Care Home: Woodlands Residential Home

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What the care home does well The service ensures that staff employed are well trained. The organisation has tried to ensure that the Deputy Manager is supported whilst they recruit a new manager for the service, and the Care Manager visits to support them on a monthly basis. Residents are encouraged to bring their own possessions into the home, and rooms were personalised. The service has a good quality assurance procedure in place and collated information was available to view during the inspection. The home offers a comprehensive list of activities and social events and varied and planned activity programme. What has improved since the last inspection? The home was inspected last three years ago. Since then policies and procedures have been reviewed as required and their is a on going maintenance plan in place. The service now offers a varied and planned activities programme. What the care home could do better: The service is currently running without a Registered Manager, evidence found in the inspection confirms that the service is required to do work to improve risk assessments, there is evidence of a particular service user being put at risk due to poor procedures in the home and lack of clarity with regard to recording. Staff have been employed under the previous manager without CRB and POVA checks and staff are working without regular supervision. Key inspection report Care homes for older people Name: Address: Woodlands Residential Home Beacon Road Crowborough East Sussex TN6 1UD     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: Alexis Reilly     Date: 0 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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: Woodlands Residential Home Beacon Road Crowborough East Sussex TN6 1UD 01892653178 01892653178 woodlands@shc1234.fsnet.co.uk www.sxhousing.org.uk Sussex Housing and Care care home 38 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: 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 who can be accommodated is: 38 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) Date of last inspection Brief description of the care home Woodlands is a purpose built care home situated on the outskirts of Crowborough; the town centre is approximately one mile away and bus services run past the home. Accommodation is provided on three floors with shaft lifts fitted to assist those who may have mobility problems. Bedrooms are all ensuite and are situated on five separate units, each with its own lounge. The home is registered to accommodate up to 38 older people and the registered owners are Sussex Housing and Care. The amount of fees charged range from £366 - £519.90 per week. Extra services Care Homes for Older People Page 4 of 27 Over 65 38 0 Brief description of the care home including hairdressing and chiropody are charged separately and charges for these are 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 inspection began at 10.30am and finished at 2.50pm. The inspector spent time with service users in the home and individually with two of the service users who were part of the case tracking. The inspector took a number of general documents away from the site visit to assess these included the activities list, the medication audit, quality assurance questionnaires, and the list of staff training. Fifteen service user surveys were returned directly to the Care Quality Commission, the inspector has included the comments received throughout the report. The inspector case tracked three service users, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. Other documents examined were copies of notifications, accidents and appointments, evidence of external reviews, the complaints procedure, copies of service users meetings and staff meetings. Staff recruitment files and staff induction training sheets were also examined, as were a sample of the sheets which record the administration of Care Homes for Older People Page 6 of 27 medication and the duty rota. The plan of staff supervisions were also viewed. The inspector visited all the communal areas in the home, spending time to talk to three residents in the lounge, the inspector passed through the dining area and kitchen briefly. The inspector visited the bedrooms of the three residents involved in the case tracking process, speaking with two of them in their rooms. The inspector spent time with the Deputy Manager, Care Manager, and one senior carer. The inspector also observed other staff interacting in a positive manner with service users during the inspection. Information was also taken from the AQAA which was comprehensively filled in and returned by the due date. 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. Service users benefit from receiving relevant and up to date information, which is made available to them prior to admission. This allows them to make an informed choice about the home in which they wish to live. Evidence: As part of the inspection the inspector looked in detail at the care which three service users received in the home. The inspector had the opportunity to spend time with two of these people individually, other service users were seen during the course of the inspection and staff were observed interacting in a positive manner with residents. The inspector also had the opportunity to speak with the Care Manager the Deputy Manager and a senior carer. As part of this process the inspector viewed the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the placing team to ascertain if the needs identified in the assessment are used as a basis for a care plan. Care Homes for Older People Page 10 of 27 Evidence: Evidence was supporting to confirm that service users are involved in the admissions process and are given choice, the service had assessment document in place which were used to assess someone referred to the service. Also available to view was collated information with regard to service users in the home, and their referring documents. This highlighted that the Registered Manager obtains background information and up to date CPA and mental health assessments if applicable prior to offering a place in the service. Intermediate care is not offered by this home. 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 service has not embraced the opportunity to formulate person centred care plans since its last key inspection three years ago. A good level of service is provided in general for residents however this is marred by poor recording and by staff not addressing the health care needs of some residents as quickly as they should when these are subject to change. Care is administered in way that protects residents privacy and dignity. Medication procedures are in order. Evidence: As part of the inspection the inspector looked in detail at the care which three service users received in the home. The inspector had the opportunity to spend time with two of these people individually, other service users were seen during the course of the inspection and staff were observed interacting in a positive manner with residents. The inspector also had the opportunity to speak with the Care Manager the Deputy Manager and a senior carer. As part of this process the inspector viewed the person centred care plans and the associated documents such as risk assessments and the list of activities that people are involved in in the home. Care Homes for Older People Page 12 of 27 Evidence: The inspector looked at the care that three particular residents received in the home these were chosen in relation to level of support required and length of time in the home. The inspector found that care plans were basic documents to work from, they were informative, but must contain more detail. There is a lost opportunity to detail information about the residents and their goals and aspirations. The inspector was told during the inspection there is a plan to bring in a new more detailed care plan when the service appoints the new Manager which is hoped to happen later in the year. It is unacceptable to wait for the appointment of a new Manager as care plans are working documents which must form the basis for the delivery of care to the resident these must be comprehensive and detailed. This was also true for the risk assessments viewed on the day, they were basic documents which if detailed all the risks comprehensively would have been a sufficient document to work from. However one of the risk assessments had not mentioned that this particular resident had a risk of urine track infections which in turn can have a potential factor on the care and support they needed in the home. Also of great concern was that during the inspection the inspector walked out of the building through a downstairs door, which was un alarmed and wide open. This was discussed with the care manager and the deputy manager at the time, and the door was subsequently closed and alarmed. The inspector had seen previous risk assessments to state that residents may be at medium risk if accessing the community due to traffic. The door opened onto a small patio path and grass verge then indirectly into the car park. With regard to meeting the health care needs of residents the inspector found that the service in general responds appropriately to the health care needs of individuals. However the inspector found poor practise in relation to one resident were a UTI was suspected and no GP was called for six days. Again the inspector found with the care of the same person a UTI was suspected again no GP was called and no recording was evident in the care notes until four days later when this person had had a fall. The Care Quality Commission received 15 surveys from service users in the home out of these the responses showed that in relation to receiving the care and support needed 4 replies stated always and 11 said usually. In relation to staff listening to service users and acting on what they say 1 replies stated sometimes, 3 always and 11 usually. With regard to medical care 7 replies stated the home usually makes sure they get the medical care needed and 8 replies stated always. Direct quotes from the surveys were 24 hour care should mean that if X has catheter problems and needs it emptied twice a day. X should not be told sorry we are on Care Homes for Older People Page 13 of 27 Evidence: lunch, there have been several occasions when the catheter has been rushed and not turned off after being drained. The home has a procedure in place to put a night claim disclaimer in residents care plans, this is signed by the deputy but the ones seen were not signed by residents. In discussion with staff during the inspection the inspector was assured that if no answer had been received from a person and they were thought to be unwell the staff would enter the room. The home should review the use of this document. 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. Evidence was supporting to confirm that a range of social, cultural and recreational activities are on offer with the wishes of the service users being central to the provision. The menu is varied and specialist diets are provided for service users, with service users choice and wishes being respected. Evidence: As part of the inspection the inspector looked in detail at the care which three service users received in the home. The inspector had the opportunity to spend time with two of these people individually, other service users were seen during the course of the inspection and staff were observed interacting in a positive manner with residents. The inspector also had the opportunity to speak with the Care Manager the Deputy Manager and a senior carer. As part of this process the inspector viewed the care plans and the associated documents such as risk assessments and the list of activities that people are involved in in the home. It is clear that the residents at Woodlands have a varied and planned activity program on offer to them. Residents have a monthly newsletter containing details of the activities program and these are in large print for those who are partially sighted. Residents are encouraged to join in with other events such as coffee mornings and Care Homes for Older People Page 15 of 27 Evidence: fetes within Sussex Housing and Care, and the home has a mini bus available for these trips. Religious services are provided in the home. Quotes taken directly form the surveys returned to the CQC included Home arranges activities well, entertainment is excellent we are looked after so well, We are looked after very well and have several interesting outings each month and entertainment at woodlands. A further comment received was very friendly and helpful staff. Pity they call as darling!. The service should ensure it promotes respect and dignity throughout the service and staff are reminded of the importance of being respectful when addressing residents. Menus are varied and seasonal, and visitors are welcome to join residents for a meal or take coffee and cake in the lounge. Personal relationships and family relationships are encouraged if these are helpful and appropriate. Evidence was supporting to confirm that the service has updated their policies regarding Equality and Diversity. 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. Residents benefit from a effective complaints procedure and the home manages incidents of safeguarding appropriately. However residents are being placed at risk due to poor recruitment practises within the home. Evidence: During the inspection the inspector examined copies of notifications, and accidents and appointments, evidence of external reviews, and the complaints procedure. Also viewed were the recruitment files of two members of staff. The inspector was concerned to find that both of these staff started to work unsupervised on shift prior to the return of a CRB check and a POVA first check Evidence was supporting to confirm that staff have received training in POVA. The home has had one safeguarding referral this year which was dealt with effectively by the service. Evidence is supporting to confirm that complaints in the home are addressed and taken seriously. Staff are made aware of the Whistle Blowing policy on Induction. Care Homes for Older People Page 17 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. Accommodation at the home is provided in such a manner that it is safe, hygienic and odour free. Appropriate infection control procedures are in place, in order to reduce or eliminate the risk of infection to staff and service users. However the home must ensure residents are not placed at risk due to the practise of leaving external doors open and not alarmed. Evidence: As part of the inspection the inspector visited all communal areas, and passed through the dining area and kitchen briefly. The dining room, and lounges were also viewed and the inspector spoke with residents in the lounge. The inspector also visited two residents and spoke to them in their bedrooms. The bedrooms were personalised and contained belongings from individuals homes. Quotes taken directly from the surveys returned to the CQC stated There is a very pleasant atmosphere here and in the short time I have made several good friends, Its very comfortable I have some of my furniture and pictures and many things from my own home. The home is well maintained. The size, location and layout of the home are suitable for its stated purpose. During the inspection the inspector walked out of the building through a downstairs door, which was not alarmed and wide open. This was discussed with the care Care Homes for Older People Page 18 of 27 Evidence: manager and the deputy manager at the time, and the door was subsequently closed and alarmed. The home was clean and odour free throughout. The home has an infection control policy in place and staff are trained in infection control procedures, staff training records viewed confirmed this. Care Homes for Older People Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment procedures are poor and service users are potentially being placed at risk of harm associated with poor recruitment practises. Staff do however received comprehensive training. Evidence: As part of the inspection the inspector examined the recruitment files of two newly recruited staff to the service, also viewed was the list of staff supervisions and the program of training that staff complete. The inspector spent time with the care manager, deputy manager and also a senior carer. The inspector was concerned to find that the two staff files viewed showed that staff had been employed in the home and were working as full members of the staffing shift unsupervised without a CRB or POVA check. The inspector was assured that this practise had now stopped. However this practise has inevitably produced a risk of harm that the organisation should have addressed. Staff have not received regular supervision and the inspector has evidence that in fact one of the staff members had not received supervision since February 2009. However senior staff have received training in providing supervision and there is a plan for them to supervise care staff in the near future. The service has a comprehensive training program in place and staff records confirmed that this training is taken up and staff received the appropriate training in the home. Senior staff team meetings have taken place on a regular basis. Care Homes for Older People Page 20 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is currently running without a Registered Manger and this has had a detrimental effect on the running of the service and in turn the safety of the residents placed within it. Evidence: The service is currently running without a Registered Manager, due to a recent safeguarding investigation the previous manager has now left. The service is being run by a Deputy Manager with a level of support from the services Care Manager, and the process of recruiting a new manager for the service is underway. Evidence found in the inspection confirms that the service is required to do work to improve care plans and risk assessments, there is evidence of a particular service user being put at risk due to poor procedures in the home and lack of clarity with regard to recording. Staff have been employed previously without the correct checks being carried out. The inspector was assured during the inspection the practise of employing staff prior to the appropriate checks were a practise associated with the previous manager of the home and that new staff are only now employed following receipt of the appropriate Care Homes for Older People Page 21 of 27 Evidence: documents. However this practise has inevitable put residents at a degree of harm and should have been overseen by the organisation. Staff have not received regular supervision and the inspector has evidence that in fact one of the staff members had not received supervision since February 2009. However senior staff have received training in providing supervision and there is a plan for them to supervise care staff in the near future. Due to the fairly stable staff group service users outcomes are generally good. The service has maintained good standards in quality assurance and questionnaires were available to view on the day of the inspection as were the records of the Regulation 26 visits completed by the care manager on a monthly basis. It is evident that the loss of a Registered Manager has effected the overall service provided by the home. The AQAA was completed comprehensively and returned by the due date. However some of the evidence provided in this was not found to be accurate on the day of the inspection. This may be due to the new procedures which the service currently hopes to bring in when they recruit the new manager. Care Homes for Older People Page 22 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 23 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 1 8 12 The registered person shall 01/11/2009 ensure that the care home is conducted so as to promote and make proper provision for the care and where appropriate treatment, education and supervision of service users. The Registered Person must ensure that health care needs are addressed in a timely manner to ensure service users are protected from risk. 2 9 13 The registered person shall ensure that all parts of the home to which services users have access are so far as reasonably practicable free from hazards to their safety; unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. 01/11/2009 Care Homes for Older People Page 24 of 27 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 The Registered Person must ensure that risk assessments are in place and that identified risks are eliminated and the procedures in place to minimize risks are followed. 3 29 19 The Registered Person shall 01/11/2009 not employ a person to work at the car home unless the person is fit to work at the home, and the employer has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of Schedule 2 of the National Minimum Standards The Registered Person must ensure the required checks are carried out prior to employing a member of staff to work unsupervised on shift, thus ensuring the safety of the service users at all times. 4 36 18 The Registered Person shall 01/12/2009 ensure that persons working in the home are regularly supervised . Care Homes for Older People Page 25 of 27 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. 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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