are recorded and disposed of. MAR sheets are completed at the time of administration. A photograph of each resident accompanies their MAR sheet. In the case of residents receiving respite care, a MAR sheet is completed manually to control and supervise their medication administration. A check of medication procedures at the premises was carried out by Social Services in January 2009 and these were found to be satisfactory. An declared aim of support is to help residents remain as independent as possible. This involves encouraging them to move around on their own with any necessary staff observation. Care plans seen and discussion of profiles of residents indicated that good end-of-life planning is carried out. This includes improvement in the ways residents wishes are discovered and how these are recorded in care plan records. The registered provider Care Homes for Older People Page 12 of 27 Evidence: said that this aspect of resident support would be more fully described in support plans and that this is part of improvements that Social Services is helping the service to develop. The AQAA referred to the introduction of the Department of Health end-of-life care planning programme over the next twelve months supported by palliative care training for the providers. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported on a day-to-day basis to remain mentally and physically active and alert. Evidence: The AQAA stated that efforts are continuing to be made to involve residents family and friends in helping with day-to-day activities. Residents may receive visitors at any time and the service encourages this continuing contact. Two sets of visitors said that residents are encouraged to be independent and to make their own minds up about how to spend their time. They said that there are activities arranged such as summer barbeques, visiting musician, regular parties and get-togethers for families/residents. The AQAA pointed to the close relationship between providers and residents/visitors because of the small number of residents. There were five residents and up to seven may be admitted. The AQAA states that questionaires returned from visitors and residents indicated satisfaction with how residents are helped to remain physically and mentally active. Each resident has his/her own bedroom which contains their own possessions and encouragement is provided to increase the levels of personalisation. Care Homes for Older People Page 14 of 27 Evidence: The registered provider had a good understanding of each residents personality and disabilities. The AQAA states that residents and family members are encouraged to say what they feel and to give their views about any issue they feel affects them. Residents gave examples of particular activities promoted by the service. A range of newspapers is available. There are two comfortable lounge areas. Arts and crafts (eg. painting) are available to residents. Golfing equipment has been purchased for use by residents in the back garden. TV and DVDs are available in communal areas as well as in individual bedrooms. Staff assist residents on a one-to-one basis, helping them to walk about the premises, provision of books and newspapers, talking to them, providing music and helping them visit the garden. All facilities are on the ground floor which benefits residents. There are several communal areas throughout the premises and residents may choose which area they wish to use. Two residents and two visitors referred to how well staff do in helping them remain mobile, to spend time in lounge areas meeting other residents and to have meals in the dining room. They gave examples of how they are involved in life at the home and how they are helped and encouraged to make decisions about how they use their time. The AQAA stated that arrangements are being made for better access to church services; the provider said that residents wishes are being met as part of improving equality and diversity awareness. A notice board outlined planned activities over the coming months. During the inspection, there was a positive atmosphere and the registered provider and agency carer were working actively with residents when they were not engaged in household activities. An outline of residents interests, expectations and capabilities would be updated in their care plan records, according to the registered provider, as part of the revised procedures for achieving more appropriate support plans, risk assessments and daily notes. As referred to earlier in this report, Social Services are supporting the providers with aspects of how the service must be developed for the benefit of residents. Nutritional assessments are carried out and recorded in care plans. The registered providers keep written information about residents food intake and an example of this was seen in a support plan. They are working with Social Services contracts officers to improve the way these procedures are carried out. In two instances discussed with the registered provider, residents made good recoveries after they took up residence when their health was failing rapidly at that stage. Care Homes for Older People Page 15 of 27 Evidence: The lunchtime meal was observed during the inspection. Over lunch, some residents were assisted. Residents referred to choices of meals, to the way meals are served and to how they enjoy the occasion with fully laid tables including linen tablecloths and serviettes. On this occasion, residents did not receive a choice of main meal but a resident said that there is normally a choice between two main meals. The home provides 3 main meals, drinks at regular intervals and a suppertime drink/snack according to the registerd provider. Drinks were served to residents in lounge areas at regular intervals. The provider said that the evening meal contains a heated component that residents may choose. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected from abuse. Their views and those of relatives are listened to and acted upon. Evidence: The AQAA states that members of staff, residents and visitors are aware of the complaints procedure and that comments about the service are welcome. It states that residents and visitors are involved in saying how improvements would be of benefit to them. One way of doing this is through quality assurance questionnaires sent to families, friends and advocates. According to the registered provider, visitors are closely involved in all aspects of the service and a copy of the complaints procedure is made available in the service users guide. Both registered providers and the carer at the service have received training in matters associated with POVA according to the staff files seen. The registered provider stated that he knew how to report any incidents to Social Services. A copy of the Local Authority Safeguarding Adults policy was available at the premises. The Commission received no complaints about the service during the past year and the registered provider confirmed that no safeguarding issues are currently in progress. Care Homes for Older People Page 17 of 27 Evidence: The current AQAA confirmed this declaration. The annual quality assurance assessment (AQAA) stated that members of staff are aware of all the necessary procedures relating to protection of residents. Specific training on the wider implications of POVA formed part of the improvements in staff training and development now in place according to copies of certificates seen. The AQAA outlined how questionaires are given to residents and visitors and that the outcomes have been positive. Two residents and a visitor confirmed that the providers value the views of residents and relatives and that they are satisfied with the support provided. The AQAA also stated that the providers plan, during 2009, to update their knowledge on what constitutes restraint and that they intend to attend a training course to obtain this update. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for use by frail older people. Residents live in a comfortable and well maintained environment and benefit from the ongoing improvement programme of redecoration and routine maintenance. Evidence: Radiators are covered for the safety of residents. Hot water outlets accessible to residents are temperature controlled and are manually checked, the registered provider said, each week for safety reasons. The AQAA stated that, as an added precaution, residents have each been provided with a thermometer to check water temperatures. The AQAA contained declarations relating to safety checks and associated safety certificates being in place and up-to-date. This included confirmation that PAT (portable appliance tests) are carried out. The AQAA refers to how residents are involved in aspects of bedroom refurbishment. There is a high level of attention given to maintaining all areas of the premises. Communal areas and all bedrooms were visited as part of the inspection. Lounges, dining area and bedrooms are decorated and furnished to a high standard. All parts of the premises at the time of the visit were clean, odour free and in a good state of Care Homes for Older People Page 19 of 27 Evidence: repair. Residents spoken to said they like their bedrooms which are all individual and personalised. All bedrooms are single occupancy and are en-suite (toilet and washbasin). The premises have a communal bathroom and staff WC. The premises are safe and comfortable. Indoor and outdoor facilities are suitable for residents. Bedrooms are comfortable and well furnished. Residents are provided with a call bell handset for use in their bedrooms. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by an effective staff team. Evidence: Staff files seen showed that an application form is completed, two written references are taken up, CRB checks are completed followed by induction/supervision/training. The correct procedure was followed in relation to the three staff files seen. The registered provider is currently recruiting an additional member of staff and he said he intends to carry out all the necessary checks. During the inspection, an agency carer was present in the morning and a different agency carer attended in the afternoon. It was noted that the agency carer on duty in the afternoon received a tour of the premises, advice on safety issues and an outline of the support needs of residents. There is currently considerable reliance reliance on agency carers while additional carers are being sought. The registered providers live at the premises and undertake the majority of night time support for residents. In anticipation of the arrival of new staff, a new induction procedure was recently put in place. The evidence from staff files was that the carers receive formal supervision in the meeting of residents needs. Care Homes for Older People Page 21 of 27 Evidence: At the time of the inspection, one of the registered providers and an agency carer were working on duty with five residents. The AQAA contains details of the barriers to improvement and some of these were discussed during the inspection. They include the challenge of coping with competitive fees and low bed occupancy. According to the training records seen, the providers and carer have attended training courses in first aid, moving and handling, infection control, medication administration, food safety, fire safety and health and safety. Where updates are needed, arrangements are being made to book the required courses. The intention is to complement this training by attendance on training courses on the Mental Capacity Act and on principles of restraint. Both registered providers are trained nurses and the registered manager has achieved the registered managers award. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have the benefit of living in a care home where their interests are promoted. Evidence: Both registered providers are former hospital nurses. The registered manager has completed the registered managers award. Residents receive good healthcare support. The stated objective of the service is to help residents to remain independent even when their physical and mental capabilities are declining. Where residents are judged to be no longer able to conduct their legal or financial matters, the home has strict procedures for assisting residents and relatives in identifying independent representation. A declaration was made in the AQAA that all relevant safety checks for the premises Care Homes for Older People Page 23 of 27 Evidence: and associated records are maintained by the registered provider. The examples discussed during the inspection were portable appliance tests, fire alarms and equipment, gas appliance tests and call bells. The registered provider outlined the advantages accrueing from questionnaires given to residents and visitors and residents meetings and how the outcomes are followed up. Formal staff supervision (approximately every 4 to 6 weeks), of which a record is signed by both parties, is carried out. This was one of the areas that has improved following Social Services contract officers advice to the providers during 2008. Social Services are continuing to encourage and assist the service to put in place the records required under current contracting arrangements. Following their inspection in January 2009, Social Services provided further advice on how support plans and recorded risk assessments should be maintained. The providers are taking steps to update each support plan in accordance with this advice. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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