Care Home: Cedar House

What the care home does well People said things like there is a `very friendly atmosphere` at the home, and `it`s like home from home`.People said that they are given enough information about the home to help them make a choice to stay there.Privacy and dignity is maintained for people throughout their stay.People can make their own decisions about how they spend their time.There are lots of activities for people to choose from.Staff understand the different ways in which peoplecommunicate their needs and wishes.People told us that they know who to talk to if they are not happy with anything, and they said staff listen to them and support them well. What has improved since the last inspection? This is the first time we have visited since the home registered with us in October 2009, so we can not say whathas improved. What the care home could do better: There could be more details into people`s care plans about things like epilepsy, and moving and handling.There could be a report written about what the manager finds when she checks things like care plans and medicine records.The manager also said that she would make sure that the service user guide and statement of purpose are updated to show her own details.She said that she will look at how they plan menus, and how they record what people eat and drink.She said that she will look at how quickly things that are broken are repaired.She said that she will look athow there could be more space in the main lounge. Key inspection report Care homes for adults (18-65 years) Name: Address: Cedar House Cedar House Off Pinchbeck Road Spalding Lincs PE11 1QF The quality rating for this care home is: two star good 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: Wendy Taylor Date: 0 5 0 5 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) Page 2 of 37 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 37 Information about the care home Name of care home: Address: Cedar House Cedar House Off Pinchbeck Road Spalding Lincs PE11 1QF NotKnownYet NotKnownYet cedarhse@heritagecare.co.uk www.heritagecare.co.uk Heritage Care Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: The maximum number of people who can be accomodated is 6 The registered person may provide the following category of service only, Care Home only, Code PC to service users of the following gender, either whose primary care needs on admission to the home are within the following category, Learning Disability, Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home Cedar House is near to the town centre of Spalding, Lincolnshire. It is near to the local shops, restaurants, and bus routes. There is plenty of car parking at the front of the building, There is a nice garden for Care Homes for Adults (18-65 years) Page 5 of 37 people to use when they stay there. Up to 6 people with a learning disability can 6 stay at Cedar House at any one time. The local social work team arrange for people to stay at Cedar House, and the Local Authority pay £300,000 a year for the home to do this. More information about these costs, and the day to day management of the home can be obtained from the main office within the home. Care Homes for Adults (18-65 years) Page 6 of 37 Care Homes for Adults (18-65 years) Page 7 of 37 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 8 of 37 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 stars, which means that people who use the service get good quality outcomes. This was the first time we visited the home since it was registered in October 2009. We had a lot of information before we visited the home, such as surveys that people had sent to us. This helped us to know what the home is like. 2** 1st Care Homes for Adults (18-65 years) Page 9 of 37 An inspector visited the home to see how things are done. We met people who were staying there. We spoke to the manager and staff, and watched how staff do their jobs. We looked at things like care plans, and staff records. We also looked at the general Care Homes for Adults (18-65 years) Page 10 of 37 records that the home keeps to show that people are kept safe. What the care home does well People said things like there is a very friendly atmosphere at the home, and its like home from home. People said that they are given enough information about the home to help them make a choice to stay there. Care Homes for Adults (18-65 years) Page 11 of 37 Privacy and dignity is maintained for people throughout their stay. People can make their own decisions about how they spend their time. There are lots of activities for people to choose from. Staff understand the different ways in which people Care Homes for Adults (18-65 years) Page 12 of 37 communicate their needs and wishes. People told us that they know who to talk to if they are not happy with anything, and they said staff listen to them and support them well. What has got better from the last inspection This is the first time we have visited since the home registered with us in October 2009, so we can not say what Care Homes for Adults (18-65 years) Page 13 of 37 has improved. What the care home could do better There could be more details into peoples care plans about things like epilepsy, and moving and handling. There could be a report written about what the manager finds when she checks things like care plans and medicine records. Care Homes for Adults (18-65 years) Page 14 of 37 The manager also said that she would make sure that the service user guide and statement of purpose are updated to show her own details. She said that she will look at how they plan menus, and how they record what people eat and drink. She said that she will look at how quickly things that are broken are repaired. She said that she will look at Care Homes for Adults (18-65 years) Page 15 of 37 how there could be more space in the main lounge. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Wendy Taylor Edgeley House Tottle Road Riverside Business Park Nottingham Nottinghamshire Care Homes for Adults (18-65 years) Page 16 of 37 NG1 1RT 01159340900 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 Adults (18-65 years) Page 17 of 37 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 18 of 37 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. A clear assessment process means that people know that the service can meet their needs and wishes. Evidence: We looked at the files for four of the people who use the service. The files have lots of information in them about things that people need help with, and things they like to do. For example, there is information about peoples health, personal care, how they communicate, and their daily routines. There are also assessments of peoples needs that are carried out by social workers, and all of the information shows that people and their families are involved in the assessment process. Files contain a tool kit that helps staff to plan the kind of support a person needs which shows what is and is not working in the persons life, what makes a good or bad day for them, and who is important in their lives. The tool kit also contains an explanation of the terms used in peoples files, and a checklist of all of the things that their care plan should contain. People and their families told us through surveys that they had been asked if they wanted Care Homes for Adults (18-65 years) Page 19 of 37 Evidence: to use the service, and they had been given enough information about the service to help them make that choice. Staff told us about how they help people to start using the service by offering things like tea visits, and helping them to choose the room they want to stay in, and this is reflected in their service user guide. Care Homes for Adults (18-65 years) Page 20 of 37 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. People receive the right support from staff who understand their needs and wishes. Evidence: People told us through surveys that they are able to make their own decisions about what they want to do each day, and during our visit we saw that staff were helping people to do the things that they preferred, such as going out for shopping trips. Staff told us that they are given enough information about peoples needs, and we saw that they were following peoples care plans. They were also able to demonstrate that they understood how to communicate in the right way with each person, by using body language and other communication aids. Peoples files contain care plans that help them to have their needs and wishes met in the right way. Care plans are in place for things like personal care, night support, community life, safety, communication, making choices and decisions, and medication. There is also information about making sure that peoples rights are upheld. Care Homes for Adults (18-65 years) Page 21 of 37 Evidence: Some of the plans do not contain a lot of detail about how to provide the support needed with things such as epilepsy, and moving and handling. However staff showed us that they knew about things like which slings people use, and how many staff people need to help them. We saw that there are clear risk assessments are in place for things like walking and showering. There are also records for annual reviews of peoples needs and the services they receive, which are carried out by the placing authorities. Care Homes for Adults (18-65 years) Page 22 of 37 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. People enjoy a range of activities and their privacy and dignity is maintained by knowledgeable staff. Evidence: Information we had before we visited shows that the booking system allows people to choose to stay at the same time as friends, or at the same time as people with similar needs. People told us through surveys that there is a very nice atmosphere in the house, and they made comments like everything done to make my stay enjoyable, and its like home from home, excellent. We saw that activities that people take part in are recorded each day. Records show that people enjoy things like trips out to Skegness, bowling, walks, shopping, and games of pool. We also saw people going out to local markets, watching videos of their choice, reading books, and generally socialising. Care plans do not directly refer to how peoples privacy and dignity should be maintained, Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: but we saw staff closing doors to rooms where personal care was being supported, talking to people in private about personal needs, and addressing people by their preferred names. Staff told us that they have enough support and information about how to make sure that they can meet peoples differing needs. Information we had before we visited showed that people are offered a varied and healthy diet. Although there are no set menus in place, staff described to us how they offer people a choice of foods each day, and if people cannot make a choice they use the care plans to make sure they have the foods that they like and need. The food that people eat each day is recorded in the staff handover book, but we saw that this is not done in a consistent way. During the visit we saw staff helping people to make a choice of what they wanted to eat, and helping them to be a part of the preparation process. Care Homes for Adults (18-65 years) Page 24 of 37 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory systems are in place to ensure that peoples health and personal care needs are met. Evidence: Information we had before we visited showed that people are supported to access their usual healthcare support networks such as GPs and dentists, whenever they stay at the home. Care plans contain information about their health needs such as epilepsy. Equipment such as hoists, specialist baths, and specialist beds are available for people who may need them. Records show that staff are trained in how to move people safely and use equipment, and staff confirmed this when we spoke to them. Information we already had told us that there is a policy about how to manage medication in the right way, and staff are trained in how to give people their medication in a safe way. Staff confirmed this when we spoke to them. We did not see anyone being given their medication, however we saw that medication administration was signed for in the right way, and the medication was stored in a locked cabinet. One person did not have clear guidelines about how to give medication which is only used in an emergency. The manager made sure that the guidelines were written Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: before the end of our visit. Care Homes for Adults (18-65 years) Page 26 of 37 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. People are protected by clear systems and policies, and knowledgeable staff. Evidence: People and their familys told us through surveys that they know who to speak to if they are not happy, and they know how to make a complaint. They said that staff and the manager always listen to them and act on what they have to say. Records show that there have been two complaints made to the service since they opened. Both were managed in the right way and action plans were put into place to reduce the likelihood of the situations happening again. We saw that there is a clear policy about how to manage complaints, which is available in alternative communication formats. Staff told us through surveys and by talking to them, that they know what to do is someone makes a complaint, and they also demonstrated that they know what to do if they see or suspect that someone is at risk of being harmed. We know that there have not been any alerts made to the Local Authority Safeguarding Adults team since the service opened. During the visit we looked at how staff support people to use their personal money. We saw that there were clear records kept for all the money that people spend while they are staying at the home, and their is a clear policy in place to support staff with this. Care Homes for Adults (18-65 years) Page 27 of 37 Evidence: Care Homes for Adults (18-65 years) Page 28 of 37 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. People enjoy a comfortable and clean environment. Evidence: The home was very clean and tidy when we visited, and all of the furniture and decoration was in a good state of repair. People told us through surveys that the home is always fresh and clean. Each bedroom has an en-suite facility. There are two lounges, a dinning area, and a large garden with a patio and lawn area. We saw that there was only enough room in the main lounge to comfortably accommodate one person who uses a wheelchair, at a time. Surveys from people and their familys showed us, and staff told us that they thought this room could be more spacious to accommodate more people who use wheelchairs. The manager told us that as this is a new building, repairs and maintenance are still the responsibility of the people who built it. Staff said that they report when things need repairing but this can take a long time to get done. They said that a lot of appliances do not always work. We saw that all of the hot taps in the building are temperature controlled, and there is a system for checking that the water remains at a safe temperature. Care Homes for Adults (18-65 years) Page 29 of 37 Evidence: We saw that substances which could cause harm to people are locked away, and there are information sheets available to show staff how to use them safely. We also saw that staff know how to lessen the risk of spreading infection by using things like aprons, gloves, and hand washing techniques, in the right way. Care Homes for Adults (18-65 years) Page 30 of 37 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. People benefit from a well trained and safely recruited staff team. Evidence: Staff told us through surveys and by talking to them that they went through a thorough recruitment process, and their files show that things like application forms, written references, and criminal record bureau checks were obtained before they started work. We know that there is a system in place to supervise and support staff in an individual way. Records show that staff have regular supervision with the manager, and they confirmed this when we spoke to them. All of the staff are supervised by the manager at present, and records show that she has been trained to carry out this role. Staff told us that they received a good induction when they started work at the home, and the on-going training they receive helps them to understand peoples needs and keep up to date. Records show that induction training is based on nationally recognised programmes, which are relevant to the needs of the people who use the service. The programme includes information about record keeping, and moving and handling. On-going training records show that staff learn about things like how to keep people safe, helping people to make decisions, epilepsy support, autism support, and how to administer medication Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: safely. The duty rotas in the home show that the numbers of staff on duty are flexible depending on the needs and numbers of people staying in the home at the time. We know that the last report from the local fire service said that the home must review the staffing levels, especially on night shifts, so that people remain safe. The manager said that they have done this, and some people have risk assessments in place to show the staffing levels that are required. Care Homes for Adults (18-65 years) Page 32 of 37 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 appropriately managed, and there are systems in place to promote peoples health, safety and welfare. Evidence: The current manager has been in post since March 2010. Our records show that she has applied to register with us. She has 20 years experience working in the care sector, and has qualifications in care and management. She also holds qualifications in information technology, and is trained to teach care workers how to manage aggressive behaviours. Staff said that she is a good manager, who is supportive, listens to everyones views, and makes people feel part of the team. We know that there are comprehensive policies and procedures in place, and we saw that the provider organisation carries out an audit every year to make sure that staff are following them. Information we had before we visited showed that the provider organisation is about to begin using a computer based tool to help them to monitor outcomes for the people who use the service. The manager said that the home carries out informal audits of things like care plans and Care Homes for Adults (18-65 years) Page 33 of 37 Evidence: medication records but there were no written reports to confirm this. The manager said that she would make sure that records are kept for all of the audits carried out in the home. We saw reports to show that every month a representative of the provider organisation visits the home and looks at the quality of things like general record keeping, the condition of the building and furniture, staffing levels and supervision records, health and safety records, and peoples individual files. General risk assessments are in place for things like falls, harmful substances, and water temperatures. The manager said that further assessments are in the process of being completed. We saw that fire safety records were up to date, and staff fire training is recorded. The manager said that random fire drills are being arranged. Care Homes for Adults (18-65 years) Page 34 of 37 Are there any outstanding requirements from the last inspection? Yes  No  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 Adults (18-65 years) Page 35 of 37 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 Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 It is recommended that more detail about how to provide support is recorded in peoples care plans for things like epilepsy and moving and handling. This is so that people continue to have all of their care needs met in an appropriate way. It is recommended that written records are kept to show that audits have taken place for things such as medication administration records and care plans. This is so that the quality of the service provided to people can be more effectively monitored. 2 39 Care Homes for Adults (18-65 years) Page 36 of 37 Helpline: Telephone: 03000 616161 or 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 37 of 37 - 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!