Linthouse Housing Association Ltd - Sheltered Housing Housing Support Service 1 Cressy Street Linthouse G51 4RB Telephone: 0141 445 4418

Type of inspection: Unannounced Inspection completed on: 20 March 2015 Inspection report continued

Contents

Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 22 5 Summary of grades 23 6 Inspection and grading history 23

Service provided by: Linthouse Housing Association Ltd.

Service provider number: SP2004006767

Care service number: CS2004080355

If you wish to contact the Care Inspectorate about this inspection report, please call us on 0345 600 9527 or email us at [email protected]

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Summary

This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection.

Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service.

We gave the service these grades Quality of Care and Support 5 Very Good Quality of Environment N/A Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good

What the service does well The service had maintained an excellent level of participation with tenants in both the care and support and management and leadership of the service. This had resulted in people benefiting from events of their choice taking place and being extensively involved in the service development.

Staff displayed a caring and dignified approach and were knowledgeable about the tenants.

This had all resulted in positive outcomes for service users.

What the service could do better No requirements or recommendations were made at this inspection however the service should consider the areas for development highlighted within this report. These included making sure all staff appraisals were completed and that tenant specific training was extended to all staff supporting them.

We highlighted some parts of the support plans which could be better recorded and the Manager was receptive to addressing these.

Linthouse Housing Association Ltd - Sheltered Housing, page 3 of 25 Inspection report continued What the service has done since the last inspection Since the previous inspection, we concluded that outcomes for tenants had remained positive and the service had continued to provide a quality service.

Conclusion Tenants expressed that they were very happy with the service. The service demonstrated that they had continued to operate to a very high standard across the three Quality Themes looked at during this inspection.

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1 About the service we inspected

The Care Inspectorate regulates care services in . Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at www.scswis.com.

The service was first egisterr ed by the Care Commission on November 2004.

Linthouse Housing Association provides sheltered and very sheltered housing support and care at home services for older people in the area of Glasgow, allowing them to live independent lives within their own homes.

Each tenant has their own tenancy agreement. The service supports individuals to use other agencies, such as home helps who carry out personal care for tenants, as well as General Practitioners and other health care professionals when required.

Tenants are supported by a Warden and domestic staff, and in the very sheltered service a cook provided meals on a daily basis. The members of staff are managed by the Senior Housing Officer from Linthouse Housing Association.

The Care Inspectorate regulates care services in Scotland. Information in relation to all care services is available on our website at www.careinspectorate.com

This service was previously registered with the care commission and transferred to the Care Inspectorate on 1 April 2011.

Requirements and recommendations If we are concerned about some aspect of a service, or think it needs to do more to improve, we may make a recommendation or requirement.

- A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. Recommendations are based on the National Care Standards, relevant codes of practice and recognise good practice.

- A requirement is a statement, which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 and Regulations or Orders made under the Act or a condition of registration. Where there are breaches of the regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate.

Based on the findings of this inspection this service has been awarded the following grades:

Linthouse Housing Association Ltd - Sheltered Housing, page 5 of 25 Inspection report continued Quality of Care and Support - Grade 5 - Very Good Quality of Environment - N/A Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good

This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection.

Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.careinspectorate.com or by calling us on 0345 600 9527 or visiting one of our offices.

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2 How we inspected this service

The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care.

What we did during the inspection Activities Undertaken (How we inspected the service ) In this service we carried out a low level intensity of inspection. We carry out these inspections where we have assessed that the service may need a less intense inspection.

The inspection was carried out on 19 March 2015 between the hours of 10.05am and 3.05pm and 20 March between 10am and 3.30pm Feedback was given at the end of the inspection to the registered Manager of the service and the Policy and Continuous Improvement Officer.

During the inspection evidence was gathered from a number of sources

A range of policies, procedures and other documentation including the following was looked at including:

- Participation strategy - Tenants Handbook - Minutes of resident Meetings - Newsletter - Tenant satisfaction surveys - Tenants Records and Support Plans - Staff training records - Staff appraisal records - Minutes of warden's meetings - Consultation register - Quality Assurance systems - Complaints - Supporting evidence from the up to date self assessment

During the inspection discussion took place with the following:

- Six Tenants - The Manager

Linthouse Housing Association Ltd - Sheltered Housing, page 7 of 25 Inspection report continued - the Policy and Continuous Improvement Officer - One of the wardens

All of the above information was taken into account during the inspection process and was reported on.

Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements.

Details of what we found are in Section 3: The inspection

Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement.

Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org

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The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic

Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. A fully completed self assessment document was submitted by the service. This was completed to a satisfactory standard and gave relevant information for each of the Quality Themes and Statements. The service identified its strengths and some areas for future development.

Taking the views of people using the care service into account We were joined at the inspection by an Inspection Volunteer who spoke with 6 tenants. All of the tenants were complimentary about the service and comments included:

- All good, no complaints" - "Notices tell me what is on" - "It's good to know who is checking" [referring to inspections] - "It is the best move I have ever had" - "Quite happy here" - "Food is quite good, prepares lunch themself, but goes over to main complex - for evening meal" - "Food is brilliant, if you don't like stew etc., chef will give me an alternative" - "Feels so secure in this house, wish I had done it years ago." - "So happy and contented"

We also received 19 Care standards Questions from tenants, which we send out before inspections. These all contained positive responses from tenants.

Linthouse Housing Association Ltd - Sheltered Housing, page 9 of 25 Inspection report continued Taking carers' views into account No carers were spoken with during the inspection

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3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found.

Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 5 - Very Good

Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths Consultation and inclusion of tenants was promoted to an excellent standard throughout the service and was very much integral to how the service operated.

A 'Participation Strategy' was available for tenants which had initially been set up by consultation with tenants using the service at that time. The strategy highlighted the ways in which tenants could become involved in the service. The strategy as well as other information leaflets was also available in other languages and formats such as braille and audio.

An Information Pack was given to people when they first started the service to remind them of how the service could support them and how they could become involved in the development of the service. The aims and objectives of the service was also included within the pack

A professionally produced newsletter helped keep people informed about the service including the outcomes of any consultative exercises. They also provided tear off slips for people to return if they wished to contact the service or put forward any comments. We saw that all communications with tenants were recorded in a way that was easy to read and free from jargon.

An annual satisfaction survey was issued to tenants to determine how satisfied they were with the service. As well as the accommodation the survey asked about food, staff including any training requirements and meetings. Outcomes had been developed into an easy read format for people and we saw that responses were positive about the service people received

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Quarterly surveys were also undertaken on a sample of tenants to determine 'real time' opinions on the service. An independent contractor carried out this survey to help seek a more impartial view. Analysis was fed back to the service.

Tenants were consulted through the surveys on a range of topics based on the Scottish Housing Charter Outcomes set by the Scottish Housing regulator. These included tenants' preferred methods of consultation and quality of the information received by the service. We were told how the survey could be adapted to include specific questions where required.

We saw that there were very positive responses within the survey about people's satisfaction with opportunities in decision making. The service actively monitored all the survey responses and analysed these for any common or recurring trends. Where people indicated they were not satisfied, we saw the outcomes of this which showed that there had been actions taken

A 'You said/We did' Feedback from surveys was sent to tenants and uploaded to the service website as a way of keeping people informed about actions taken following suggestions made from consultation exercises.

We found that the 'Tenant Consultation Register' was an effective system which was used to monitor tenant participation such as the surveys. This helped make sure that all tenants views were sought via the quarterly survey over a three year cycle and that quarterly targets were achieved. The register also recorded the preferences of tenants as to what areas of participation they would like to be involved in. This was reviewed regularly to make sure tenants still wished to be involved in the ways they had previously indicated.

Tenants were provided a copy of the service Annual Report. Participation was reported upon within the report.

An annual participation calendar was displayed within each complex to keep people informed about ways they could become involved in the service development and delivery.

An Annual General Meeting (AGM) was held and tenants were invited to attend this and take part. Minutes of the AGM were available for tenants and also publicly available on the service website.

Warden's meetings were held every two months. At the end of the meeting, there was a scheduled opportunity for tenants to speak with the manager outwith the presence of the warden. This meant that any issues relating to staffing could be raised more confidentially.

Linthouse Housing Association Ltd - Sheltered Housing, page 12 of 25 Inspection report continued Each tenant had an individual support plan. These had been developed following consultation and contained signed agreements between the tenant and the service.

Care reviews were carried out in line with legislation. This meant that minimally every six months, tenants were involved in a formal discussion about their care and their views/suggestions were sought and actioned if required. Tenants also had the opportunity to invite a chosen representative to these reviews. People we spoke with told us they remembered these review meetings taking place. .

Tenants spoke very highly about having the chance to have their say about the service and that the staff listened to them and took action.

We were satisfied that the service had maintained the ways identified at the previous inspection and have therefore maintained their excellent grade. Areas for improvement It would be helpful if the six monthly care review records could reflect the previous review date. This would provide an 'at a glance' record of the timescales between reviews.

The service should continue to demonstrate the current excellent practice demonstrated at this inspection.

Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0

Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths A 'Monday Club' had been established following an initiative to develop partnerships working with other local organisations. This had resulted in the 'club' offering ways in which tenants could engage with each other and other people in the community through using the facilities of each of the organisations. Tenants had benefitted from the set-up of the group such as discounted meals at the LUV café, IT and mobile phone workshops and organised trips of their choice. The club set up their own planned events agenda for the year.

We saw a paper which had been produced on the Monday club which included the background, activities and outcomes of the club as well as giving case studies of how people had benefitted from it. From reviewing records and speaking with people, we would agree with the statement which said that the Monday Club had 'reduced the social isolation of its

Linthouse Housing Association Ltd - Sheltered Housing, page 13 of 25 Inspection report continued members who regularly attend the activities'. We saw that the group intended to expand the IT classes and invite guest speakers to the club to talk about their area of expertise in the future.

The service had a range of policies which helped make sure the service was delivered effectively and in line with legislation and best practice guidance. There was a designated Policy and Continuous Improvement Officer whose remit was to review and update policies in conjunction with the tenants. We were pleased to see that where required, Scottish legislation had been reflected within the policies.

Each tenant had a Support Plan in place. These had been developed to reflect how the service met the individual tenants' needs including where additional support may be needed. Support plans also included tenants' preferences as well as any community or clinical support they received.

We saw how the service would help support tenants when they first moved in in relation to some of the practical equipment, furniture or utensils needed.

We received 19 Care standards Questions from tenants, which we send out before inspections. These all contained positive responses in relation to people knowing about their support plans and contents and that the service was meeting their needs.

We were joined at the inspection by an Inspection Volunteer who was supported by one of our Inspection Volunteer Co-coordinators. All tenants who spoke with the Inspection Volunteer were complimentary about all aspects of care, from food choices to personal support.

An accident / incidents procedure was in place and we looked at some of the records completed. Records reflected a generally good level of relevant and clear information. We were satisfied that the service had undertaken appropriate follow up actions where accidents/incidents had occurred.

Staff training was on-going and is reported in more detail under Quality Statement 3.3

The provider undertook compliance checks to make sure there were positive outcomes for service users. These are reflected in more detail under Quality Statement 4.4

From looking at records and speaking with people, we concluded that outcomes for tenants were of a very good standard. Areas for improvement At times there were inconsistencies within the support plans such as:

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- Sections did not reflect dates of eviewr s which had been completed. - The 'records of incidents' section had been recorded in some support plans as a daily log. - There should be a clearer record of signature of tenants following their three monthly reviews. - At times, records were written in pencil and we saw that correcting fluid had been used in some support plans.

We discussed these during feedback and the Manager was receptive to addressing these.

Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0

Quality Theme 2: Quality of Environment - NOT ASSESSED

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Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good

Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths There were ways in which tenants could put their views across about any issues within the home including the quality of the staffing. These are identified under the strengths section of Quality Statement 1.1 Areas for improvement We acknowledged that there had been limited opportunities to involve tenants in staff recruitment, due to no significant turnover.

Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0

Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We saw staff training records which reflected a ar nge of training had been undertaken by all Warden staff. Topics included Rights, Risks and Limits to Freedom, Dementia, Challenging Behaviour and Adult Support and Protection. Staff who returned a CSQ or who spoke with us told us that they received a good level of training to support them in their role.

Training Evaluation forms had been used following the dementia training undertaken by staff. We encouraged the manager to use these more frequent to determine how effective the training was.

All staff had been issued with copies of the National Care Standards and the Scottish Social Services Council Codes of Practice.

Linthouse Housing Association Ltd - Sheltered Housing, page 16 of 25 Inspection report continued Formal Warden Meetings were held regularly. Minutes of meetings which we saw covered matters arising from the previous meeting and covered topics such as accidents incidents, health and safety issues, training and furniture equipment replacement. This had all helped to make sure staff were kept informed and had a structured way of discussing any concerns.

We saw Staff Appraisals which had been undertaken which focussed on performance and development of the individual staff member. Parts of the appraisal asked the staff member to reflect and review achievements and outcomes they had achieved in the last six months as well as identifying any future training needs. Work targets and objectives for the coming year were also considered and recorded. We saw that team or organisational issues resulting from outcomes of tenants' satisfaction surveys were also discussed during appraisals.

Staff interacted well with tenants and visitors throughout the inspection and appeared motivated and professional.

Staff we spoke with told us that they could contact the Manager at any time and they were supported well in their role.

Tenants who spoke with our Inspection Volunteer commented favourably about the staff and comments included: - "Staff could not do enough for me, keep me up to date what is going on" - "Keeps place to a very high standard" referring to housekeeping. - "Staff have a rota for cleaning" - "Staff are 100%, I am quite a nervous person" - "Staff communicate quite well"

Staff did not receive formal supervision sessions. However we were told that staff could discuss topics such as workload issues and personal development in a confidential manner on request. The Manager told us that they were in touch with all staff daily in the process of daily business and staff told us this happened. Areas for improvement We noted that not all staff had completed their appraisals. The Manager acknowledged this but assured us that they were aware and were currently working towards making sure all staff appraisals were completed.

We were pleased to see Domestic staff had all received the same training as wardens to help them engage and support tenants better. However this level of training had not been extended to the Chef, who also had daily input with the tenants. We suggested that this be reviewed and actioned and the Manager was receptive to this.

Linthouse Housing Association Ltd - Sheltered Housing, page 17 of 25 Inspection report continued Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0

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Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good

Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths There was a mixture of formally constituted groups and informal tenants groups throughout the provider's complexes.

The service had supported residents to set up a 'Tenant Panel Group of which the purpose was to be a 'Critical friend' of the organisation. The service statement on the group was: "this group is open to tenants who would like to become involved in improving the association's performance and contributing to how we manage service delivery"

The group helped to determine how well the service was performing and review policies and targets of the service. One of the ways the group had helped monitor performance was to review the role of the Estates Management to ensure they were carrying out works agreed and that other tenants were satisfied with the works. Pictures had been taken to help evidence the effect of this level of monitoring and the results were included within the newsletter to keep other tenants informed.

During the inspection we were told of other areas which the group planned to scrutinise such as the cleaning of residents' 'closes' and the review of void properties before new tenants were allocated them.

Tenants were involved in the development of the service website and had put forward various items to be included in the content.

A Registered Tenants Organisation was also established as a way in which tenants could be consulted on a range of management and leadership policies and procedures. This included policy reviews and management committee reports Focus groups were set up where there was to be a full review of any of the service policies. We saw that people had been invited along to a focus group recently although no one had wished to participate on this occasion.

Linthouse Housing Association Ltd - Sheltered Housing, page 19 of 25 Inspection report continued The service had introduced a self-assessment template which is based on the National Care Standards and planned to invite the tenants to become involved in completion of this during the next internal audit. The Manager and Policy and Continuous Improvement Officer agreed to modify the already existing survey before the next self assessment.

The service had completed a self-assessment as requested by the Care Inspectorate. This highlighted a number of examples where tenants were involved in or had made decisions on how the service was delivered. The evidence we gathered as part of our inspection demonstrated that this information was accurate.

Other ways in which service users and carers could participate in relation to this quality theme are identified under Quality tatementS 1.1 Areas for improvement The service should continue to demonstrate the current excellent practice demonstrated at this inspection.

Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0

Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths Continuous Monitoring took place as a way of helping monitor the service delivery. This has been commented on in more detail under Quality Statement 1.1 There were a number of other ways in which tenants could become part of the service quality assurance systems. These are also reflected in more detail under Quality Statement 1.1 and have been taken into consideration when grading this Quality Statement.

The service submitted its self-assessment and annual return to us when requested. These were ways in which they could review and consider their service and its delivery.

Regular quality assurance checks were carried out in the service's three sheltered complexes. This helped the service check how well records had been completed and how well procedures worked and covered a wide range of areas to help make sure outcomes were positive for people, including:

- Service user invitation to attend the tenant participation strategy focus group/ Staff

Linthouse Housing Association Ltd - Sheltered Housing, page 20 of 25 Inspection report continued training and appraisals are up to date/ - Staff Disclosures completed every 2 yrs./ - Support Plan reviews - Care Inspectorate report and information posters displayed - Public liability insurance

We were satisfied that where issues had been identified through audits, relevant actions had been taken.

Care plan audits were also carried out within the complex audits to make sure all relevant details were recorded and actions taken where required.

Internal Benchmarking charts were used to determine how well the service was performing in relation to the organisations other services.

The service analysed its performance and statistics against the different yearly quarters. As part of this, survey results were also analysed to look at whether there were any changes to service delivery or people's overall satisfaction levels. .

The Senior Management Team met regularly to discuss service and management issues. As part of this, outcomes of tenants' surveys was also discussed. This helped make sure communication was effective at a more senior level and that any issues could be resolved appropriately.

The service had a complaints procedure in place. This meant that if tenants had any issues, they would be addressed. Complaints were monitored regularly. Areas for improvement The service should continue to demonstrate the current very good practice demonstrated at this inspection

Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0

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4 Other information

Complaints No complaints have been upheld, or partially upheld, since the last inspection.

Enforcements We have taken no enforcement action against this care service since the last inspection.

Additional Information

Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1).

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5 Summary of grades

Quality of Care and Support - 5 - Very Good

Statement 1 6 - Excellent

Statement 3 5 - Very Good

Quality of Environment - Not Assessed

Quality of Staffing - 5 - eryV Good

Statement 1 5 - Very Good

Statement 3 5 - Very Good

Quality of Management and Leadership - 5 - Very Good

Statement 1 6 - Excellent

Statement 4 5 - Very Good

6 Inspection and grading history

Date Type Gradings

20 Nov 2013 Announced (Short Care and support 5 - Very Good Notice) Environment Not Assessed Staffing 5 - Very Good Management and Leadership 5 - Very Good

23 Aug 2012 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good

22 Jun 2010 Announced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership Not Assessed

10 Jul 2009 Announced Care and support 5 - Very Good Environment Not Assessed

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Staffing 4 - Good Management and Leadership 4 - Good

24 Jul 2008 Announced Care and support 5 - Very Good Environment Not Assessed Staffing 4 - Good Management and Leadership 4 - Good

All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission.

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To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0345 600 9527.

This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: www.careinspectorate.com or by telephoning 0345 600 9527.

Translations and alternative formats This inspection report is available in other languages and formats on request.

Telephone: 0345 600 9527 Email: [email protected] Web: www.careinspectorate.com

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