Care Home: The Beeches

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• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
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• St Joseph`s
• Ridgemount
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• Old Hastings House

What the care home does well The Beeches is a well maintained home with an open and friendly atmosphere. Prior to people moving into the home thorough assessments are undertaken to ensure that the home is able to meet their needs. Care plans are detailed and give staff the information they need to care for people in the way they wish. The home provides people who move into the home with information about the home which is also available in large print and audio formats. Residents enjoy living at The Beeches, like the food and feel that the staff are helpful and supportive. There are enough staff on duty to meet the needs of the residents. Staff are knowledgeable about individual residents` likes, dislikes and needs. The home takes any complaints or concerns raised seriously and responds promptly with investigations and replies. Comments we received from residents include; "I like the warm approach of the staff toward the residents and patients. This is the best home I have stayed in." "The home is friendly and welcoming, the staff are very pleasant and helpful. The home is always clean." "Home is always clean and fresh. Staff are very friendly and caring." A relative told us; "The home looks after my husband very well. He is always made comfortable. He is very well looked after by the staff." Comments we received from social and healthcare professionals include; "This is a very well run nursing home. The food always smells and looks good. Staff are kind and attentive to patients. Any requests I make are always carried out which is fantastically helpful to me." "The staff at The Beeches are excellent - the trained nurses really know and care about their patients, referring appropriately to the surgery and following all advice given. I have complete confidence in The Beeches from the owner to the lady who keeps the place looking spotless, there is a sense of pride in doing a job well. In my opinion the best nursing home in Worthing." What has improved since the last inspection? Since the last inspection the home has made the Service User guide available in large print and audio formats and have included completed quality assurance questionnaires. Care plans are more comprehensive and have been made easier and more time saving for staff to keep up to date. The home has a rolling refurbishment programme. Since the last inspection a new picture window has been added to improve the light in one room, three rooms have been enlarged to allow for nursing, a new bathroom with track hoist has been added, lighting has been improved in the dining room and there is a new staff room with improved facilities. There is a new deputy manager who is a trainer in moving and handling and first aid. A part time administrator has been employed and staffing levels have been increased. Staff meetings are being held more regularly and a stress risk assessment has been devised for staff as part of their appraisal and ongoing support and supervision. The manager of the home has successfully completed a Foundation Degree in Health and Social Care. At the last inspection it was noted that residents` records were not being held in secure storage, this has now been addressed. What the care home could do better: At present staff are not receiving the required amount of supervision each year. The manager is aware of this and is going to address it. Some residents would like more flexibility in when they receive their meals. The home should address this so that residents` individual needs and wishes are met. Key inspection report Care homes for older people Name: Address: The Beeches 45 Wordsworth Road Worthing West Sussex BN11 3JB     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: Jo Hartley     Date: 0 7 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Beeches 45 Wordsworth Road Worthing West Sussex BN11 3JB 01903239875 01903217668 info@thebeechesnursinghome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Diana Jane Wyatt Name of registered manager (if applicable) Mrs Alexandra Baker Type of registration: Number of places registered: care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 43 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category; Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home The Beeches is a care home which is registered to accommodate up to forty-three residents in the category (OP) old age, not falling within any other category. It provides personal care and nursing care. The Beeches is a three storey property which has been extended and adapted for its current use. It provides accommodation in shared and single bedrooms located on the Care Homes for Older People Page 4 of 26 Over 65 43 0 Brief description of the care home ground and first floors. A vertical passenger lift provides access to all floors. A dining room and lounge are located on the ground floor. An attractive garden, located to the rear and side of the premises is available for residents to use. The property is located in a residential area of Worthing, near to the seafront. The registered provider is Mrs D. J. Wyatt who also owns the service. Mrs A Baker is the registered manager, who is responsible for the day to day running of the care home. Fee levels at the time of the inspection ranged from £675 to £866. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 purpose of this inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These include previous reports of visits to the home, the Annual Quality Assurance Assessment, (AQAA), completed by the home and an unannounced visit to the home which was carried out on the 7th October 2009, over a period of five hours. During the visit we looked at policies, procedures and records kept at the home including staff recruitment and training, residents records and health and safety information. We observed interactions between staff and people living in the home, and visited areas of the home including bedrooms and communal areas. The manger was present throughout the visit and gave assistance when needed. Care Homes for Older People Page 6 of 26 All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Care Quality Commission and its predecessor, the Commission for Social care Inspection. Several residents living at the home and staff assisted with this inspection. Their evidence and information was very useful in compliing this report. In addition to this we received surveys from fourtten residents, seven staff and three social and healthcare professionals. The last key inspection of this service was carried out on the 9th October 2007. The quality rating of this service is Two Star. This means that people who use this service experience good quality outcomes. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? Since the last inspection the home has made the Service User guide available in large print and audio formats and have included completed quality assurance questionnaires. Care plans are more comprehensive and have been made easier and more time saving for staff to keep up to date. Care Homes for Older People Page 8 of 26 The home has a rolling refurbishment programme. Since the last inspection a new picture window has been added to improve the light in one room, three rooms have been enlarged to allow for nursing, a new bathroom with track hoist has been added, lighting has been improved in the dining room and there is a new staff room with improved facilities. There is a new deputy manager who is a trainer in moving and handling and first aid. A part time administrator has been employed and staffing levels have been increased. Staff meetings are being held more regularly and a stress risk assessment has been devised for staff as part of their appraisal and ongoing support and supervision. The manager of the home has successfully completed a Foundation Degree in Health and Social Care. At the last inspection it was noted that residents records were not being held in secure storage, this has now been addressed. 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 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 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective service users with the information they need to make an informed choice about where to live. Peoples needs are assessed before they move in to ensure that the home can provide the service they need. The home does not provide intermediate care, therefore Standard Six does not apply. Evidence: We looked at the care plans of four people who are living at the home. They all contained assessments that had been carried out prior to admission to ensure that the home is able to meet individual needs. The assessments were detailed and covered areas such as medical, communication, psychological and social needs. Information included likes and dislikes such as when people prefer to go to bed, what time they like their first drink of the day and their meal preferences. A resident who is having respite care told us that the manager visited her in her home Care Homes for Older People Page 11 of 26 Evidence: before she moved in to discuss her needs and tell her about the home. She said that the home arranged for a wheelchair taxi and carers to pick her up and take her to the home. We received fourteen surveys from people who live at the home. Ten people said they received enough information before they moved in to decide if the home was the right place for them, three said they didnt and one person couldnt remember. The service user guide produced by the home gives details of the services the home provides and is also available in large print and audio. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents health, personal and social care needs are set out in an individual plan of care. Residents health care needs have been met. Residents are protected by the homes policies and procedures for dealing with medicines. Residents feel they are treated with respect and their right to privacy is upheld. Evidence: The four care plans that we looked at were drawn up from the initial assessments that were undertaken prior to people moving into the home. They are reviewed monthly and any changes in care needs are recorded. Care plans include risk assessments for manual handling, pressure areas and nutrition. Likes and dislikes are also recorded. A record is kept of visits from healthcare professionals such as GPs and chiropodists including any treatment prescribed. Care Homes for Older People Page 13 of 26 Evidence: All seven of the staff who returned surveys to us said that they receive up to date information about the people they look after. We were also told by staff during the visit that there is a detailed handover at the change of each shift. At the last inspection it was noted that care plans were kept in an unlocked office where members of the public and residents could access them. The home has now ensured that all confidential information is stored in locked cabinets. We received fourteen surveys from residents. Nine said they always receive the care and support they need; four said they usually do and one said they sometimes do. Eleven people said they always receives the medical care they need, two said they usually do and one person said they sometimes do. A resident told us the care day and night is extremely good. We looked at the storage and recording of medication The records regarding the handling, administration and disposal of medication were well kept with no gaps in the recording seen. A picture of each resident is attached to their individual medication records to minimise the risk of medication being administered to the wrong person. Medication is stored safely and securely. All as required medication administration was clearly recorded with the dose and the reason it was given. Trained nurses administer all medication. We found an open and friendly atmosphere in the home. Staff listened and chatted to people and gave any assistance requested or needed. Personal care was given behind closed doors, respecting the privacy and dignity of individuals. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the Beeches are provided with a range of activities. They are able to maintain contact with their families and friends who are made welcome at the home. People are able to make choices in their lives, however one person would like to eat their main meal later in the evening and this has not yet been catered for. Residents receive a wholesome appealing balanced diet in pleasant surroundings. Evidence: The Beeches provides activity sessions on three afternoons a week and entertainers visit the home every fortnight. During the visit some residents were playing card and board games in the lounge. Residents said that there are usually or always activities available that they can take part in. Each resident has a folder in their room where the staff record activities they have taken part in and one to one keyworking time with staff such as chats, walks and manicures. A selection of books, including audio books and large print books were available to residents on bookshelves in the lounge. A visiting library visits regularly to ensure books can be ordered and exchanged. Residents assessment records also include details of recreational and social activities Care Homes for Older People Page 15 of 26 Evidence: residents have enjoyed before moving into The Beeches. We saw evidence in the visitors book that people are welcome to visit their friends and relatives at all reasonable times. One visitor told us that she is always made to feel welcome by the staff and is able to bring her dog into the home as her relative likes to see it. A person living at the home said they were able to see their relatives in communal areas or in the privacy of their own room. In the surveys we received three people said they always enjoyed the food, nine said they usually did and two said sometimes. On the day of the visit people we spoke with were complimentary about the meals provided. Residents told us that there is a choice of main meals and that if they dont like what is on the menu something else is provided. One resident said, The food is very nice. Staff come round and ask what you would like. If you dont like either choice they will suggest other things. Another resident said, There is good food, plenty of vegetables that are well cooked. There are hot and cold choices. One resident said that she would like her evening meal a bit later but the home wasnt able to do this at present. The home should look at ways that this can be made possible to enable people to have more choice in their daily living. On the day we visited the choices of meals were minced beef and onion pie or haddock in parsley sauce with fresh vegetables followed by apricot crumble and custard. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in The Beeches know how to make a complaint if they need to. They are protected from abuse by the policies, procedures and staff training at the home. Evidence: The Beeches has a written complaints procedure that is given to all new residents in the Service User Guide and is also displayed in the hall of the home. It includes details of the person to whom the complaint should be made and indicates the timescales by which the complainant will receive a response. Surveys returned by residents confirmed they knew who they should speak to if they wished to complain about the care and services provided. We looked at the homes record of complaints and it showed that any complaints they have received have been thoroughly investigated with a comprehensive written reply to the complainant. All complaints recorded were responded to well within the timescales of the complaints procedure. We saw training records that showed staff receive training in Safeguarding Vulnerable adults. Staff who spoke with us confirmed this and were able to explain what they would do if they had any concerns. The registered manager has a copy of the Sussex Multi Agency Policy and Procedures for Safeguarding Vulnerable Adults available to all staff. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well-maintained environment. They are able to have their own personal possessions with them in their rooms. The home is very clean and hygienic throughout. Evidence: We looked at the rooms of ten residents, kitchen, bathrooms and all the communal areas of the home. The home is decorated and furnished to a good standard. Residents are able to bring their own belongings to enable them to personalise their rooms. Individual aides and adaptations have also been provided as required. For example there was evidence of hoists, specialist beds and mattresses and wheelchairs. Bathrooms and toilets have also been fitted with appropriate equipment such as raised seats, grab rails and specialist bathing aids. Information supplied by the registered provider prior to the visit indicated that the premises has been visited by the Fire Officer and Environmental Health officer to ensure it is safe and meets requirements in terms of fire safety and health and safety regulations. Equipment such as gas installations, electrical wiring and equipment have been regularly checked and maintained to ensure they are safe to use. Care Homes for Older People Page 18 of 26 Evidence: All areas of the premises have been maintained to a very good state of cleanliness. This included the laundry and sluice areas. Policies and procedures are in place for control of infection. The home has a contract with a waste disposal company for the collection and disposal of clinical waste. Surveys returned by residents confirmed the home is always fresh and clean. Comments includes, The home is always clean. Cleanliness is kept to a very high standard. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered provider has ensured there is sufficient staff on duty with the appropriate mix of skills to meet the needs of residents accommodated. Residents are supported and protected by the homes recruitment policy and practices. The registered provider has ensured staff are trained and competent to do their jobs. Evidence: We looked at the staff rota and found that the home has enough staff on duty to meet the needs of the current residents. On the day of the visit their were two trained nurses and seven assistants on duty plus the manager and deputy manager. At night there is one trained nurse and four care assistants. The home also employs a housekeeper, three housekeeping assistants, a chef, a kitchen assistant, two servery assistants, a part time administrator, a book keeper and maintenance personnel. Residents told us that they felt that there are enough staff on duty and that staff respond quickly when they are needed. We looked at the recruitment records for four members of staff. They all contained the required employment checks including Criminal Records Bureau and Protection of Vulnerable Adults Checks, application forms with complete employment history and Care Homes for Older People Page 20 of 26 Evidence: two written references. Records seen showed that all newly appointed staff have undergone an induction programme that includes how to treat people with dignity and respect their privacy during personal care. Records of training provided were also examined and demonstrated that training for all staff has included mandatory training such as fire safety, food hygiene, adult protection and health and safety. Staff on duty confirmed the training they had received. Residents made the following comments about the staff at The Beeches; The staff are very friendly. Staff come quickly when I call them The care day and night is extremely good. There are plenty of staff they are very considerate. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Beeches is well managed and is run in the best interests of residents. Residents financial interests are safeguarded and their health, safety and welfare are promoted and protected. Evidence: The registered manager is Mrs Alexandra Baker. She is a first level nurse and has completed a Foundation Degree in Health and Social Care that includes the Registered Manager Award. Staff and residents said that they find Mrs Baker approachable and helpful. Staff who responded to the surveys we sent them said that the manger gives them support when they need it. We looked at staff supervision records and found that they are not currently up to date. The manager is aware of this and said she will address it. The home has an external assessor who visits on a regular basis to conduct an audit Care Homes for Older People Page 22 of 26 Evidence: of the care and services provided. There is also a quality assurance system in place that seeks the views of residents and their relatives to enable the home to identify any areas that need improving. Residents manage their own finances or get help from their relatives. The home keeps detailed records of any accidents or incidents in the home and reports these to The Commission when necessary. The premises have been well maintained, ensuring a safe environment in which residents can live and staff can work. Equipment such as boilers, other gas installations and electrical equipment have been regularly serviced and maintained. Staff confirmed that they have received training in areas such as Health and Safety, Manual Handling, Fire Safety, Infection Control, Food Hygiene and other health and safety subjects. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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