Inspection on 30/06/09 for Woodlands

This inspection was carried out on 30th June 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodlands 23/12/09

Woodlands 07/08/08

Woodlands 14/08/07

Woodlands 02/10/06

Woodlands 08/12/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Woodlands 50 High Street Earith, Huntingdon Cambridgeshire PE28 3PP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janie Buchanan     Date: 3 0 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Woodlands 50 High Street Earith, Huntingdon Cambridgeshire PE28 3PP 01487841404 F/P01487841404 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Farrington Care Homes Ltd care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Woodlands provides care, accommodation and support for up to 24 older people, some who have a degree of confusion or a form of dementia. The home is situated in the village of Earith, which is approximately 6 miles from the market town of St. Ives; from the rear of the home are good views across the River Great Ouse. Residents accommodation is on two floors, the upper floor being accessed via a shaft lift. The home has 18 single and 3 double rooms, but would only be used to accommodate a couple if the need arises. Sixteen of the single rooms have en-suite toilets, and 4 rooms also have baths. There are 4 toilets, one specialist bath, and a level access shower. Communal areas include 2 lounges, a dining area, and a large conservatory, all of which are available for residents use. A pleasant garden area leading down to the river is provided outside. Residents are supported by a team of care staff; the premises are looked after by domiciliary staff and a maintenance person. Care Homes for Older People Page 4 of 26 Over 65 24 24 0 0 Brief description of the care home A copy of the latest CQC inspection report can be requested from the home or downloaded from www.cqc.org.uk Charges vary between £363 and £563 per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: For this inspection, we (The Care Quality Commission) looked at all the information we have received about the home. This included the annual quality assurance assessment (AQAA) that was sent to us by the them. The AQAA is a self assessment that focuses on how well outcomes are being met for people living there. It also gave us some numerical information. We received surveys from people living at the home, their relatives and from staff working there. We visited the home and talked with residents, staff and the manager. We also had lunch at the home so we could watch how staff interacted with, and helped, residents. We undertook a tour of the premises, checked medication records and storage, and viewed a range of the homes paperwork and policies. Four requirements and seven recommendations have been made as a result of this inspection. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Residents who are able must be actively involved in planning and reviewing their care so they have a say in how they are to be helped and can agree to any chances in their plan of care. The monthly reviews of residents plans must be much more detailed so that changes in their care needs can be monitored closely and picked up. Residents need to be given opportunities to discuss their preferences about end of life issues and have these recorded to ensure that are respected. Better signage and orientation aids should be provided around the home to help residents find their way about. In particular bedroom doors should have peoples names on them so they are easier to find. Medication recording and administration must improve so that there is a clear record of what residents have received and who has administered it. An accurate record must also be kept of what medication is in stock. Residents should be provided with a genuine choice of what they eat, especially for their main meal of the day. Menus showing this choice should be available to them so they can actively choose what to eat that day. Screening must be provided in all shared rooms so that residents living there can have their privacy and dignity maintained. At least 50 of staff should have an NVQ level 2 or above in care to ensure that residents receive their care from staff whose knowledge skills and competency to care has been assessed. Care Homes for Older People Page 7 of 26 Information about how to raise complaints and also how to report any adult protection issues should be made easily available around the home so that residents their visitors and staff know who to contact should they wish to raise any concerns. Staff need to have a better understanding of the local adult protection system in their local area and the part they have to play should the need arise. The homes recruitment procedures are poor and put residents at unnecessary and serious risk. Staff should not start working until a POVA first and full CRB check have been completed to ensure that only the right people are employed to look after vulnerable adults. Staff should receive regular supervision so that their working practices can be discussed, their training needs identified and so that they can raise any concerns they have If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes admission procedures are good ensuring that people know their needs can be met there. Evidence: There is a statement of purpose and service user guide that give people good information about the home and the services it offers. Residents also receive a contract which clearly states the homes fees and the terms and conditions of their stay there. We checked the files for two recently admitted residents and each contained a preadmission assessment of the persons needs completed by one the homes management team and also additional information from social service and/or the local primary care trust. Residents we spoke to told us they had visited the home before moving in, giving them a chance to assess its facilities and to see if they liked it. The manager told us she also uses this visit to further assess peoples capabilities and Care Homes for Older People Page 10 of 26 Evidence: needs. One relative was particularly pleased with the way her mother was admitted to the home. She told us: after struggling for a year to care for my mum it was hard to accept that she needed to go into full time care but Pam, the manager of Woodlands, made this as easy as she could. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are treated respectfully by staff, but the homes care planning and medication procedures are not robust enough to fully meet their needs. Evidence: We checked the care plans for three residents and also sat with one resident and went through their plan with them. Information about their daily routines and needs were clearly documented in good detail, ensuring staff had the information they needed to offer consistent and comprehensive care to residents. However there were a number of shortfalls. Some details were wrong, for example in one plan it stated that the resident had a full set of dentures: in fact they only had a top set. Their plan also stated that they wore a hearing aid in their left ear but they actually wore it in their right. There was no evidence that this resident had ever seen their care plan or been involved in its review despite being very able to do this. Staff told us that residents rarely see their care plans and they dont routinely sit with residents (where appropriate) to discuss their plan with them. Other residents we spoke to also confirmed this. Information about peoples end of life wishes was very poor and not in enough detail to ensure their needs would be met in respect of this. Nutrition Care Homes for Older People Page 12 of 26 Evidence: assessments had not been completed for another resident and they had not been weighed since 20/01/09. In one plan it stated that the person had been in hospital but there was no record of why they had been admitted, how long they stayed, and the outcome of their stay. It was not clear if the plan had been updated as a result of the hospital visit. One resident regularly takes Warfarin but there was no information in the plan about how they managed this or what support from staff and district nurses was required. Moving and handling assessments were very basic and did not provide enough detail for staff to know how to assist someone safely and consistently. We checked a sample of residents medication records and also medication storage. We noted the following shortfalls: there was no signature tally in place to ascertain who had given out medication; a number of handwritten additions to the MAR sheets had not been signed or dated or checked by a second person to ensure their accuracy; there was no record of the number of Warfarin tablets one resident had; the date on which liquid medication bottles had been opened had not been recorded; there were one or two signature gaps in the records where it was not possible to tell if someone had received their medication; one person had a prescription cream kept unlocked in her bathroom cabinet, and the home does not have a proper controlled drugs book to ensure the safe recording of these medications. Residents we spoke to told us that staff treated them well and helped them in a way that they liked. Relatives also confirmed this one told us: they treat dad with respect, always helpful. Another :staff treat the residents as individuals. Interactions that we observed between staff and residents during our visit were always respectful and appropriate Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to activities to keep them stimulated and entertained and the food is plentiful and nutritious. Evidence: The home has an activities co-ordinator who works three days a week to provide arts and crafts, games and walks for residents. Three residents attend a nearby day centre, two attend an over 60s club, and one resident regularly goes to a bowls club and the WI, which they told us , they greatly enjoy. The home also has good links with the local school and residents are invited to attend its sports day and plays etc. Despite this however, one relative told us levels of activity and entertainment should be improved to keep residents minds active. One resident told us they greatly missed a regular visit from the local priest who used to come when they resided at a previous home. We took lunch with the residents: this was a relaxed a sociable affair and the food was plentiful and nutritious. However it was served to residents fully plated up thereby denying them the chance to choose how much and what they wanted. This practice is a little institutionalised also there was no genuine choice of what to eat as the only thing advertised on the menu was Shepherds Pie, no alternative was listed and Care Homes for Older People Page 14 of 26 Evidence: residents we spoke to were not aware of anything else on offer if they didnt like or want to have Shepherds pie that day. Residents we spoke to during lunch told us they enjoyed their food at the home. One resident told us:I always ask for a small amount and I always get it. Another described the food as plain but good. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes complaints and protection systems are adequate but they need to provide more information to ensure residents know how to raise any concerns. Evidence: Details of how to complain are included in the homes statement of purpose and service user guide that are given to all new residents on arrival. Apart from this there is no other information available to residents about how to complain and how they need to contact should they wish to raise any concerns on display and easily accessible to them around the home. However, residents we spoke to did tell us that they felt able to complain identifying Pam the manager as someone they could easily to talk to and they felt confident that their complaints would be taken seriously. The manager told us she has not received any formal complaints since our last inspection. We have not received any complaints either. Staff files we viewed showed that staff had received training in protecting vulnerable adults. However, when we asked staff what they would do if they became aware of a serious adult protection matter their answers were poor and showed a lack of knowledge of reporting guidelines and the local adult protection system. Without this knowledge, residents could be put at risk. There is also little information available around the home for residents, visitors and staff with details of who to contact if they wish to report their concerns. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely and comfortable environment with easy access to pleasant grounds outside. Evidence: The premises are homely and comfortable and were clean and free from strong smells on the day we visited. One relative told us: bedrooms and all parts of the house and gardens are always clean and well cared for. A new hoist has recently been purchased so that residents can be moved safely and mixer valves have been fitted to taps to ensure that residents do not get scalded by hot water. The layout of the home is a bit confusing and there are very few orientation aids and signs to indicate where certain rooms are and to help residents find their way about. Only one resident has their name on the door other rooms only have numbers on them at the very top of the door making it very difficult for residents to actually see them. We noted that screening wasnt available in one shared bedroom to help maintain residents privacy and dignity and some of the bedrooms did not have a lockable space for residents to keep their money, valuables and medications in safely. The grounds surrounding the home are very pleasant offering residents a chance for fresh air, sunlight and a view of the river. Care Homes for Older People Page 17 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive their care from competent staff but the homes recruitment procedures do not adequately protect them. Evidence: There are 3 care staff and a manager on duty each morning, two care staff and a manager on each afternoon and two night staff to meet the needs of 20 residents currently. Additional staff are available at busy times. Residents told us that there were enough staff around when they wanted and staff told us that there were enough of them to meet residents needs. We checked the duty rota which showed us these staffing levels were maintained. The home is rarely shorts staffed and does not need to use staff from an outside agency ensuring residents receive their care from staff who know them well. We checked the personnel files for two recently employed members of staff. There were serious shortfalls in the homes recruitment procedures. Staff are routinely employed with just a POVA first check whilst awaiting their full CRB disclosure. Although this is allowed in exceptionally circumstances only it is not best practice. In one case a member of staff had started working at the home even before her POVA first check had been completed. This is a serious breach of the regulations and puts residents at unnecessary risk. Care Homes for Older People Page 18 of 26 Evidence: Staff who completed our survey told us they received training relevant to their role and that kept them up to date with new ways of working. Files that we viewed showed that staff had undertaken a range of training including dementia care medication continence management and health and safety. However only 2 staff hold an NVQ level 2 in care which is well below the minimum standard that 50 have this qualification. Care Homes for Older People Page 19 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and residents health and safety is protected. Evidence: The management team are regarded highly by residents their relatives and staff and we received many positive comments about them including :Pam is approachable and brilliant with the residents and I cannot speak highly enough of Pam Claire and all the staff. Staff told us they felt well supported by their managers and that there were regular staff meetings where their views were listened to. One told us: we can put our point across. However we checked a number of staff files which showed that one member of staff had not received any supervision at all since they started working at the home and other members of staff had not received formal supervision as frequently as recommended by the standards. The home seeks feedback about its service by asking residents to fill out questionnaires. We viewed these questionnaires which were a little basic and did not elicit much meaningful responses from residents and the views of family friends and Care Homes for Older People Page 20 of 26 Evidence: other health care professionals who visit the home are not sought. We checked and number of records in relation to health and safety including gas, hoist, lift and portable appliance testing, which showed us the home regularly maintains and services its equipment to ensure its safety. The kitchen has been award 4 stars by the environmental health officer indicating that its hygiene and food preparation standards are very good. Care Homes for Older People Page 21 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Residents must be involved in planning and reviewing their care. You must do this to ensure they have an active say in how they are to be helped by staff. 01/09/2009 2 8 12 Residents must have their nutrition assessed and be weighed regularly. You must do this to ensure their health is monitored and maintained 01/09/2009 3 9 13 The recording and administration of residents medication must improve. Please refer to the section under Health and Personal care in this report. You must do this to ensure their is an accurate record of what residents have received and that their health is maintained 01/09/2009 Care Homes for Older People Page 23 of 26 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 29 19 No member of staff must start working at the home until a POVA first check has been obtained. You must do this to ensure that only the right people are employed to look after vulnerable adults. 03/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 11 Residents should be given the opportunity to express their wishes about what they want to happen when death approaches and to give instructions about the formalities they want observed after their death. Residents should be offered a genuine choice in what they eat each day. This choice should be advertised on the menu and made explicit to residents. Information about how to raise complaints and also how to report any adult protection issues should be made easily available around the home so that residents their visitors and staff know who to contact should they wish to raise any concerns Better signage and orientation aids should be provided around the home to help residents and their visitors find their way about. 50 of staff should have an NVQ level 2 in care to ensure they have the knowledge and skills to adequately care for residents. Residents surveys should be better designed to ensure that meaningful information about how they rate the service they receive can be collected and used to improve the home. 2 15 3 16 4 19 5 28 6 33 Care Homes for Older People Page 24 of 26 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 7 36 Staff should receive formal supervision at least 6 times a year so they have a chance to discuss their training needs, their working practices and any other issues of concern. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!