Inspection on 18/07/07 for Weymouth AfterCare Centre

This inspection was carried out on 18th July 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Weymouth AfterCare Centre 26/06/08

Weymouth AfterCare Centre 25/05/06

Weymouth AfterCare Centre 03/11/05

Weymouth AfterCare Centre 19/04/05

Weymouth AfterCare Centre 14/09/04

Weymouth AfterCare Centre 21/04/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Weymouth AfterCare Centre Carlton House 9 Carlton Road North Weymouth Dorset DT4 7PX Lead Inspector Trevor Julian Key Unannounced Inspection 18th July 2007 10:15 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 Weymouth AfterCare Centre DS0000026891.V345667.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. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Weymouth AfterCare Centre Address Carlton House 9 Carlton Road North Weymouth Dorset DT4 7PX 01305 779084 01305 750879 carlton9@tiscali.co.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) Mrs Joy Marie Felgate Dominic Robert De Putron Castle Care Home 15 Category(ies) of Past or present alcohol dependence (15), Past or registration, with number present drug dependence (15) of places Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Past or present alcohol dependency (Code A) Past or present drug dependency (Code D) The maximum number of service users who can be accommodated is 15. 25th May 2006 2. Date of last inspection Brief Description of the Service: Weymouth Aftercare Centre is a private care home that provides a residential rehabilitation programme for up to 15 men who are drug or alcohol dependant. The Centre is a large house situated in a quiet residential area of Weymouth within easy walking distance of the seafront and local amenities. There is a small garden area at the back of the house and parking for a few cars at the front of the building. It has been established as a care home for approximately 15 years and retains strong links with the local community. The Centre accepts service users from any part of the country. Ordinarily, service users are admitted from a primary care unit, where treatment has already commenced. In some cases service users may come directly from prison or may be subject to a probation order. Placements are of a short-term nature, ordinarily approximately of three months duration. Service users either then return to their own area or move on to a half-way house in Weymouth. Service users are encouraged to take responsibility for their own recovery. The emphasis is on participation in daily activities, household chores and group meetings. Staff provide support through individual and group counselling sessions. Service users are expected to comply with the structured programme. In pursuance of the goals that service users are seeking to achieve, certain rules and restrictions are in place, which limit individual freedom. Service users formally agree to these arrangements before admission. The fees for the home are £450 each week. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection started on the 18th July 2007 at 10:15. The people using the service were having a day out on Brownsea Island so the inspection was concluded on the 20th July with a follow up visit to meet the residents. Before the inspection, Mr Castle had completed an Annual Quality Assurance Assessment (AQAA) giving brief information on the management of the service and an overview of the care needs of the individuals. Additionally, residents, visitors, health and social care professionals had completed and returned surveys on their views of the service. 13 surveys were received from residents, 6 relatives and 5 professionals, all showed very high levels of satisfaction with the services provided at the home. During the visit information was obtained through discussion in a group meeting and individually with most of the people living in the home, discussion with a care manager and the home’s staff. Records were examined and there was a tour of the premises. Since the last key inspection in May 2006, two random inspections had taken place. One to monitor progress made since that inspection the other to focus on medication. What the service does well: During the group meeting with the people using the service they reported that the home offers them an excellent chance for continued recovery. All appeared optimistic and realistic about their future. They felt comfortable in the knowledge that there was local help and support within and outside of the project. The staff and management were seen as knowledgeable and approachable. People responding to the surveys and in the group meeting said that the home’s process for pre-admission assessment was very good with overnight stays allowing the individual the chance to see what can be expected. One person said it had been useful as it allowed him to make informed decisions; it had also dispelled a few of his own misconceptions about the project. The home’s care planning process considered health, social and spiritual needs. There was evidence in the AQAA and confirmed by the surveys that people were consulted about the running of the service. They were also able to raise complaints without any fear of recrimination. People found the weekly outside activities and voluntary work was another positive element in their programme; they felt it helped to develop a sense of responsibility and involvement in the community. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 6 Food continues to be praised by the residents both in the surveys and in discussion. They did add that they would like more lunchtime choice and the senior counsellor said they would review it at the next group meeting. The food was all freshly prepared and there was a good supply of fresh fruit. The home encourages people to register with the local health centre who carry out an initial review of medication. The home also helps people to arrange dental and optician appointments. 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. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s pre-admission procedure ensures that the placement is correct for the individual and the others residing at the project. EVIDENCE: The home accepts people from care manager referral or the probation system with the vast majority coming from outside the county. Two people were visiting the home overnight as part of the assessment process. They had been involved in group work and had time to discuss the programme with the existing residents. One person who was visiting from a primary treatment centre said the visit had been very helpful, as it had removed preconceptions he made about the routines and life in the home. The manager said that it was important not to get the person on assessment to jump to a quick decision about the placement and the person would return to where they had come from and discuss the options with peers. This was confirmed by all those people seen during the visit. If circumstances require then the home does complete a pre-admission assessment over the phone with reference to other agencies involved in the referral. Comment cards also showed that people had found that the admission process had been carried out thoroughly and had allowed the individuals an insight into what to expect. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the project are supported to make informed choices about their daily lives. They are involved in the development of their individual care plans. EVIDENCE: Care plans were developed from the initial assessment and the funding authority’s care plan. In case tracking three files, all contained evidence of care plans and the involvement of the residents in the care planning and review process. The care plans included information on both health and social care needs. Spiritual needs were considered at the assessment stage to ensure that the home could meet individuals’ expectations and if there were dietary implications that the home would not be able to meet. The home’s expectations for people coming into the centre are clearly laid out in the contract and service users guide. The project works on the “Twelve Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 10 Step” model with the individuals gaining more responsibility as they progress through the programme. There was evidence that the home seeks the views of the residents both individually and as groups. All the residents were clear that they received good support and guidance from the staff team. On a returned survey, one person commented that “they didn’t always like the answer given by staff to their questions however, they always trusted the response and understood there was a reason behind the answer”. Risk assessment is carried out during the assessment and initial part of the stay at the home. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. People using the service are supported to make informed choices about their life style, in order to develop their life skills. All activities are agreed to help meet individual’s expectations. EVIDENCE: The home organises regular activities for the residents. On the first day of the visit, the residents had gone over to Brownsea Island where they performed an open air play as part of their drama group. On the way back to Weymouth they stopped off for a fish and chip supper. At the group meeting held on the second visit the excursion had been a great success. No charges were levied for the trip; however, the fines raised by sanctions in the home were used to purchase part of the refreshments. Residents said that they had organised outings most weeks and there were other times when they had free time. The free time activities were subject to peer agreement. One person added that Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 12 when the group was out in the community they had a responsibility to ensure that the home was seen in a positive light, as they were the home’s ambassadors. As people progress through the programme, some volunteer for community work and others take up training at the local college. Whilst no one in the home had particular spiritual needs, the home had previously arranged for support for individuals from the relevant community. The home imposes restrictions on outside contacts while the person is on the programme. Family contact is supported through the telephone and a visit during the stay, as agreed through the peer group. In some circumstances, home visits can also be agreed. Most of the rooms in the home are doubles and the individuals have to agree to share. The rooms seen had screens and furniture to help safeguard privacy. Residents are encouraged not to spend time in their own rooms except for sleeping. The food was described as very good; one person pointed out that the home did not have a microwave oven and that all food was always freshly prepared. In the group meeting, several people commented that they would prefer greater choice of items at the lunchtime buffet. This matter was a regular topic at the residents meetings. The senior counsellor said the issue had been discussed and changes made following the last inspection but he would include the item in the next group meeting. The food stocks were good and there was a selection of fresh fruit available for the residents. The residents also said they appreciated having the food prepared and cooked for them. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home generally offers good support for the residents’ health needs; however not all the required improvements to the medication system had been implemented and could create risk to the residents and staff. EVIDENCE: The files showed there was good support from healthcare professionals. People are registered with a local GP surgery as soon as they arrive at the project and there is an initial review of medication. One person had complex health needs and he had been well supported during his stay. He said that they helped him to be independent with most of his medication; however, they did store his stock for him to help ensure he did not run out of medication. In the group meeting, several people said that the staff had helped them to arrange dental appointments. Other specialist health services were arranged as needed. There had been improvements to the medication system since the last inspection. The home used a medication administration record to check that Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 14 all residents received the correct medication at the correct time. The charts seen were up to date and the general information, including known allergies and prescribing GP, was complete. The records allowed a clear audit trail. There was a recent occasion when medication was not given to one resident; there was no explanation or follow up. A lockable container had been provided for temperature sensitive medication to be stored in the fridge. The main stock of medication was safely stored; however, some medication, waiting return to the supplying chemist for destruction, was not held securely. Mr Castle was aware of the problem and had obtained a suitable container but it was not in use at the time of either visit. This could expose the residents to undue risk and needed prompt attention. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s procedures allow people who use the service to be able to express their concerns, and have access to a robust, effective complaints procedure, and are protected from abuse, and have their rights protected. EVIDENCE: The home’s complaints procedure was displayed on the noticeboard and within the service users guide. There was a register of complaints indicating the outcome of previous complaints. Residents were very clear that they were able to raise issues with the staff privately or in the group setting. They said that any issues were dealt with properly and without recrimination. No one seen had felt the need to raise any formal complaints. They also said that if they had major concerns they would be able to contact their care manager for advice and support. These views were also confirmed in the returned surveys. The care manager said that in her experience there were seldom issues about the service although she was involved in supporting people with issues outside of the project. She said that she visited clients during their stay at secondary treatment before they moved on. Two staff were booked in for adult protection training by the Local Authority to cover how to respond to signs and allegations of abuse. Both were aware of their responsibilities. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 16 Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The premises provide a comfortable environment for the residents and staff. Further action was identified to help keep the residents safe. EVIDENCE: The building is an Edwardian house which is well maintained. The rooms seen were comfortable and appropriately furnished. Each person had a notice board where they had posted their pictures and other personal items. It was noted that the rooms on the first floor had unrestricted window openings and there was no assessment to consider the risk. Bathrooms had unrestricted hot water supplies and when considered with the medical conditions of a current resident this could expose individuals to the risk of scalding. This should be addressed through a risk assessment. Draw bolts were fitted to the bathroom doors again they should have an assessment to consider the risk of people locking themselves inside. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 18 People said the home was comfortable and the rooms adequate. They said they were encouraged not to isolate themselves in their bedrooms and tended to use them only for sleeping in. They identified no issues with the building. The home did not have laundry facilities. This is covered in the service user guide and helps the residents to retain independence and to use community services. None of the residents found this a problem and some said they found it all part of the recovery programme. The home was well presented and clean. The residents clean the house as part of their therapeutic duties. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff have the skills and training to provide appropriate support for the residents. The staffing levels are appropriate to the needs of the residents. EVIDENCE: The staff in the home have a wealth of experience and a good skill mix. The counsellors all possess qualifications in counselling and are in the final stages of qualification. The staff have attended core training and other specialist training. Only staff trained and assessed as competent are able to administer medication. New staff work through an induction programme which is assessed through the supervision process to ensure competence. As found at previous inspections the home tends to recruit staff from its own volunteer network and the people taken on have been known to the project for some considerable time. The files seen showed that they had adopted a formal application form and references had been obtained. There was evidence that Criminal Records Bureau checks had been completed. However, the clearances did not show that individuals had been checked against the Protection of Vulnerable Adults list before starting work. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 20 The people using the service said that the staff were approachable and very knowledgeable about their addictions and were supportive. The staff were able to offer them guidance and alternative solutions. Two counsellors/ project workers staffed the home during the daytime. During the evening and overnight, the home was staffed either by the manager or senior counsellor. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed with systems in place to ensure it is run in the best interest of those people using it. EVIDENCE: Since the last inspection, Mr Castle had been approved as the home’s registered manager. He is continuing to work on the NVQ level 4 Registered Managers Award. He has worked in the project for many years, has very good levels of experience, and has developed skills in the specialist area of addiction and relapse prevention. The home had introduced exit surveys for people leaving the project and the results were used to identify areas for improvement or development. The programme includes community meetings that allow the residents to give their views on the running of the home. There were minutes of the meetings and Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 22 the action taken. The home had a suggestion box in the library on the ground floor, the items posted were taken as topics to the community meeting. The records showed that staff regularly received training in Fire safety; the formal training was supported with video and questionnaires. A fire safety officer, from Dorset Fire and Rescue Services, had recently seen the home’s fire risk assessment. Accidents were recorded in the accident book and the principles of data protection applied as no personal information was retained in the book. The system allowed an audit trail. Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 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 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation 13(2) Requirement The Registered Person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received in the care home including: a) The system for recording the administration of medicines must be reviewed to ensure that medicines are offered as prescribed and the administration recorded, or the reason they were not taken. b) All medication must be safely stored. The registered person must ensure that all pre employment checks are completed before the employee, or volunteer, starts working at the home Timescale for action 31/08/07 2 YA34 19(b) 31/08/07 Weymouth AfterCare Centre DS0000026891.V345667.R01.S.doc Version 5.2 Page 25 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 YA24 Good Practice Recommendations The registered person should ensure that assessments are completed to consider the risk posed by: • Drawbolts fitted to bathroom doors. • Unrestricted windows above the ground floor. • Unrestricted hot water. 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