Care Home: Rosemount Care Home Limited

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What the care home does well Staff were observed to be kind and attentive to the people living at the home. Positive comments were received in all of the completed comment cards and from staff and people living at the home about the care given. One comment was `the staff are very good and kind, I am very happy here`. All of the comment cards from people living at the home indicated that they always receive the care and support they need and that staff listen and act on what you say. The atmosphere in the home felt calm and relaxing. One member of staff said `we are a small team but very caring`. The manager and staff spoken to had a good knowledge of people`s individual needs and personal preferences. Staff and people spoken to said that where possible people are encouraged to make their own choices around their day-to-day lives. People have an assessment of their needs before being admitted to the home to make sure that all of their needs can be met and people are encouraged to come and visit the home before making a decision to move in. People living at the home who were spoken to were all complementary about the quality, quantity and choice of food provided. All of the comment cards from people living a the home indicated that they always liked the food provided. There are daily activities that vary from a choice of in house activities based on what people want to do that day to a monthly entertainer. One person spoken to said she was never bored as there was something going on every day. Staff spoken to said that the manager and the staff team were very supportive of each other and there was plenty of training. All of the people living at the home knew the manager and said if they had any problems they would talk to him and he `would sort it out for them`. What has improved since the last inspection? Since the last inspection visit all of the individual plans of care have been reviewed and rewritten. They contained details of peoples care needs and their individual preferences around their day to day lives. The management of medicines has improved so people living at the home can be confident they will receive their medicines as prescribed. Several bedrooms and the first floor corridors have been redecorated and some new carpets have been fitted. A new walk in shower has been fitted in the upstairs shower room and an assisted bath has been fitted in the ground floor bathroom. A ramp has been fitted so that there is now easy access to the garden area for people who are less mobile. What the care home could do better: No requirements were made during this visit. Key inspection report Care homes for older people Name: Address: Rosemount Care Home Limited 133 Cheadle Old Road Edgeley Stockport Cheshire SK3 9RH     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: Geraldine Blow     Date: 2 9 0 9 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) © 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 Older People Page 3 of 27 Information about the care home Name of care home: Address: Rosemount Care Home Limited 133 Cheadle Old Road Edgeley Stockport Cheshire SK3 9RH 01614771572 01614803320 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rosemount Care Home Ltd care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home is registered for a maximum of 17 service users to include: *up to 17 service users in the category of OP (Old age not falling within any other category). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home Rosemount Care Home is a detached residence in its own grounds, situated in Edgeley, Stockport. Rosemount is registered to provide accommodation for up to 17 older people. Rosemount has a lounge, which adjoins a smaller lounge. There are four steps leading from the lounge to the dining room. Handrails are provided to both sides of the steps. There is a stair lift for people to access the first floor of the home. Care Homes for Older People Page 4 of 27 Over 65 17 0 2 4 0 9 2 0 0 8 Brief description of the care home Bedroom accommodation is provided on two floors. The Care Quality Commission inspection report is available in the main reception and the homes own website for people to access. The fees for staying at the home were reported to be between 342 pounds and 365 pounds per week. 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: This report is based on information gathered by the Care Quality Commission (CQC) since the last inspection visit on 24 September 2008 and supporting information received in the Annual Quality Assurance Assessment (AQAA) submitted prior to this visit. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Some people living at the home were sent comments cards so that we could get their views on how the home is run. We received four completed comment cards and some of the comments are included in the body of the report. This visit was unannounced, which means that the manager and staff were not told that we would be visiting. The visit took place on Tuesday 29 September 2009. This report is an overview of what we found during the visit. Care Homes for Older People Page 6 of 27 References to we or us in this report represent the CQC. As part of the visit we spent time examining relevant documents and files. We also spent time talking with several people living at the home and some members of staff. We also walked round the home and looked at the communal areas and some bedrooms. Feedback was given to the manager during the course of the visit. 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: No requirements were made during this visit. Care Homes for Older People Page 8 of 27 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. People moving into the home are given information about the home and have their needs assessed so they will know if their needs can be met there. Evidence: The completed AQAA identified and the manager confirmed that admissions to the home are made after a pre admission assessment of the persons needs has been undertaken, to ensure that those needs can be met. In addition to the homes own assessment they also receive information from the care managers assessment of the placing authority. Evidence was seen of the assessments undertaken by the manager on the care files looked at during this visit. The AQAA and the manager confirmed that people are welcome to visit the home, have a cup of tea, a meal or stay over before making a decision to move in. A trial period is offered to allow people to adapt to their new environment and to decide whether the home suits their needs. Care Homes for Older People Page 11 of 27 Evidence: A copy of the Service User Guide is given to all people thinking of moving into Rosemount and their relatives. The home has their own website for people to access if they so wish. All of the returned comment cards indicated that they had received enough information before deciding if they wanted to live at the home. Rousemount does not provide an intermediate care service although it does provide respite care. 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. The health, social and personal care needs of people were being met by staff who respected their privacy and dignity. Evidence: Since the last inspection visit all the care plans have been reviewed and a new format has been implemented. They were filed in order and easy to follow. The care plans were all typed so that they were east to follow. The plans of care were seen to contain details of peoples care needs, personal choices and preferences. For example the files looked at contained information about preferred places to eat meals and who they liked to sit with, what clothes people liked to wear and that one person enjoyed a glass of sherry in the evening. The plans of care clearly set out how the persons individual, identified needs should be met by the staff delivering the care. We saw that regular reviews of the care plans were being carried out. This means that when peoples needs change this is identified and a new care plan is put in place. This makes sure that the person receives the right level of support. Care Homes for Older People Page 13 of 27 Evidence: Appropriate risk assessments had been undertaken and regularly reviewed to ensure that any identified risks are minimised. There was no formal assessment for oral hygiene needs. To ensure that peoples needs are appropriately met it is recommended that an oral assessment is undertaken on admission and then any specific care needs are incorporated into the care plan. People spoken to during the visit were complimentary about the staff and the care received. Staff were seen to be kind and patient when helping people. They seemed to have good relationships and had a good knowledge of peoples needs and personal preferences. We examined the records and stocks of medication to make sure that people were getting their medication as prescribed by their GP. Evidence was seen that the GPs original prescription comes to home and copies were taken so that it could be checked that the medication received from the pharmacy is the same as was prescribed. We saw that they kept a record of any medication received into the home. They had lockable trolleys to store peoples medication and a system of recording the disposal of unused medication. We looked at the medication administration record sheets. We saw that that there were photographs of each person to reduce the risk of giving a person the wrong medication. There were no gaps in recording and we saw that the manager undertakes regular audits to ensure that people are receiving their medication as intended by their GP. Staff and people living at the home confirmed that people were treated with respect and dignity and that their care needs were met. Staff were observed to approach people with respect, encouraged choice and helped to maintain peoples dignity. We saw staff knocking on peoples bedroom doors and waiting to be invited in. Comments received in the completed comment cards included that the staff give me care and attention and listen to me, this is a friendly home where people get to know each other and the staff are lovely. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were a range of activities on offer and people were offered a varied and balanced diet. Evidence: On admission to the home a social history was taken which includes peoples hobbies, interests and religious beliefs. A plan of care is developed for social and recreational needs and one for religious needs. In house activities are provided every afternoon based on what people would like to do on that particular day. Some examples are singing, exercises, skittles, magnetic darts, watching a film or going to the pub. Once a month an entertainer is booked and birthdays and festivals are celebrated. Relatives and friends are encouraged to join in. There is a service and communion every Sunday which many people said they enjoyed. People spoken to said that they enjoyed the activities and the returned comment cards indicated that activities were arranged by the home. The home accesses the use of a mobile library as two people specifically like to spend time reading books. The library also offers talking books as well as DVD films. Care Homes for Older People Page 15 of 27 Evidence: We were told that the home is ready for the digital switch over on 4 November 2009 so there will not be any disruption for people. A copy of the menus was seen. The meals were varied and nutritionally balanced. There were various alternatives to the main meals provided on a daily basis and we were we saw that everybody is asked in the morning what meal they would like that day. There were two choices of the main meal or a choice of various salads at lunch time. There was a daily menu on display in the dining room as well as the menu for the whole week. The AQAA demonstrated and the manager confirmed that they can and have catered for particular dietary requirements such as diabetic, low fat or vegetarian meals. We were informed that the cook has experience in providing Indian Curries, Italian pastas and Halal food but at the moment people preferred traditional English cooking. Nutritional risk assessments had been undertaken on a regular basis to ensure that people were not at risk of malnutrition and peoples weight was also monitored on a regular basis. People spoken all said that they could have drinks and snacks when they wanted and could eat their meals wherever they wanted. People living at the home and staff spoken to all confirmed that visitors were made welcome to the home and could visit whenever they liked. From speaking to people living at the home and staff it appeared that people were encouraged to exercise choice and control over their lives. One lady told us she liked to stay up until about 11pm and enjoyed a galss of white wine before going to bed. The care plans documented peoples personal preferences around their day to day lives and people were free to access their rooms or any of the communal areas without restriction. The manager has recently completed Deprivation of Liberty Safeguard training (DoLS), which came into force on 1 April 2009 and forms part of the Mental Capacity Act. It was his intention to access training for staff. A booklet was available in the main reception for people to access. 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. There were policies and procedures in place to safeguard people from harm and people are encouraged to express any concerns. Evidence: There was a complaint procedure on display in the main reception, there was one in everybodys bedroom and it is also included in the Service User Guide which everybody is given on admission to the home. This is to ensure that people are made aware of how to make a complaint or raise any concerns. The manager documents all complaints and has a system to monitor them on a monthly basis. No complaints had been made since the last inspection visit. The manager also recorded any concerns or informal complaints and a conclusion to the issues raised. It was seen that concerns are addressed promptly and in the best interests of the person. The manager was very visible and everybody living at the home knew who he was and said how nice he was. He told us that he encourages people to raise any concerns they may have straight away. All of the returned comment cards indicated that people knew how to make a complaint or who to speak to if they were not happy. People spoken to during the visit said they would talk to Ken the manager if they had any problems. One person said that she had never wanted to make a complaint because she was very happy but Ken would sort out any problems for her if she had any. Care Homes for Older People Page 17 of 27 Evidence: There was a copy of the Stockpot All Agencies Safeguarding Adults policy that was available for all staff to access if an allegation of abuse was made. Staff spoken to were able to correctly describe the actions to be taken if an allegation of abuse was made. Records indicated that all staff had received safeguarding adults training and this was confirmed by staff spoken to. 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. A clean and comfortable environment is provided at Rosemount. Evidence: Rosemount is a family run home which provides a friendly, homely environment. Evidence was seen of ongoing maintenance and improvements to the decor and furnishings of the home, some of which are already detailed in this report. During this visit a tour of the building was undertaken which included the communal areas and peoples bedrooms. The home was clean and tidy and people spoken to said that the home was always kept clean. All of the returned comments cards indicated that they thought the home was always clean and fresh. People were seen reading with staff, watching television, or just relaxing in the lounge. One person who was sat in her bedroom told us I have got a new slim television and I can watch it whenever I want to. We saw a sample of bedrooms. We saw that people had brought some of their own belongings from home. This means that people were surrounded by familiar things. There was a well maintained garden area and a sensory garden has been created for people to enjoy in the nice weather. Care Homes for Older People Page 19 of 27 Evidence: We saw that they had the appropriate aids and adaptations available to assist in moving people safely. These included a hoist and adapted bathing facilities. We saw that staff were given manual handling training, which means that they knew the correct way to operate equipment and safely help to transfer people. There were detailed policies and procedures around infection control. We saw that they have received an award from Stepping HIll NHS Trust following an audit undertaken by the infection control team. 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. People receive care and support from staff they like and who have the skills to support them correctly. Evidence: At the time of this visit 11 people were accommodated and from looking at the rota and observations during the visit we saw that there were enough staff on duty to meet peoples needs. The manager confirmed that 8 care staff are employed. Five care staff had successfully completed National Vocational Qualification (NVQ) Level 2 or above and one member of care staff was in the process of applying to undertake NVQ Level 3. We saw a sample of staff files to check the required documentation was in place and the necessary checks had been made. We saw that each person has to fill in an application form. We saw that they have to give two references so that the manager can check their suitability for the job with previous employers. We saw that they had a Criminal Records Bureau (CRB) check and that a check against the Protection of Vulnerable Adults list (POVA) had been made before staff started work. This is to make sure that all staff are safe to work with vulnerable people. In two Of the files looked at a POVA first check had been obtained and they were working under supervision until a clear CRB has been obtained. Care Homes for Older People Page 21 of 27 Evidence: In two of the files looked there was no proof of address. The manager stated that proof of address had been submitted for the CRB application but made assurances that he would obtain them as soon as possible. The files looked at contained some photocopied documents but they were not signed or dated to show that the original had been seen. There was no contract in two of the files looked at. The manager explained that they were working on a trial period, under supervision until a clear CRB had been obtained . Then if the CRB was clear and they were happy to take up the post a contract is issued. There is a structured, Skills for Care, induction in place that the manager said all new staff have to complete. The manager was waiting for the updated format from Skills for Care. There was an up to date training matrix in place and certificates were seen on the staff files looked at. Training was accessed from the City Councils Adult Social care Service or in house DVDs. The manager who is a Registered general Nurse (RGN) undertakes the in house training. On completion of the DVD staff must complete a competency questionnaire to ensure they have understood the training and are competent. 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. The home is managed in the best interests of the people who live there. Evidence: We spoke to staff who said that the manager was always available and was very supportive. The manager regularly worked alongside staff which enabled him to monitor staff practice and be aware of peoples individual needs and personalities. The home does not have the responsibility for managing peoples finances. However they did hold small amounts of money given to them for safe keeping from peoples relatives or advocates. There were systems in place for managing this money. Receipts were not routinely given to relatives or advocates when the money was given to the home. We saw that there was a quality assurance system in place to get peoples views about the care they received. They told us that questionnaires were sent out to people living at the home, their friends or relatives and visiting professionals. Care Homes for Older People Page 23 of 27 Evidence: The manager who is also the owner of the home has a number of years experience in running a care service. We saw that the manager is a RGN and has the registered managers award. This means that he has the skills, knowledge and experience needed to run a care service. They told us in the Annual Quality Assurance Assessment (AQAA) that maintenance records were up to date. Fire safety checks were looked at and found to be up to date. This means that the home is safe for people to live in. 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 To ensure that peoples needs are appropriately met it is recommended that an oral assessment is undertaken on admission and then any specific care needs are incorporated into the care plan. It is recommended that proof of address is kept on staff files. It is recommended that a receipt is given when any money is received by the home for safe keeping. 2 3 29 35 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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