Care Home: Willan House

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What the care home does well This home provides a pleasant clean and very well decorated environment for residents. The manager has provided evidence prior to this inspection which shows that the provider continues to meet the needs of the residents. Those residents spoken to expressed their satisfaction about all aspects of the care provided. Comments received were, I enjoy the meals the food is always very good. The staff are always very nice and helpful, I am happy with life and I undertake a number of activities here,I am very happy and go bowling. The expert by experience observed carers throughout this visit and found them to be competent, kind and polite when speaking to people. What has improved since the last inspection? The provider confirmed that they have continued to carryout good practice and have person centered care planning relating to those aspects of the daily life of residents. She also confirmed that they have a new management structure with the appointment of senior carers and deputy manager. This inspection also found that there has been an increase in signs, which are dementia friendly including pictures, colour and wording that residents can easily understand. What the care home could do better: Some care plans identified mental health issues for residents and what decisions they were unable to make. Care plans also need to identify those decisions that residents can make relating to their daily living and record this in their care plans. Key inspection report Care homes for older people Name: Address: Willan House Willan House Stainfield Market Rasen Lincolnshire LN8 5JL     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: Douglas Tunmore     Date: 1 7 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Willan House Willan House Stainfield Market Rasen Lincolnshire LN8 5JL 01526398785 01526399719 willan.house@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr John Shiers,Mrs Christine Shiers care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Mr and Mrs Shiers are registered to provide personal care at Willan House for service users of both sexes whose primary needs fall within the following categories:- Old age, not falling within any other category (OP) 20 Dementia DE(E) 10 The category DE(E) applies to service users aged 60 years and over The maximum number of service users to be accommodated at Willan House is 20 Date of last inspection Brief description of the care home Willan House cares for older people in a non-smoking environment in a detached property situated in the small village of Stainfield. The home is approximately four miles from the small town of Wragby and ten miles from the historic city of Lincoln. The home stands in its own grounds and gardens with car parking facilities to the front. The home has two floors and a stair lift is fitted to both staircases to the Care Homes for Older People Page 4 of 27 Over 65 10 10 0 0 Brief description of the care home bedrooms on the first floor. There are a variety of aids and adaptations around the building allowing service users to move round the home more independently. Sixteen of the bedrooms are single, six of them have en-suite toilet facilities. There are five communal toilets, two communal bathrooms and a disabled shower room. We were told that the current fees for a weeks stay at the service range from three hundred and fifty pounds to four hundred and seventy five pounds depending on the level of care required. Extras charged for include chiropody, hairdressing toiletries and newspapers. The providers Survice Users guide and the last inspection report is available from the manager. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit undertaken by an inspector and an expert by experience and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. From 1 April 2009 the duties of The Commission for Social Care Inspection (CSCI) has been taken over by the Care Quality Commission (CQC), the new independent regulator of all health and social care in England. Throughout this report the terms we and us refer to the Care Quality Commission (CQC). We took into account previous information held by us, including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Care Homes for Older People Page 6 of 27 Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We also received two surveys from people living in this home. The main method used to carry out the inspection is called case tracking; this includes following the care of a sample of two people through their records and assessing their care. We spoke with the provider, a number of residents two of which were being case tracked and one carer. The provider was informed of the general outcomes of this inspection. 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: 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 8 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 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was information available to enable residents to make a choice as to whether or not to enter the home. People received an assessment, which resulted in their needs being met. Evidence: We were told that, We undertake a pre-admission assessment in a mutually convenient place - own home, in hospital, or at Will an House as part of a visit. The results are put in writing to the person to state whether we can meet their needs. We encourage potential resident to look round at different times, or to come and join us for a meal.When families come to view we state that the resident needs to come as well. A survey received from an advocate at the last inspection dated June 2008 showed that she received information about the care home to help her advise her friend. All surveys received at this visit showed that prospective residents received information Care Homes for Older People Page 10 of 27 Evidence: about this home prior to admission enabling them to decide if it was the right place for them. A review of all information available prior to this inspection including a previous inspection report dated 2008 and evidence seen at this inspection in residents care plans shows that the provider does not admit residents without a care needs assessment being undertaken. Prospective residents are also written to by the home confirming whether they can meet the residents care needs or not. This visit found that residents had been involved in their admission to this home and assessments are carried out by a skilled and trained member of staff. We looked at care plans and found that assessments were also available to the home from health care professionals and well as social workers detailing the needs of those residents. The provider confirmed that trial visits are available and prospective residents can stay for a meal if they so wish. The home does not provide intermediate care. Care Homes for Older People Page 11 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 and welfare needs of people living in the home are fully met. Medication procedures keep people safe. Evidence: Peoples surveys confirmed that they always receive the medication and health care support that they need. We looked at those files and found that care plans evidenced that accident reports and body maps are used for the mapping of any cuts or abrasions to residents. We also looked at risk assessments in residents files and found that they were available giving details of various risks concerning residents health care needs. Files seen also confirmed that health care professionals visit the home when required by the residents. Files showed that people are actively involved in their care plans and comments found were, I feel that my mobility is better, the girls (staff) are very good and meet any requests I have. Other comments were, I am very happy here. All care plans seen had a section called whats working well, which had been completed by Care Homes for Older People Page 12 of 27 Evidence: the resident or with help from their key worker. Those care plans which we looked at did not make reference to new laws about decisions that may effect peoples lifestyles. Care plans should make reference to what decisions residents can make and what they cannot make without support. The provider stated that training had taken place to ensure that all staff are aware of how to assess and record in care plans. One residents file evidenced that they had a care plan relating to their capacity in which a community psychiatric nurse was involved. The Willan House Newsletter, dated March 2009 gave useful information to residents and relatives regarding power of attorney, the Mental Capacity Act and why advanced care planning is important. Those care plans of two residents showed that one had their dignity and privacy requests recorded and the second did not. This was amended immediately by the provider after a discussion with the resident. A carer was aware of maintaining the privacy and dignity of residents and treating them with respect. She was also very knowledgeable concerning the general care and welfare of people living in this home. The expert by experience talked to a number of people during her visit. One lady visited in her room was found to be comfortable, nicely dressed with her hair brushed and her daily care plan was at hand and up to date. It was observed that the resident was checked on regularly by carers passing by. The pharmacist visited the home on the 8th April 2009 and recorded that storage and administration records of medication is carried out and everything was in order. Medication sheets were seen by the inspector and it was found that an accurate record of medication was kept of medication given on that day. The providers training file evidenced that staff receive training in the administration of medication. A file of one resident who self medicates showed that a risk assessment was available detailing any risk that she might present. Care Homes for Older People Page 13 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. A range of activities is available to residents, which suits their needs. Meals provided are well balanced and take into account personal preferences. Evidence: We were informed, we provide residents with choices in their daily life. We provide activities on a one to one level in small groups or as a home. We foster an environment that is homely families are welcome to join in any activity or help with daily live. We keep in touch with the community writing in the parish news about activities or information and going to events and occasions within the area. Offer residents a range of methods of communication email, phone fax available We keep in touch with families regular family lunches to keep in touch, encourage visiting, and to enable families to get to know one another. It also helps us show case our food. Family lunches are popular events. Two residents surveys show us that one felt that activities are always arranged by the home and the other felt that they were sometimes arranged. The expert by experience was informed by residents that the majority knew each other prior to admission and some of the staff knew many of the residents before they Care Homes for Older People Page 14 of 27 Evidence: needed care. The home is in a small knit community. The inspector was contacted by a relative from America regarding a resident who had lived at this home. The relative stated that this home did a wonderful job with my mother who had dementia and could be problematic. He said that the care she received gave her two more years of life and she was so happy at the home. The people who care for her are committed and do a great job. The providers signing in book showed that people visit their relatives at various times of the day and evening. A previous inspection in 2008 found that some residents help to put plants in tubs for the garden; these were brought into the lounge and residents were observed choosing plants and putting them into the pots. At that visit records showed that regular church services are held in the home and residents are able to attend religious meetings of their choice outside of the home. Residents had also confirmed that visitors are always welcomed and one visitor said this is a really homely place. Another relative praised the care given to her mother by both staff and the providers. We looked at care plans and found that peoples likes and dislikes were recorded. Other records showed that life story work is undertaken so that staff have a wider view of the people they are caring for and some idea of activities they might like. Their is no activities organizer and the provider confirmed that activities are undertaken by staff. Those people seen by the expert by experience stated that they were happy and one felt that he liked his privacy and was content sitting in his room from choice, although he confirmed that he is invited to join in if he so wishes. The main interests is painting and a number of peoples work is displayed in their rooms or in the dinning area. One resident stated that he goes bowling, enjoys the meals and goes to bed when he wants. The expert by experience found that although there was not an activities programmer as such, many things went on, painting, an exercise lady came, outsiders entertained and singing and music were popular. All rooms and facilities have reversible signs on residents doors, so that the privacy of residents could be maintained and they knew which room was theirs. The expert by experience observed residents during lunch and she reported that this Care Homes for Older People Page 15 of 27 Evidence: meal looked wholesome and well presented. Residents seemed to be enjoying their meal. Surveys showed that residents liked their meals. 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. Clear policies and a responsive and caring staff team protect people in this home. Evidence: We were told that, we have a complaints policy that ensures that any comppaints will be acted on and investigated. We have an open door policy for families, residents and others to speak to owners about any any issues of concern. We have raised no alerts relating to safeguarding adults in 2008 and 2009. Surveys showed that people knew who to speak to if they are not happy and they know how to make a complaint. The provider confirmed that there has been two complaints since the last inspection relating to clothes being misplaced and food needing to to be hotter for a resident who eats in his room. The provider confirmed that these issues had been resolved. In house staff questionaires show that all but one member of staff kwew what action to take if a resident or family member complained. The provider has an up to date copy of Lincolnshire County Councils revised safeguarding adults protocol and are amending the homes procedure to ensure it follows local guidelines. Care Homes for Older People Page 17 of 27 Evidence: People who use this service are supplied with a complaints procedure that they can understand. The complaints procedure is clearly displayed in the reception area as is the last inspection report of this home. One carer spoken with had a good knowledge of the types of abuse that might occur and she was clear of the action to take should she need to report any allegations. Training records given to us showed that this member of staff had undertaken training in safeguarding adults, which she confirmed. During this visit no residents made negative comments about their care to the expert by experience. Observations made were that people are treated with dignity and respect by carers. The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. 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. Residents benefit from a comfortable, warm and clean environment that meets their individual needs. Evidence: We are told that, we continue to improve and update the fabric of the building, major spend in 2008 was to replace the roof over the oldest part of the house. Access improvement plan, to alter entrance lobby to improve wheelchair access. Access to garden from conservatory has been improved We have provided signs that are pictorial as well as clear. We also have signs on doors stating personal care in progress, that are clear and visible. Residents surveys showed that the home is always fresh and clean. The expert by experience visited a number of rooms and found that everything was clean and tidy with no unpleasant odours detected. A previous visit found that there were call bells in all rooms, which residents have good access to. Rooms were also seen to be personalized to a good standard. People are encouraged to bring into the home items of furniture, television, pictures and personal items.The provider and manager have ensured that the physical environment of the home provides for individual requirements of the people who us Care Homes for Older People Page 19 of 27 Evidence: the service. People who use this service are encouraged to see the home as their own. It is very well maintained, attractive home and has very good access to the community facilities. An infection control policy is in place and staff were seen wearing gloves and aprons and using the correct disposal bags when dealing with dirty laundry. The Environmental Health Officer visited the home in January 2007 and has awarded a four star certificate. 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 are protected by the homes robust employment procedures and the training and knowledge of the staff. Evidence: We are told that, We have maintained a stable workforce. We have developed a learning environment where staff are keen to learn and develop, so they can provide appropriate care. Staff are encouraged to develop through education. We offer courses to let staff learn about relevant subjects, we have seen three of our staff achieve their first ever qualification NVQ 2. We encourage staff to learn and develop and see the possibilities. Staff surveys from the 2008 visited showed that training is provided, which is relevant to their role and helps them understand the needs of people living in the home. Residents surveys confirmed that they receive the care and support that they need and that staff listen to them and act on what they say. The expert by experience observed that staff anticipated peoples needs, be it a cup of tea at any time or personal care which was handled discretely. A senior carer said she felt that there are generally enough staff on duty to meet the needs of people in the home. She confirmed that there is a key worker system and Care Homes for Older People Page 21 of 27 Evidence: she is responsible for the care of some residents. She stated that she discusses with people how they want their care to be delivered and residents sign to show that they have been involved in their care planning. She also stated that she has undertaken training relating to the care of elderly residents and that the providers have always given her the training that she has asked for. The expert by experience confirmed that the latest carer to join the staff said that, at the moment I am shadowing a proficient carer and was learning daily. Other comments made by care staff was that in-house training is excellent. We looked that the training profile of carers and found that all staff are encouraged to undertake NVQ training, National Vocational Qualification and other courses relating to the care of the elderly. The provider confirmed that out of twenty staff eighteen have an NVQ qualification and all staff attend training days and complete the homes induction training pack. We looked at three personnel files and found satisfactory CRB, POVA, Criminal Record Bureau Checks and Protection Of Vulnerable Adults checks have been received prior to their employment and staff have been given copies of the General Social Care Council, code of conduct. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and staff benefit from the positive leadership of the management team. Management records show that the peoples, health and welfare, safety and choices are promoted. Evidence: We were told that, staff feel supported by management, who are seen as approachable. Staff support each other, sharing knowledge and encouraging further training etc. We Value staff contributions to the running of the home. The home is run by Mr & Mrs Shiers, who are the registered providers. Mr Shiers is also the registered manager and has completed the Registered Managers award. Since the last visit the management team has been changed and now has a deputy manager and two senior carers who support the manager. One senior carer stated that the providers are very supportive and that there is Care Homes for Older People Page 23 of 27 Evidence: regular supervision and yearly appraisals. she also confirmed that they also spends time on the shop floor. We looked at the residents belongings book was seen and showed that an up to date record is made of valuables that residents bring into the home with them. The provider confirmed that all residents valuables are recorded and will be updated as required. The providers do not deal with residents financial matters, these are looked after by families or representatives. The quality surveys undertaken by the provider were seen, which included surveys from visitors. With privacy and dignity surveys from people who live in the home. There were also staff surveys and visiting professionals surveys. All those responses received were positive. The providers AQAA identified that there are a range of policies and procedures available in the home relating to the health and safety of residents. This document also showed dates when equipment was serviced and fire alarm checked to ensure the safety of residents and staff. 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 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. 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