Care Home: Holmside

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What the care home does well There are good arrangements in place for people who live at the home to maintain contact with their family and friends. There are opportunities for people living at the home to visit the community for outings. There is a varied programme of activities for people living at the home to take part in if they wish. The home is well decorated and comfortably furnished for the benefit of people living at the home. The home offers prospective residents whatever length of time they need to decide if they wish to live at the home. Detailed information is collected about a new resident to ensure staff can provide the necessary levels of care and support to the person. Residents have the opportunity to pursue their religion if they wish to. People living at the home enjoy home cooking and a varied diet. Residents are treated with dignity and respect. People living at the home receive a high standard of care and support from staff. There is a good standard of record keeping at the home. There is a very good level of staff training to help ensure staff are aware of the different needs of people living at the home. What has improved since the last inspection? There is an ongoing programme of decoration and refurbishment around the home. All the care needs of people living at the home are reviewed on a regular basis. The home is continuing to find ways of involving people with memory loss in decision making in their daily living. The management structure has been strengthened, a deputy manager`s post has been created. An activities co-ordinator has been appointed to organize social activities with people living at the home. What the care home could do better: Care records should contain details of how to work with people whose behaviour may be challenging or difficult to work with. "Best interest" decisions should be recorded on the care files of people who live at the home as required. Key inspection report Care homes for older people Name: Address: Holmside Station Road Bedlington Northumberland NE22 5PP     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: Karena Reed     Date: 2 1 0 7 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 27 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 27 Information about the care home Name of care home: Address: Holmside Station Road Bedlington Northumberland NE22 5PP 01670530100 01670530100 holmsidenorth@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr M Chawla,Mr K K Kholi care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 30 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 categories: Old age, not falling within any other category - Code OP, maximum number of places 30, Dementia - Code DE, maximum number of places 30 Date of last inspection Brief description of the care home Holmside is a care home registered to provide personal care to thirty residents. Categories of registration include twenty-three places for older people over the age of sixty- five years and seven places for people with memory loss over sixty-five years of age. The home does not provide nursing care. The home is situated in a residential area in Bedlington and is on a bus route. It is close to local shops, pubs and the town centre. The home consists of a large detached house with a garden. All bedrooms are for single occupancy. Bedrooms are available on the ground floor and first floor of the Care Homes for Older People Page 4 of 27 Over 65 0 30 30 0 Brief description of the care home building, a passenger lift is also available to the first floor. There is a very large lounge and combined dining room. There are some assisted bathrooms and lavatories equipped with specialist equipment for the use of residents. A Statement of Purpose and service user guide are available at the home for residents who are interested in coming to live at the home. The guides describe the services and facilities provided by the home and how staff are trained to meet service users care and support needs. CSCI Inspection reports are also available at the home detailing the quality of care provided by the home. Fees payable for living at the home at the time of inspection in July 2009 vary between 449.90 and 454.90 per week. Additional charges are payable for hairdressing, private chiropody, personal toiletries and newspapers. Care Homes for Older People Page 5 of 27 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 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: The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements,to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations,but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit: We looked at information we have received since the last inspection in July 2007, how Care Homes for Older People Page 6 of 27 the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people and the views of people who use the service and their relatives, staff and other professionals. The Visit: An unannounced visit was made on July 21st 2009. During the visit we talked with people who use the service and staff. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building to make sure it was clean,safe and comfortable and checked what improvements had been made since the last visit. We told the the manager what we found. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Care records should contain details of how to work with people whose behaviour may be challenging or difficult to work with. Care Homes for Older People Page 8 of 27 Best interest decisions should be recorded on the care files of people who live at the home as required. 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 9 of 27 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 10 of 27 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. There are good procedures in place to ensure that prospective residents are making an informed choice about living at the home. Very good arrangements are also in place for assessing the needs of people before they are admitted into the home. Evidence: The homes Statement of Purpose and service user guide were examined.They have been reviewed and up dated since the last inspection. They were interesting and informative and contained the necessary information as required by the Care Homes Regulations 2001. In surveys received, people who live at the home and their relatives felt that they got enough information from the home and other agencies to make a decision about whether to use this home. Records for four people who live at the home showed that when they were admitted to the home an assessment of their care needs had been carried out before their admission. A copy of the social services assessment and care plan for each person had Care Homes for Older People Page 11 of 27 Evidence: been obtained before they moved into the home. The home also carries out its own pre-admission assessment to ensure that it can meet each individuals needs.The person living at the home and relevant people are involved in the assessment. The homes assessment form encourages staff to explore issues relating to equality and diversity as it refers to gender, culture, religion and spiritual preferences. It also looks at mood, speech, behaviour, mental health and risks.This provides staff with the information they need to safely care for people living at Holmside. The home recognises and promotes the equality and diversity of people living at the home.The homes self assessment,(AQAA) stated:We ensure all staff are trained to recognise and respond to individual residents.Evaluate on regular basis residents plan of care to ensure Equality And Diversity is being met. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A prospective resident may come for meals, have overnight stays and be introduced to other people who live at the home at a pace suitable to the individual. Care Homes for Older People Page 12 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements in place to ensure the health and personal care needs of people living at the home are met by staff. Evidence: After a person has moved into the home a care plan is designed around their assessed needs so that staff know how to provide the right amount of support. The homes AQAA stated: There are detailed assessments in residents care plans, which gives clear instructions to staff on how to support residents. Residents care plans show they have regular access to external health care services. Separate care plans detail the night time needs of people living at the home. Care plans cover areas such as continence, personal hygiene, mental health and social care needs. One of the care records looked at did not record advice on how to work with a person with challenging behaviour. The sample of care plans examined were written in a respectful way that promotes the individuality and dignity of the person living at the home.The sample showed that all care plans had been evaluated regularly by the homes management team. Care Homes for Older People Page 13 of 27 Evidence: Records were in place to show how the medical and nutritional needs of people living at the home were being met. Residents care plans recorded information about their social and leisure needs. Comments from people living at the home include:Holmside takes care of all residents needs and gives family support when needed. I am cared for always. They look after me very well at all times. The staff provide care that the residents need. Holmside caters for the comfort and well being of the people living at the home. Health care records were available on the files of residents to show they are supported to have access to health care services such as GPs, dentists, district nurses and continence advisors. Risk assessments are in place for residents covering areas such as health care including prevention of falls, continence and nutrition. Moving and handling assessments have also been carried out to show the moving and handling needs of more dependent residents. A health care professional commented:Staff display good manual handling skills. Technical aids and equipment are available for people who are unable to move independently. The home has a medication policy that is available for staff to read. All medication is stored in an appropriate locked cabinet to which only senior staff have access. Records covering the administration and disposal of medication are kept. The records examined were satisfactory. All staff administering medication have received accredited training. Staff are polite, respectful and courteous to people in their care. Care Homes for Older People Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have very good opportunities to make choices about activities and daily routines so that they may lead a lifestyle that matches their social care needs. Evidence: There are various areas around the home where people living at the home can sit and meet. Since the last inspection a part time activities organizer has been employed by the home to work 20 hours per week, usually from 11:00am to 3:00pm,although this is flexible if people are out on day trips. There is a varied programme of activities available for people living at the home, which include:videos, sing-a-long, manicurist, dominoes, quizzes, religious services, hairdressing, memory skills, massage, board games, bowls, painting, reminiscence, exercise, song and dance, movies, baking, family visits,arts and crafts,gardening, armchair aerobics, bingo and dominoes. Various seasonal parties are arranged which are supported by relatives. Residents enjoy sitting in the large well- tended garden when the weather is suitable. People living at the home are involved in a gardening project growing fruit and vegetables for the use of the home similar to during the war years and the land army. Entertainment is also provided in the home by choirs for Care Homes for Older People Page 15 of 27 Evidence: example and there is also other seasonal entertainment. The homes AQAA stated people living at the home have the opportunity to go out with relatives and staff. Small groups of residents go out on trips to the town centre, to the coast, for an ice cream and for meals out.Outings are also arranged by the home to garden centres and whatever is of interest to the resident. Residents were very positive about the activities provided. Comments include:There is plenty of entertainment for residents. Staff also support people living at the home to keep in touch with relatives. Staff ask each resident about their wishes,interests and choices. Training has taken place for the staff team about memory loss. This training should help ensure residents are given more choice in order to keep some control in their lives. Staff training has taken place about how to implement the Mental Capacity Act. Senior staff will look at what choices and decisions each person with memory loss is able to make for themselves. The cook talks with the residents to collect up to date ideas for making the menus and finding out about the food likes and dislikes of residents. At least two hot meals are provided daily and an alternative is available. Residents were very positive about the food. On the day of inspection lunch was steak and vegetable pie or sausage casserole with seasonal vegetables followed by apple crumble and cream. Comments from people living at the home include: There is good home cooking. There is good food. Care Homes for Older People Page 16 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear,complaints and protection system,which helps to protect people who live at the home. Evidence: The homes complaints procedure is given to new people as they move into the home. The procedure assists and supports them and their relatives to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within the home. There is a complaints procedure on display within the home for the use of residents and their relatives. The home keeps a record of complaints.There have been no complaints received and investigated by the home since the last inspection. There have been no safe guarding incidents reported or investigated since the last inspection. Surveys returned stated people living at the home knew how to complain if they needed to. The home has a copy of the local authorities Vulnerable Adults procedure. This provides staff with clear guidance on how to deal with adult protection concerns. Care Homes for Older People Page 17 of 27 Evidence: Staff have received training about Protection of Vulnerable Adults, the local authority multi-agency training. Staff have also received training about behaviour that may be difficult to work with,this should help them understand the different support needs of individuals. Staff have received training about dementia care to give them more insight into the needs of people with memory loss. Care Homes for Older People Page 18 of 27 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. The home provides a comfortable and safe environment for those living there. Evidence: The home is accessible and placed in the centre of a local community near Bedlington town centre.There are some shops and pubs quite nearby. The home is very near to a bus route with a bus stop almost outside of the home. There is an ongoing programme of decoration and refurbishment around the home. Since the last inspection the communal areas and some bedrooms have been decorated. Dining room furniture and lounge chairs have been replaced. Some bedroom carpets have been replaced. Blinds have been placed in some communal areas of the home. The boiler has been replaced. A new microwave has been purchased. Furniture and fittings were domestic in design and the home was well decorated and comfortably furnished. The home has an appropriate amount of sitting, recreational and dining space. All people living at the home have their own bedroom. The rooms were comfortable and personalized with some of their own belongings and small pieces of furniture. Care Homes for Older People Page 19 of 27 Evidence: The home is clean, well maintained and has a very good standard of hygiene. Staff have received training about infection control which helps to reduce the spread of infection within the home. Comments from people living at the home include: The rooms are well heated,hazard free and clean. The home provides a clean,safe and warm environment. The laundry room was seen and was appropriately equipped for the size of the home. Care Homes for Older People Page 20 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff for the occupancy levels of the home. They are appropriately recruited, and well trained to meet the needs of the people living at the home. Evidence: Examination of staff rosters and discussion with the manager and members of the staff team showed that staff numbers are as follows: 6 carers including 1 senior 7:30am - 3:00pm 4 carers including 1 senior 3:00pm- 10:00pm 2 carers 10:00pm- 8:00am These numbers do not include the manager. There is a senior staff member on each shift when the manager is not on duty. A full time deputy managers post has been created to assist the manager in the day to day running of the home. Other members of staff are employed for duties such as cleaning,maintenance and Care Homes for Older People Page 21 of 27 Evidence: food preparation. A sample of staff files were examined.The necessary checks are carried out before a person is appointed to work at the home. Two written references were available on staff files examined. An application form had been completed for each staff member. Employment histories were available. CRB checks are carried out before a person is appointed. Staff photographs were available on staff files examined. There is a very good level of staff training. 13 carers have achieved a National Vocational Qualification(NVQ) at level 2 and 2 staff members are still completing it. 7 staff members are studying or have achieved level 3 NVQ. Comments from staff include: There is good up take of NVQ and training for staff. Staff have received the necessary statutory training and developmental training to ensure staff can meet the specialist needs of people with memory loss. Training carried out includes: infection control, moving and handling, first aid, health and safety, food hygiene, continence, bereavement, end of life- palliative care, safe handling of medication, care planning, falls awareness, equality and diversity, deprivation of liberty, hearing impairment awareness, safe guarding, challenging behaviour, Parkinsons disease and Mental Capacity. People living at the home and their relatives were very complimentary about the staff team. Comments include: Staff are always pleasant,helpful and respectful towards both clients and professionals. They are knowledgeable and will seek information if need be but usually have information to hand. Care Homes for Older People Page 22 of 27 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. People are living in a home that is well run,and run in their interests, and where the welfare of all is promoted. Evidence: The manager has the relevant qualifications for managing the home. The home is well run and there is an ethos of involving staff and residents in the running of the home. The homes self assessment,(AQAA) was well completed and showed that the management team was aware of the need for any further improvements and identified how these would be achieved in the following twelve months. Residents are involved in decision making in their daily living and again the homes AQAA stated that there were further plans to involve people who may not communicate their needs verbally. Staff meetings take place monthly. Residents meetings take place monthly. Supervisions take place every two months with each staff member,as well as an annual appraisal when staff will help identify their training needs. Care Homes for Older People Page 23 of 27 Evidence: Comments include: There is a friendly activity co-ordinator, staff and manager. There is good communication within the home. There was a very good standard of record keeping and documents detailing fire safety and other statutory records were all up to date. Periodic fire checks are carried out and fire instruction for staff take place within the necessary time scales. Maintenance certificates were checked for the gas heating system, internal wiring of the building, small portable appliances, moving and handling equipment, fire appliances and passenger lift. All were in order. The financial records recording the details of any personal monies held for people living at the home were appropriately recorded. Lockable facilities are available for residents to keep their own money if they wish. Staff training relating to health and safety was up to date. Appropriate records are maintained of accidents and incidents. Care Homes for Older People Page 24 of 27 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 25 of 27 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 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 7 Care plans should contain details of how to provide the care and support to people with needs that may be challenging to work with. Best interest decisions should be recorded on the care files of people who live at the home as required. 2 14 Care Homes for Older People Page 26 of 27 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. 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