Inspection on 27/09/06 for Sycamore Court

This inspection was carried out on 27th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Sycamore Court 14/12/05

Sycamore Court 20/07/05

Sycamore Court 22/11/04

Sycamore Court 01/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Sycamore Court 33 Robert Hall Street Leicester Leicestershire LE4 5RB Lead Inspector Keith Charlton Unannounced Inspection 27th September 2006 02:00 Sycamore Court DS0000006315.V311668.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 Sycamore Court DS0000006315.V311668.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. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sycamore Court Address 33 Robert Hall Street Leicester Leicestershire LE4 5RB 0116 2610663 0116 2610663 sycamore.court@lha.org.uk 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) Leicester Housing Association Ms Dawn Cooke Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 14/12/05 Brief Description of the Service: Sycamore Court is a Registered Home for Adults with Learning Disabilities and is situated near to many amenities, including shops, pubs, sports facilities, bus routes, canal and parks. The house offers main residential accommodation, and has an annex with a kitchen and three bedrooms for residents who are more independent. The accommodation is on two floors, including bedroom and communal rooms. There is a large enclosed garden to the rear of the property, with direct access from the communal lounges. Fees are £326 per week – this information was provided before the day of the inspection. There are costs for extras – hairdressing, newspapers etc. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service user and their views of the service provided… The primary method of inspection used was ‘case tracking’ which involved selecting two service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. This was an unannounced Inspection. The Registered Manager was on duty to assist with the inspection process. Other support staff also assisted. Planning for the Inspection included looking at the last Inspection Report and assessing any notifications of significant events sent to the Commission for Social Care Inspection by the home. There have been no complaints received regarding the home in the past year. The Inspections took place between 14.00 and 18.30 on day one and 10.00 and 12.00 the following day, and included a selected tour of the building, inspection of records and indirect observation of care practices. The Inspector spoke with four residents, two members of staff, one relative and the Registered Manager. Eight Comment Cards were received from residents, and two Comment Cards were received from medics. There was a high degree of satisfaction with the service, as testified by the following statements: ‘ I have found staff helpful. My patients are well cared for.’’ ‘ One of the well managed homes. Staff are caring’’. ‘’ The staff are my friends and will always help me’’. ‘’ This is my home and I like everyone here’’. What the service does well: The service focuses on residents’ individual needs, e.g. residents spoken with said they liked living in the home and thought staff were friendly, the food was Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 6 good and they liked their bedrooms. Care Plans are comprehensive and detailed to assist staff to deliver care that fits individual service users care needs. A choice of foods is always available to service users and there is an emphasis on healthy eating. Pictures are used for residents’ information – Quality Assurance Surveys, the Statement of Purpose that describes the services offered, the Complaints Procedure etc., to make it easier for residents to understand this information. The Registered Manager said residents do not have to pay for larger cost items – holidays and transport provided by the home. This situation is commended. Staff were again found to be positive, friendly and helpful in their dealings with residents. Bedrooms are personalised and homely and organised to residents’ styles of living with a large amount of possessions in them to make them homely. Facilities are kept in a clean and tidy condition and decor is kept to a good standard. The Registered Manager arranges residents meetings to provide information about services and asks their views about them. The minutes kept are detailed and clear. The Registered Manager continues to be proactive in planning for staff training and asking for suggestions on how to improve the service. Detailed staff meeting notes continue to be kept to alert staff to care needs and staff practice. What has improved since the last inspection? What they could do better: To always contact medical authorities to ask for advice on the course of action to follow if a service user has sustained a head injury, and to ensure that fire safety is always preserved. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 7 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. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 8 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 Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An assessment system to meet residents needs is in place. EVIDENCE: Evidence indicated there are social work assessments prior to admitting residents. A trial period is available for residents to sample living at the home before becoming confirming a permanent stay. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The individual needs and choices of people living in the home are generally well met. EVIDENCE: Residents spoken with thought they were well looked after and no one thought they were restricted in any way. The inspector case tracked two care records, which again clearly demonstrated that service users changing needs are being monitored and supported whilst living at the home. Records, observations and discussions with service users demonstrate that they make decisions about their lives and have independent life styles as much as possible, e.g. some residents are able to go out on their own, residents are encouraged to do household chores, do as much of their personal care as possible and they can use the kitchen with staff supervision and take it in turns to help with cooking. Staff said service users can make decisions about their own lives wherever Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 11 possible e.g. what time to get up and go to bed, to clean their own bedrooms, to help out in domestic chores. They are asked their views on important issues in their meetings and these are recorded regarding food, holidays, outings etc. It was recommended that residents have representation in Staff Meetings and for staff interviews, if they wish, so as to increase their voice as to the running of the service. Individual plans contained details of the circumstances in which service users’ rights to make particular decisions may have to be limited, e.g. the need to accompany on trips outside because of the lack of road skills. Two residents’ care plans were viewed within individual record files. Both files contained detailed care plans with actions stated as to how staff were expected to meet those identified needs. Evidence was seen of a range of risk assessments, which addressed activities chosen by residents that may present risk. These included safety in the community. Risk assessments identified aspects of each resident’s care needs that resulted in increased vulnerability. This is good practice. A resident showed the inspector her Person Centred Plan, which identified her individual needs and aspirations. There was a discussion with the Registered Manager as to expanding, if possible, residents life histories so that all relevant issues relating to the resident can be fully appreciated by staff. Also to specifically record cultural needs - a resident said she wanted to have more Caribbean food – the Registered Manager said this would be followed up. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents living at the home have the opportunity to have a fulfilling lifestyle. EVIDENCE: Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 13 Residents spoken to said they liked going out. One resident said she had recently been on a holiday to Skegness, which she really enjoyed. The evening of the inspection people who wanted to go were going to the Gateway club, which they said they liked doing. There was evidence of activities – arts and crafts, music, cooking, going out to activities – colleges, discos, advocacy group, leisure centre and local pubs. Because of the reduction of outside day care activities the Registered Manager said that she had advertised for an Activities Organiser to arrange more in house activities. This is commended. Records showed that residents have been on trips and are asked where they want to go on holiday. Residents Meeting notes showed that they have been consulted and trips are planned in the future. Staff said that service users use a range of community facilities including local shops, pubs, the park and leisure centre as well as attending specific groups for people with learning disabilities. Residents said they could have their visitors to the home and staff stated that there were no restrictions on visiting times. A staff member said that she had been assisting a resident to try to regarding establish contact with her family. A relative came to visit at teatime and said that staff always welcomed her and that the care provided to her daughter was always of a high standard. Food records showed that service users were given a choice of food for each meal. Menus indicate a consistent supply of fresh vegetables and a large amount and variety of fruit was observed. The tea tasted was of a good standard with a choice of food, four vegetables with boiled potatoes. There was evidence of a dietician being consulted and guidelines found in a resident’s Care Plan. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive good personal support with their physical and emotional health needs being generally well met. EVIDENCE: There is a very comprehensive information kept which details all medical appointments and check ups on an individual basis - from nurses, GPs, dentist, etc. Care Plans indicate all aspects of service users health care needs are covered – e.g. management of diabetes, personal care, monitoring weight, communication, social skills, work and play etc. There was an accident where a service user had a fall banging her head reflected in the Accident Record. A discussion was had with the Registered Manager for staff to always contact medical authorities to ask for advice on the course of action to follow if a service user has had a head injury. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 15 The Registered Manager has followed up a concern regarding the medical treatment of a service user, to ensure that this situation does not occur in future. This is commended. Staff were observed to be working with service users in a positive and friendly way and understood that service users wanted to chat and be around them for company. Staff were considerate in their dealings with service users needing personal support. The Registered Manager stated that staff that issue medication have all been trained and are now attending an accredited training programme entitled ‘Safe Handling of Medications’ which is a twelve-week course. Evidence was produced to support this. The home has a policy and procedure for the safe administration of medications and has devised a rigorous procedure to ensure medication had been issued and recorded appropriately. Medication records were checked and found to be up to date and medication is kept securely locked away. All medications are supplied individually in a Monitored Dosage System or ‘blister packs’. A sample check was undertaken and found to be satisfactory. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents welfare is protected by robust procedures. Residents views are listened to and acted upon. EVIDENCE: Residents said that if they were worried about anything they would speak to staff and they thought it would be followed up. The Registered Manager stated that there have been no complaints made by service users or relatives for many years. The Commission for Social Care Inspection has also received no complaints regarding the service. The Complaints Procedure seen by the inspector generally reflects the National Minimum Standard in that it stated that any complaints would be properly followed up. It needs to be slightly altered to give the complainant the option of referral to the Commission for Social Care Inspection as well as using the in house procedure. There are residents meetings held where all residents are invited to attend and share their views about the home. A record of these meetings is available for residents and staff to refer to. Staff members on duty were asked about their understanding of whistle blowing procedures, and both demonstrated a good understanding of the protection of residents from abuse. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 17 Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely and comfortable environment, and standards of hygiene are satisfactory. EVIDENCE: Residents said that they liked their bedrooms and they could have their things in them. The inspector looked at some of the bedrooms of residents and the communal areas. Observations of the bedrooms demonstrated that décor in their bedrooms suit their lifestyles. Standards of cleanliness and odour control in all areas of the home were good. The Registered Manager said that there was a three year rolling programme of decoration and that any maintenance issues were quickly attended to after being passed to the caretaker. One resident said that a corridor door banged too loudly. This was noticeable with a number of doors, which could be a noise nuisance to some residents. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 19 The Registered Manager said she would ask the caretaker to check all doors and rectify as needed. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a dedicated staff group. EVIDENCE: Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 21 The service users spoken to were very happy with staff and saw them as their friends. Staffing levels during the course of the inspection met the relevant minimum standards. There are generally two care staff on duty when service users are in the home though another staff member can be called in if there is a planned activity. There is a sleeping staff member on duty at night and staff on call if needed. The Registered Manager said there was currently no need for an awake staff to be on duty at night and that staffing levels would be increased if there was need to do so. Staff records were inspected but not found to have all the necessary statutory checks, as it is policy to keep application forms, references and Protection of Vulnerable Adults checks at Head Office. The Registered Manager said she would obtain copies of such documents to ensure they are available for inspection. Staff members were spoken to and had a good knowledge of service uses care needs and were again committed to providing a good service to residents. They are supplied with regular supervision, which is very well recorded. The Registered Manager has completed the National Vocational Qualification level 2 training. There will be over fifty of staff with a National Vocational Qualification level 2 qualification when current staff undertaking this training have completed it. This will then meet the National Minimum Standard. Staff have had training in a wide range of topics – the Person Centred Planning system which identifies service users individual needs, Health and Safety, Medication, Mental Health, Equality and Diversity, Learning Disability Award Framework, Fire, Food Hygiene, First Aid, Communication, Mental Health, Moving and Handling etc. Training records are kept within individual staff files. New staff have to go through a detailed induction programme, based on the Skills for Care professional model. Future training includes dementia training. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 22 Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 23 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the proactive management of the home. EVIDENCE: Both residents and staff spoke highly of how the Registered Manager runs the home. The Staff Meeting notes seen are detailed and comprehensive and focus on ensuring staff meet residents care needs. The Registered Manager demonstrated a very good working knowledge of the issues affecting people with learning disabilities, has a good understanding of the National Minimum Standards and how the home achieves them. The manager offers clear guidance and leadership to the staff team, as demonstrated by staff comments, minutes of staff meetings and staff supervision. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 24 Service users and relatives have been asked as to their views on the way the home is run through a detailed Quality Assurance survey. The Registered Manager has analysed the results of surveys and is to produce an Action Plan. Staff members were asked as to the fire procedure and were aware of this. Fire records showed that regular testing of fire bells and emergency lighting was in place and there are regular fire drills. The fire risk assessment is in place. A fire door to the dining room/kitchen was wedged open which could compromise fire safety. The Registered Manager said that this would be kept closed until measures are put in place to deal with this. The Registered Manager said that the fitting of radiator covers as assessed was not needed as the current thermostatic controls on radiators protected service users from heat injuries and this was frequently checked as part of the Risk Assessment system. The hot water temperature was measured and found to be within the National Minimum Standard. Health and Safety Policies and Procedures are in place and staff said they are encouraged to read them. Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 25 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 3 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 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 3 32 X 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 1 X Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA42 Regulation 23 (4) Requirement That there are adequate arrangements for containing fires. Timescale for action 28/09/06 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 Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 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 Sycamore Court DS0000006315.V311668.R01.S.doc Version 5.2 Page 28 - 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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