Inspection on 27/11/07 for Troydale Farm

This inspection was carried out on 27th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Troydale Farm 04/12/06

Troydale Farm 20/02/06

Troydale Farm 02/11/05

Troydale Farm 09/12/04

Troydale Farm 03/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Troydale Farm Troydale Lane Pudsey Leeds West Yorkshire LS28 9JT Lead Inspector Paul Newman Key Unannounced Inspection 27th November 2007 10:00 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 Troydale Farm DS0000001517.V356614.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. Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Troydale Farm Address Troydale Lane Pudsey Leeds West Yorkshire LS28 9JT 0113 255 5984 0113 239 4439 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) Mrs Edna Gilbank Mrs Edna Gilbank Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th December 2006 Brief Description of the Service: Troydale care home was built as a farmhouse in 1706 and was first registered as a care home in July 1989. The house has been sympathetically converted and many of the original features have been retained. The home now provides personal care for up to thirteen older people with a moderate level of disability. Nursing care is not provided. Troydale is set in farmland in the Tong-Cockersdale conservation area and has extensive views over Troydale valley. It has pleasant gardens and car parking is provided in the grounds. The home is only a short distance from Pudsey town centre and has public transport links with Leeds and Bradford. Accommodation is provided in nine single and two double rooms on two floors. Bedrooms are fitted with washbasins and there are a number of communal toilets and bathrooms. The communal lounge and dining room are on the ground floor. There is level access to the home and a stair lift provides access to the first floor. Information about the home is provided in the form of a statement of purpose and service user guide. Both these documents are available at the home, are regularly updated and outline the terms and conditions for residents. The current fees charged are £425 per week. There are additional charges for hairdressing; newspapers; toiletries; dental treatment and chiropody. There is a charge for escort to hospital appointment and this is dependant on the agency rate of pay. This information was provided by the home in November 2007. Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit carried out by one inspector that started at 10:00 and finished at 13:30 on 27 November 2007. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who live there and that the outcomes for the people meet National Minimum Standards. Before the inspection, information collected about the home over the last year was reviewed. This included looking at any reported incidents, accidents and any complaints. Survey forms were sent to the home before the inspection for the manager to give out to people living at the home, visitors, healthcare professionals involved in peoples’ care and the staff working at the home. This gives people the opportunity to comment if they want to. Information provided in this way may be shared with the provider but the source will not be identified. A good proportion of surveys were returned and some of the written comments that were made are included in the report to show what people think of the way the home is run. The manager had completed an Annual Quality Assurance Assessment (AQAA) before the visit to provide additional information. This is a self-assessment of the service provided and this gives a lot of information about how the manager thinks the home is meeting standards, how it has improved during the last year and what it intends to do in the coming year. All of this information was used to plan the inspection visit. A number of documents that the home must keep up to date were looked at during the visit. All areas of the home used by the people who live there were checked. Time was spent talking with the people and visitors, watching what was going, as well as talking with the manager and staff on duty. What the service does well: The home is well managed and the staff team are trained in safe working practices, experienced and equipped for the job. They are happy in their work and committed to providing high standards of person centred care. The needs of people living at the home are the focus of the staffs’ attention and people looked happy and well cared for. The owners are fully involved in the home, in touch with what is going on. Staff make sure that residents are treated with dignity. Staff are also good at supporting family members who visit the home. People are properly assessed before they come to live at the home. This helps to make sure a good care plan can be drawn up that identifies peoples’ needs. Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 6 The home works closely with other healthcare professionals, makes referrals at an early stage and takes the advice that is given. The food provided is wholesome and always freshly cooked with fresh ingredients and it meets with the approval of people living there. The building is homely and comfortable. These are some of the comments made by relatives in surveys that were returned to the CSCI: • • • • ‘Treats everyone with respect and care’. ‘This is a very well run home. It is spotlessly clean and food is of first class standard. My relation is very happy and cared for very well’. ‘Excellent service – patient and helpful staff, cleanliness and meals. It is a very well run care home’. ‘They cater for my mother’s needs very well. They are loving to her, and make her laugh a lot. The food is excellent and there is plenty of it, always fresh’. 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. Troydale Farm DS0000001517.V356614.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 Troydale Farm DS0000001517.V356614.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): 3. Standard 6 does not apply to this home. People who use the service experience good quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. People are properly assessed before admission so they can be sure the home can meet their needs. EVIDENCE: The information provided before the inspection visit that was summarised in the Annual Quality Assurance Assessment (AQAA), showed that all people considering coming to live at the home and their relatives are seen personally and a visit to the home is arranged when at least the relatives and, if possible, the prospective service user can see the room available, general facilities and meet other people living there. People spoken to during the inspection visit confirmed this. Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 9 The files of two people were checked to make sure that good quality information is gathered before someone comes to live at the home, so that everyone is sure that the person’s care needs can be met. One of the files was for the most recent admission. Apart from the home’s own assessment documentation, other information is gathered from any social worker or healthcare professionals that have been involved. Easy care documentation was on file. Risk assessments are also made before a person is admitted and were on file. From this information, if the home believes it can meet the person’s needs, a plan of the care needed is written. Once living in the home, individuals’ progress is monitored to make sure that care needs are met. Troydale Farm DS0000001517.V356614.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. People who use the service experience good quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. Peoples’ healthcare needs are met and care plans provide clear instruction for staff to follow. Staff are aware of peoples’ needs and there is good communication amongst the staff group and with healthcare professionals and this makes sure people get the care they need. People are protected by safe medication policies, procedures and practices. People are treated with respect and in a dignified way. EVIDENCE: The files that were checked showed that care plans are drawn up and reviewed regularly. The plans are based on a pre admission assessment carried out by the manager and other information like easy care documentation and the two files checked showed that the care plans that had been written accurately and Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 11 all the persons needs had been identified. The involvement of the family and person about their life history, likes and dislikes, preferred ways of living and routines, is a way to make the care plans more person centred and helps staff deliver care in an individual way. Specific health care needs were well documented and audit trails of staff observations and concerns that they document about an individual’s health problem could be followed with any subsequent referral to the GP or other health care professional. The advice and treatment that was given by healthcare professionals was noted on the file. Short-term care plans are used when a person is in need of additional monitoring. The deputy manager took time to explain the medication systems in place, the way prescribed drugs are ordered and checked in, disposed of and administered. Practices were observed and these were careful, thorough and safe. The drug administration charts were checked and found to be error free over a period of time. Staff are properly trained in safe medication practices. Staff spoken with had a good knowledge of the individual needs of people. Some time was spent around the home watching staff practices. This showed that they know the care needs and personal preferences of individuals. They were good at making sure nobody was isolated and got as much positive attention as possible. The relationships between staff and the people they care for were warm and friendly with some residents obviously enjoying some physical reassurance. Clothing was clean and all of the residents looked well cared for with their hair attended to, ladies ‘made up’ and nails polished. Staff were careful to make sure doors were closed at times when personal care was delivered and were seen knocking on doors before entering rooms. They were attentive to people and some overheard conversations showed staff to have a nice manner that people appreciated. Comments made by relatives in surveys that were returned were very positive. These included: • ‘Treats everyone with respect and care’. • ‘This is a very well run home. It is spotlessly clean and food is of first class standard. My relation is very happy and cared for very well’. • ‘Excellent service – patient and helpful staff, cleanliness and meals. It is a very well run care home’. • ‘They cater for my mother’s needs very well. They are loving to her, and make her laugh a lot. The food is excellent and there is plenty of it, always fresh’. Comments made by a healthcare professional included: • ‘Friendly warm atmosphere and always welcomed into the home. Residents cared for appropriately’. Troydale Farm DS0000001517.V356614.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. People who use the service experience good quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. Peoples’ social expectations and personal preferences are met and they are able to exercise choice in their daily routines. People living at the home are provided with a varied and nutritious diet. EVIDENCE: Staff complete social care plans with people to find out what support is needed. The AQAA stated that the home likes to continue peoples’ previous lifestyle as much as possible and risk assessments are made to match this. The care plans seen showed that rights, choices and personal preferences are identified. In-house activities include baking, domestic work, parlour games, quizzes, music and dancing and records are kept of what each resident is involved in. Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 13 The surveys that were returned indicated that relatives feel welcomed into the home and also feel that they are kept up to date with information about people. Someone visiting at the time of the inspection visit confirmed this and visits her mother most days. The care plans identify peoples’ preferred routines. Overheard conversations showed that staff encourage people to say what they would like to wear (with assurances about how they looked when dressed), where they would like to be and what they would like to do. People spoken with said that they get up and go to bed when they want, can eat in their rooms if they wish and choose what activities they want to join in. The bedrooms seen showed that people are able and encouraged to bring things from home to personalise it and make it more individual and homely. The home’s cook has recently left employment so staff currently prepare the meals. This appears to work well and comments made by visitors, people living at the home and in the surveys that were returned said that the food was consistently good and there was plenty of it. The home prides itself on good wholesome cooking with fresh good quality produce. The main meal of the day looked appetising and was enjoyed by all those spoken to. Troydale Farm DS0000001517.V356614.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. People who use the service experience good quality outcomes in this area. We have made this judgment using available evidence including a visit to this service. There is a clear complaints procedure made available to the people at the home. The people who live at the home and their relatives feel confident that they will be listened to and that appropriate action will be taken when necessary. There are adult protection procedures that staff have awareness of and understand. People can be assured that they can feel safe at the home. EVIDENCE: The manager said that the home encourages people to air views and concerns so that staff can act upon this and resolve things quickly. There has been one complaint made since the last inspection. This was properly recorded, investigated and resolved. Everyone spoken to said that staff were approachable, listened and wanted to make sure people were happy. The complaints procedure is in the service user guide that all new admissions receive. It is also clearly displayed in the home. Policies are in place that set out how the home protects service users and prevents harm or abuse and this includes a whistle blowing policy. The manager is aware of the need to report any suspected or alleged abuse to the Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 15 local authority and other relevant authorities. Staff spoken with confirmed that they had received training in the protection of vulnerable adults. Troydale Farm DS0000001517.V356614.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, 25 and 26. People who use the service experience good quality outcomes in this area. We have made this judgment using available evidence including a visit to this service. The home is clean, comfortable and well maintained. The absence of radiator guards in some areas creates the opportunity for residents to be placed at risk. EVIDENCE: Part of the reason for making an inspection visit was to check that that the building and furnishings had been made good following an unfortunate ‘flood’ during the heavy rains in June this year. To make sure that people were as comfortable as possible, the owners had actually proceeded with putting some of this right like replacing carpets, before insurance claims were settled and Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 17 the manager kept the Commission fully informed. The damage did however incur unexpected costs and some additional costly work is also necessary to do some work recently recommended by the Fire Officer. As a consequence the programme of fitting radiator guards throughout the building has not been completed with some bedrooms still needing this done. These rooms are however, risk assessed. Damage caused by ‘the flood’ has all been put right and the home looked well decorated. Many of the rooms incorporate original features and all were attractive and inviting. There are no en suites but all rooms have a wash hand basin and there are sufficient communal sanitary facilities available for residents. The tour of the building found things to be clean, comfortable, well maintained and free from unpleasant odours. There is a definite ‘homely feel’ when entering the building and a visitor said this was one of the positive things that attracted them and their relative in making the decision to live there. Troydale Farm DS0000001517.V356614.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. People who use the service experience good quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. People living in the home are cared for by experienced staff who are properly recruited, trained and qualified for the job. EVIDENCE: The combination of evidence from rotas seen, watching staff at work, comments made in the surveys that were returned and conversations during the visit suggest that there are enough staff on duty and that they are able to give people the care and attention they need. There is one waking night staff and the owner, who lives in the adjacent house provides on call support overnight. Communication systems like shift handovers are well established. When watching staff at their work they are very personable but professional, the large majority having worked for a long time at the home. An analysis of the comments made by staff in the surveys that were returned to the Commission was provided to the manager and it was recommended this be discussed at a staff meeting. Well over 50 of the care staff have achieved a National Vocational Qualification (NVQ) in care at level 2. There is a clear commitment to making sure that the staff are trained and competent. Training videos are used on a wide range of subjects. These require staff to complete a questionnaire after Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 19 they have watched the video and these are sent away for marking. The manager has completed a course to enable her to provide fire training. In addition there is a good range of workbooks that have been designed in house for staff to work through. Feedback from these workbooks is given at 1:1 supervision sessions or discussed at staff meetings. Staff are enthusiastic about the training provided. The personnel files of the two most recently appointed staff were checked to make sure that they had been recruited properly. The records showed this to be the case with the right checks being made and references being taken up. Troydale Farm DS0000001517.V356614.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 and 38. People who use the service experience good quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home is well managed. The interests of the people who live there are seen as very important to the owners, manager and staff. There is a clear approach to resident care that is person centred and puts the best interests of individual residents central to staff practice. Regular auditing and checking of facilities, equipment and services make sure the home is a safe place to live. Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 21 EVIDENCE: Although the owner is the registered provider and registered manager she takes more of an administrative role. Mrs Riley, takes on most of the responsibility for the day-to-day management of the home with a deputy providing good support. The long-term plan is to formalise this arrangement with Mrs Riley becoming the registered manager on completion of a management qualification. Staff meetings are held on a regular basis and minutes were made available. In the conversations with staff they said that they felt that communication was good. To make sure it is achieving its aim, the home conducts its own satisfaction surveys, but also, the manager likes to spend time with people living at the home and make herself available to relatives on a daily basis to make sure that they are happy. In addition there is a quality assurance system that is based on National Minimum Standards. The home does not hold any personal money for safekeeping. Lockable facilities are available in each bedroom for people to keep things securely. The information provided in the AQAA showed that regular checks are made of equipment and services to make sure that everything is safe and in good working order. Staff have access to all essential policies and procedures and are trained in safe working practices. Checks were made of the fire safety records these were up to date. Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP25 Regulation 13(4) Timescale for action Radiators must be fitted with 03/09/08 guards or replaced with Low Surface Temperature radiators. Timescale of 30/06/07 not met. New timescale set. Requirement 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 OP27 Good Practice Recommendations The manager should use the analysis of CSCI survey results from staff as a discussion at a staff meeting to air their views. Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Troydale Farm DS0000001517.V356614.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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