Care Home: Stanecroft

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What the care home does well Stanecroft provides a friendly,calm and homely atmosphere for service users and the quality of the environment is being improved upon. Pre admission procedures are thorough and service users are only admitted if the home can meet their assessed needs. Care plans are completed to a good standard and the home is working towards person centred plans. Safeguarding procedures are thorough. Staff are well trained and familiar with the needs of service users,no agency staff are used and staff say they are well supported. The home is efficiently managed and there are clear plans in place for the development of the service. What has improved since the last inspection? Pre admission documentation and the assessment and introduction to the home process are more thorough,this ensures that service users only move in if their needs can be met. Work has started on making care plans person centred. Falls are being monitored and documented. A full time activities coordinator is in post and a new programme of activities is being started. A bi monthly newsletter has been started that is sent out to relatives. Redecoration and refurbishment of some units and communal areas has taken place and decking has been fitted outside one unit.Each unit has a new bath and the garden has been improved. No agency staff are being used and more staff have gained an NVQ in care. Staff training is being improved upon and staff recruitment records for new staff include full employment histories. What the care home could do better: The organisational safeguarding vulnerable adults procedure should be reviewed to make it clearer and more user friendly for staff to use. The laundry floor needs replacing and areas of flooring and pipework casing on Beech unit need to be repaired and repainted. Areas of the home including units that have so far not been redecorated are rather tired looking and the plan in place for environmental improvements should be continued so that service users on all the units have access to the same quality of accomodation. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stanecroft Spook Hill North Holmwood Dorking Surrey RH5 4EG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Deborah Sullivan     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Stanecroft Spook Hill North Holmwood Dorking Surrey RH5 4EG 01306876567 01306886827 manager.stanecroft@careuk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care UK Community Partnerships Ltd Name of registered manager (if applicable) Jennifer Frances Sharman Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 50 The registered person may provide the following category/ies of service only: Care home only - 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 - OP Dementia - DE Physical disability - PD Date of last inspection Brief description of the care home Stanecroft is a large care home for older people with Dementia situated in North Holmwood in Dorking. The home is on one level and divided into 5 units each running individually to maintain the sense of group living. Each unit has its own kitchenette, Care Homes for Older People Page 4 of 27 care home 50 Over 65 0 50 0 50 0 50 Brief description of the care home dining and lounge areas together with toilet and bathing facilities. The home is generally well maintained and bright. Stanecroft is run by Care U.K. Partnerships Ltd who also run similar establishments in various parts of the country. 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: three star excellent 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 unnanounced key inspection took place over five hours,during the visit a range of records and documents were inspected, including pre admission information,care plans,staff files,training information and complaints recording. The registered manager assisted with the inspection process throughout the visit and time was spent with care staff and service users. Evidence gained from the Annual Quality Assurance Assessment document (AQAA) that registered services are required to complete annually, and survey forms completed by service users,staff and a health professional have also been used during this inspection process. Staff and service users were helpful in providing information to assist the inspection during the day. Care Homes for Older People Page 6 of 27 The last key inspection of Stanecroft took place on 18th January 2007 the home was rated as providing a good service as a result of the inspection. The current fee range for the service is from seven hundred and four pounds to four hundred and nine pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users and their representatives have access to information about the home and are encouraged to visit before making a decision about accepting a place. Each service users needs are fully assessed before a place is offered to ensure that their needs can be met. Evidence: The home has a statement of purpose and service users guide as well as a prospectus and a welcome pack.The information pack is given to each new service user and contains clear and comprehensive information about the service.Pictures and some photographs of the home are included in the information as well as information on the capacity of the home to meet cultural needs and on community contacts for a range of different beliefs. Care Homes for Older People Page 11 of 27 Evidence: At the time of the inspection the majority of the service users were local authority funded and there were some private service users. Each service user is fully assessed before they are offered a place at the home, on receipt of a referral the manager and a team leader or a team leader and a carer with experience visit the service user to undertake a comprehensive needs assessment. Assessment documentation and processes have been improved upon and prospective service users are encouraged to spend time at the home including staying for a few nights, so that they can experience what it is really like to live there and assessment can be done thoroughly.The home has worked with local authorities and hospitals to promote this process even though there can be pressure from hospitals for quick discharges. Relatives are also encouraged to visit.The home offers respite care and this can give a helpful introduction to full time admission. Within a three days of admission a settlement review takes place to assess how the service user is settling in,this process has recently been introduced and is being actioned with new service users. 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. Care plans are up to date and accurately reflect the health,personal care and social needs of service users. Policies and procedures are in place for the correct storage,administration and recording of administration and are monitored by the organisation. Evidence: Care plan information is held on computer with sections for the recording of all aspects of each persons health,personal and social needs. Core care plan information is printed off and held on each unit in case of systems failure and each unit has a work station where care staff can enter up to date information to the system.Care plan information was read on the system for a number of service users,work is underway to make care plans more person centred and as reviews take place this is evident in the recording.Daily recording is done on the system. Each service user has their needs reviewed regularly, changes are recorded and risk Care Homes for Older People Page 13 of 27 Evidence: assessments are undertaken.Each person has a keyworker. Weight and nutritional intake are monitored.Pre admission assessments include risk assessment information as well.A falls monitoring document has been introduced and as a result two service users have been referred to phsyiotherapy services and a possible need to review the medication of another has been identified. A local GP visits the home regularly and there is good support from District nurses,any health concerns are referred on to health professionals promptly. A survey form from a health professional stated that -There is always quick action if paramedics or a GP visit is required and that there was good communication with the social care team. A relative commented that the general health of their relative living at the home -Had improved since she came to Stanecroft. The privacy and dignity of service users is respected and their preferences are recorded,if a female service user prefers not to have male staff attend to their personal care this is adhered to as far as possible. Staff receive training in end of life care,as long as the home can meet needs with the help of external professionals where necessary, service users can choose to end their lives at the home.An employee whose relative recently passed away at the home said that their relative had always been very well cared for. Medication is stored correctly and an internal medication inspection had taken place the week before,the report was read and areas identified for improvement were being actioned.The manager said there will be a follow up compliance visit.MAR sheets seen were correctly completed and medication procedures are in place. 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. Service users have access to an increased range of activities and staff are aware of their personal interests. Contact with friends and relatives is maintained and promoted. Meals are healthy and nutritious with choice available. Evidence: The home had very recently appointed a full time activities coordinator having been without one for some time,staff have been providing some activities for service users whilst the post was vacant.The organiser had been working on a new activities programme soon to be implemented which includes music sessions,reminiscence,bingo,quizzes and walks.There is also a programme of special events planned such as coffee mornings,film sessions and a pancake evening.A singer entertains the service users weekly and is very popular.Outings are arranged and in good weather the large garden can be used for social events and activities.On the day of the inspection one service user went out for a walk,others were watching TV,reading or spending time in their rooms.Individual interests are recorded on care plans. A Care Homes for Older People Page 15 of 27 Evidence: hairdresser visits weekly and was at the home during the inspection,there is dedicated hairdressing room and it was well used during the day. Visits from friends and relatives are welcomed and relative stated on a survey form that they visited frequently and were always made welcome.There is a relatives support group and relatives are sent a bi monthly newsletter. The lunchtime meals are provided by a well established external meal provider,they are delivered to the main kitchen and then distributed to the individual units where they are heated and served.The manager had recently changed from another meal provider they had found unsatisfactory.The temperature of the food is checked before serving.The meal was beef stew and dumplings,potatoes and vegetables or a vegetable pie with a choice of two hot puddings.Lunch was observed on one unit and the meal looked appetising,portion size was good and staff were aware of preferences.One service user had bread and butter as they did not like vegetables.Service users spoken with said they were happy with the meals and one that meals had improved. Meals can be provided to meet cultural needs,one service user is regularly offered meals from their cultural background although currently prefers not to eat them,this is recorded on the care plan. Suppers and breakfasts are provided by the home on individual units. Menus are displayed on the units but need to be more accessible for service users,the manager stated they were working on providing pictorial and table top menu formats. The home promotes choice and service users are encouraged to maintain their independence and to make choices such what to do during the day,what to eat and how to have their rooms furnished and personalised. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from harm by the policies and procedures in place at the home which have been improved upon in order to provide further protection. Service users and staff have access to a complaints procedure and complaints are throughly investigated and addressed. Evidence: The home has a complaints procedure that is on display and included in information about the service.Four complaints have been recorded over the past year,the content of a recent one was read,the manager had addressed the issue appropriately.Concerns are also recorded. The Commission has not received any complaints or concerns about the home since the last inspection. There are safeguarding vulnerable adults and whistleblowing policies and procedures in place.There had been one safeguarding alert since the last visit that has been investigated and is closed.The home was not at fault although the manager said that the situation raised issues about how thorough some of the assessment and admission procedures and documentation were and these have been strengthened as a result.Staff have access to the Surrey Multi Agency Safeguarding Procedures.The internal safeguarding procedure is thorough whilst it is advised the organisation look at making it more user friendly for staff regarding pathways to follow when abuse is Care Homes for Older People Page 17 of 27 Evidence: suspected. All staff receive POVA training and a care staff member said they were aware of the procedure and would not hesitate to raise any concerns. The home facilitates access to advocacy if it is needed,the manager gave an example of a service user recently referred for advocacy in respect of their house sale. Service users are supported with voting if they wish to do so. 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. Service users live in an environment that is clean,comfortable,well maintained and homely. Individual space is personalised and rooms suit the needs of service users. Continued investment in improving the environment will be of benefit to service users especially in units not yet redecorated. Evidence: The home is purpose built and accomodation for service users is in five separate small units,shared areas are quiet spaces situated around the home and a large activities room/day centre.Each unit has its own quiet space and one has a conservatory.Service users are free to access units other than their own.Each unit has a small kitchen and safe access to the garden.One unit has recently been fitted with outside decking and been very pleasantly redecorated and refurbished to give it a light and airy feel.Another unit has also been very nicely redecorated and the manager has a plan and costings to continue this refurbishment throught the home.Some areas and the other units whilst being homely,well maintained and clean are looking rather tired and in need of work. Where there has been redecoration service users have been involved in choosing colour schemes. Each unit has had a new bath fitted since the last inspection and there are plenty of accesible toilets throughout the home.The shower room was out of order and a visit from the maintenance man was scheduled.A section Care Homes for Older People Page 19 of 27 Evidence: of the bathroom flooring in one unit was peeling away from the wall and the wooden casing around pipework was flaking and in need of repainiting.The laundry floor also was due for replacement as it was peeling in places. Some bedrooms were visited on each of the units,all were clean and personalised to varying degrees to personal preference,some service users had brought their own furniture,and personal items included photos,pictures,cuddly toys and ornaments.If a service user wishes to hold a key to thier room a related risk assessment is completed. The garden is large,attractive and well maintained,each unit looks out over a garden area and there are patio areas with patio furniture.The manager said some new patio furniture is to be purchased. The garden has been improved and relatives assist with the gardening. 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. Service users are supported by a well trained and competent staff team who understand their individual needs. Recruitment processes are through and protect service users. Evidence: The home had sufficient staff on duty during the visit,care staff,two team leaders,the cook,two cleaners and administrative staff were on duty as well as the activities organiser. There was a kitchen assistant vacancy and three new staff were awaiting CRBs before starting work.The home has a number of male staff and a good mix of staff with various levels of experience and of differing ages were on duty.No agency staff have been used for some time. Staff usually work on a particular unit and prefer to do this so they are familiar with routines and the service users,where necessary staff can cover other units and float between them. The manager is promoting training this year, staff are well trained and all receive core and specialist training,the majority of current training is via e-learning and more courses personally delivered by a trainer are being planned.The manager has developed a medication training pack for this purpose.NVQ training in care at level two Care Homes for Older People Page 21 of 27 Evidence: or three is promoted and more staff have been enrolled on the training,an NVQ assessor was working with some care staff during the inspection.Specialist and service specific training provided includes,dementia,Parkinsons Disease,falls and continence. A staff member confirmed they had had POVA training and were booked to attend a dementia course. Staff receive supervision every six to eight weeks,the manager supervises team leaders and team leaders supervise care staff.Supervision is recorded and kept on staff files. Team meetings are held for staff at times that suit them there are meetings for day staff,night staff and joint meetings.New staff receive induction and shadow experienced carers until they feel confident. Staff files were sampled,they included those of well established and newer carers,all had the required recruitment documentation in place,with one omission that the manager was aware of and actively addressing.All files had satisfactory and valid CRB checks and the organisation is regularly updating CRBs as good practice. Staff who sent in survey forms and who were spoken with liked working at Stanecroft and felt well supported. Comments from carers included, It is very homely,such a rewarding job. I think our team work well together ensuring that service users receive quality of care for individual needs. I am always sent on training that is relevant to my job and that will help me progress in the future. Staff observed were cheerful,courteous to service users and respected their dignity. A relative commented on a survey form that they always found staff were kind and understanding to service users. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open and friendly atmosphere and is run in the best interests of service users and staff. The registered manager is committed to improving the service and presents clear information as to their vision for the home. Staff are well supported and supervised. Evidence: The registered manager is experienced and well qualified and regularly updates her training and attends new training.The manager is currently undertaking the NVQ 4 in health and social care,she has a clear vision as to how the home can progress and improve and has compiled business and improvement plans with costings,a major area identified for improvement is that of environment,the manager has also developed a improvement plan linked to the key standards. Care Homes for Older People Page 23 of 27 Evidence: Since the last inspection the manager has also improved some of the homes recording and reporting processes such as admission procedures and has introduced new recording tools, for example the falls monitoring forms. The home has a friendly feeling and this is echoed on the units,the views of service users are sought via service user meetings and individually and service user surveys take place. The home and organisation have robust quality assurance processes, relatives are also surveyed and the most recent survey sent out in October 2008 included a life portrait form for relatives to complete to give more backround and family information. Relatives are also invited to relatives meetings,there are internal audits and inspections and monthly regulation 26 visits.Monthly organisational audits are done by the manager on a specific topic such as care plans,laundry and personal grooming. The Commission is kept informed of any matters relating to the home and service users as required and the Annual Quality Assurance Assessment (AQAA) document that every home is required to submit annually was received on time. The two requirements and a number of recommendations made at the last inspection have been met. The home does not manage the finances of service users,relatives or other representatives act on their behalf and they can keep a small amount of personal spending money on the premises. Staff say they feel well supported comments received on survey forms include - The managers door is always open she is very approachable and has time for listening to her staff, and if I have any problems my manager is always available to talk with me about any concerns I have. Records are kept safely and securely and are completed to a good standard,service users or relatives can access care plans and contribute to them. A range of organisational policies and procedures are in place to ensure the safe running of the home and to protect service users and staff.Staff observed at work were observing safe working practices. Fire procedures are being improved upon and individual risk assessments for each service user in the event of fire are being drawn up. 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 15 It is recommended that the work started on making menus more accessible for service users be completed so that service users can always be fully aware of meal options. It is recommended that the safeguarding vulnerable adults procedure be revised so that it is more user friendly for staff. It is recommended that the laundry floor be replaced and the damaged areas of flooring and pipework casing on Beech unit be repaired at the earliest opportunity. 2 18 3 26 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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. 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