Issue 16 15.07.20 We are committed to supporting customers in these unprecedented times, please do not hesitate to get in touch with me or a member of my team to talk about how we can help Derek Breingan, Head of Health and Social Care 07818 454674
The weekly online newsletter for the care sector
Home visits get cautious welcome CARE providers have given a cautious welcome to plans to allow relatives to visit care and nursing homes. The Independent Care Group says enabling relatives to visit their loved ones is vital to both sides’ mental and physical health after lockdown. But it has urged caution and warned that a resumption of visits must be carefully planned and staged to avoid contributing to a second wave of coronavirus. Secretary of State Matt Hancock told a television interview that he thought visits to residents in care and nursing homes could resume in a matter of days. ICG chair Mike Padgham said: “The announcement is a positive one and will be welcomed by thousands of care and nursing home residents and their loved ones who have endured separation now for many, many weeks. “It is really important that we can reunite our residents with their families, as it has been distressing for both sides to be physically apart for so long. “The sector has been very innovative with quickly introducing remote ways of staying in touch. “However, this has not worked well for everyone and is
not ideal. “But we have to urge caution too, as all relaxation of lockdown restrictions carries with it a risk of reigniting the virus and contributing to a second wave of Covid-19. “Any resumption of visiting will have to be limited at first and carefully-managed, with full personal protective equipment in use, social distancing and hand washing a priority and numbers kept under control. “We will probably need to do it on an appointment basis at first as homes will not be able to cope with a sudden rush and it will ultimately be up to individual homes and individual local authority areas to decide whether they feel it is safe to allow relatives in. “We will also need to be mindful of the enormous extra demand this will create for PPE and systems will have to be in place for homes to get supplies to cope with visitors. “We look forward to hearing more about the Government’s plans, hopefully very soon.” The ICG has also supported calls from leading charities including Dementia UK and the Alzheimer’s Society, for relatives of those with dementia to be treated as key workers, enabling them to visit.
Children send home letters and pictures
Kind-hearted children at a special needs Scout group have lifted spirits at a Winchester dementia care home. Nine members of the Osborne Scouts painted around 50 colourful pebbles as sensory gifts for residents at Colten Care’s St Catherines View. The children, who all attend the Osborne School, decorated their stones with acrylic paintings of rainbows, faces, flowers, butterflies and other designs. Members of the St Catherines View companionship team received the pebbles in a socially distanced handover from Scout group leader Lisa Massey and her son Barnaby Pearce. Colleagues then placed the pebbles around the St Catherines View garden, giving residents the opportunity to pick them up and discuss their feel, weight, shape, size and colour.
STAFF and residents at Alwoodleigh care home in Huddersfield have received letters and hand-drawn pictures from local children. Children at Harlequin Nursery and Huddersfield Grammar have been sending letters and pictures to the Edgerton-based home to help put a smile on the faces of residents during the recent period of restricted visits. In their letters, the children shared stories about their experience during recent restrictions, their return to school and their delight at seeing friends once again. The children also used the letters as an opportunity to praise the efforts of carers at the home for all their hard work. Home manager Karen Williams praised the kindness and generosity of the children She said: “Pictures and letters are a wonderful way to keep in touch with people and I would just like to say a huge ‘thank you’ to all the children that took the time to contact us. “Our residents have been eager to keep in touch with the local community during the last few months and it has meant the world to us that they have taken the time to share their pictures and stories with us. “As soon as we can welcome visitors to the home again, it would be great to meet the lovely children that were involved.” The pictures and letters are now displayed on the home’s walls.
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CARINGWEEKLY
Programme is granted RCN accreditation for fifth time SUNRISE Senior Living UK and Gracewell Healthcare’s clinical development and leadership training programme has received re-accreditation from the Royal College of Nursing for the fifth year. This is a comprehensive opportunity for professional development offered to Sunrise and Gracewell’s deputy managers, clinical care leaders as well as nursing team members, who are looking to develop into leadership roles. The programme continues to lead the field after previously receiving accreditation in 2016 from what is the world’s largest nursing union and professional body. Dawn Buchanan-Hole, learning and development manager at Sunrise Senior Living UK and Gracewell Healthcare, said: “We are thrilled that the RCN has decided to grant our clinical development and leadership training programme re-accreditation for the fifth time in formal recognition of its success. “Our programme is designed to guide our employees to create a culture of continuous improvement, as well as a commitment to excellent care for every single individual in our homes. “We look forward to continuing to deliver this programme to our future team members and evolving the content to go from strength to strength.”
Beryl Hohne with her card and heart.
Residents send knitted hearts The programme provides clinical leaders who are responsible for leading the provision of care and nursing in Sunrise and Gracewell homes to obtain the expertise and skills needed to champion clinical governance, as well as providing them with the continual support throughout their career to ensure they build long-term skills. After starting in 2014, the programme continues to be reviewed and developed by leading clinical trainer Carrie Stone, who works with the organisation’s subject matter experts to ensure it is updated in line
with changes in the care sector and that it continues to meet the relevant learning outcomes required for future leaders. All team members who take part in the training have also benefited from its focus on Continuing Professional Development, including the opportunity it offers for team members to develop individual objectives and reflect upon their role and journey. The accreditation means the programme complies with the RCN’s standards of excellence and best practice promoted across the country.
STAFF at Borough Care’s Reinbek home in Davenport have been using novel ways to help keep residents in touch with their loved ones during lockdown due to coronavirus. Residents have recently been writing their own personal messages to their families in a ‘Just a note to say’ card. Each resident included a special knitted keepsake heart with their card, which family members have to remind them of their loved ones when they can’t see them. Activity lifestyle facilitator Michelle Spencer said: “We’ve received some lovely messages from families, who are appreciative of all we’ve been doing to keep everyone connected during this difficult time.”
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CARINGWEEKLY
Kathleen celebrates her 101st birthday
Jennifer Ward with Agi Rygala, interim manager of Featherton House.
Care home bids farewell to long-serving staff members FEATHERTON House care home in Deddington is saying a fond farewell to two dedicated and hard-working members of its team after more than 25 years of service. Sue King is retiring after 16 years as housekeeper, while activities coordinator Jennifer Ward is also preparing to hang up her uniform after nine years of providing entertainment and happiness to residents at the home. Interim manager Agi Rygala said: “I
would like to say a huge thank you to both Sue and Jennifer for the loyalty and passion they have shown during their time at Featherton House. “They have both given years of service, are dedicated to the home and would happily go above and beyond the call of duty to help ensure the comfort and safety of our residents. “Everyone at the home will miss them and wishes them the very best for the future.”
A RESIDENT at Hope House care home in Clayton-le-Moors, Lancashire has celebrated her 101st birthday. Kathleen Blakeley marked the day with a garden party at the Larchwood Care operated home, complete with a socially distanced singer and party food. On her special day she was also surprised by staff from the home who wore fancy-dress costumes from each decade of her life. Home manager Cathy Yates said: “Kathleen is an amazing person who deserves to enjoy and celebrate this special day. “It has been a privilege to get to know her over the last year.” Kathleen was born in Blackburn in 1919 and began her working life as a baker and confectioner, aged just 14. Coming from a family of five, she specialised in decorating wedding cakes before getting married herself. She had a daughter and a son with her husband, who passed away after a happy 33 year-long marriage. Kathleen spent the last 20 years of her working life at Blackburn College as a cook before retiring aged 65. After her retirement, Kathleen devoted her life to her three grandchildren and six great grandchildren. Her hobbies include reading, knitting and gardening – she took great pride in her garden and could
Kathleen Blakeley with pictures taken throughout her life. not settle on an evening until it was immaculate. Kathleen said that she believes the recipe for long life is hard work, determination and the love of family and friends. Staff at the care home described her as a “wonderful character” and expressed their delight at being able to celebrate her special milestone with her. Kathleen’s daughter Patricia Worsley added: “Thank you so much to everyone that took time out of their busy schedules to help my mother enjoy and celebrate her birthday. “I can’t thank the carers at Hope House enough for all their help over the past year.”
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In the wake of the Government creating a £600m Infection Control Fund for care homes, we feature a range of specialist companies who can offer expert technical advice on how you can upgrade your equipment to safeguard your residents and help stop the spread of cornavirus.
£600million to help protect care homes from Covid-19 INFECTION control specialist DDC Dolphin is advising care homes how to make best use of £600million funding to help stop the spread of Covid-19. Care home owners are contacting DDC Dolphin for expert technical advice on how to upgrade their infection control equipment to safeguard residents. Boris Johnson announced the £600m for care homes in England last month during Prime Minister’s Questions. Since then DDC Dolphin has seen an increase in enquiries. DDC Dolphin marketing director Zoe Allen highlighted how one care home had “contacted us urgently, needing to spend the budget that they had been allocated on upgrading current equipment.” She added: “The extra funding for care homes is to be welcomed. But it’s imperative they spend it on the most effective infectioncontrol solutions, while at the
same time balancing their books. “Investing in new sluice room equipment such as medical pulp macerators and bedpan washers is only half the story. “These advanced machines must be serviced and maintained over their lifespan so it’s important to factor in whole-of-life operating costs.” DDC Dolphin helps care homes, hospitals and sheltered accommodation to purchase sluice room equipment more affordably. Monthly bills spread the lifetime cost of the machines. The company offers a wide range of 360° care and maintenance packages that include:
n Twice-yearly or annual servicing and maintenance to increase the operational life of equipment. n Five-year parts and labour warranties – to help avoid unexpected bills. n Discounts of between five and 15 per cent on chemicals. n Discounts on parts. n Sluice room health checks. “Regular servicing ensures this vital equipment stays fully operational, protecting care home residents and staff from infection,” added Zoe. “Without it, care homes would close,” Poole-based DDC Dolphin manufactures and supplies sluice room equipment including medical pulp macerators, bedpan washer
disinfectors, incontinence product macerators, air purifiers, medical pulp consumables and maceratable/flushable wipes. This equipment is essential for the safe disposal of human waste in hospitals and care homes – preventing the spread of infections including superbugs. DDC Dolphin is the leading manufacturer of medical pulp macerators. It is one of only three companies in the world specialising in the manufacture of these machines. The company exports sluice room equipment and accessories across the world, protecting patients and clinicians from dangerous infections. Key markets include Europe and Asia. For more information please contact DDC Dolphin marketing director Zoe Allen on 01202 731555, email info@ddcdolphin. com or visit www.ddcdolphin.com
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CARINGWEEKLY Advertiser’s announcement
Interiors company working to provide a ‘healthier solution’ SOMMER Rose Interiors is working with upholstery manufacturers to provide a ‘healthier solution’ to care home furniture. Sarah Thompson and her team would like to introduce Sileather™. Sileather™ silicone fabrics are highly durable and abrasion resistant, thanks to our unique silicone, and Sileather™ upholstery fabrics are all over 200,000+ Wyzenbeek double rubs, over 130,000 Martindale and 3000+ Taber cycles (rotating “cement discs”). We take a long term approach when considering our production of silicone leather and want to do our part to be environmentally friendly. With our non-solvent production technique and with the lack of PVC or PU elements, we are much safer and healthier than traditional fabrics.
Unlike PVC fabrics, we do not need to use chlorine in any of the production process, and our fabrics do not leak VOC emissions throughout its life. There’s no need to clog up landfills – silicone leather is recyclable! We have passed the most common environmental standards so you can breathe comfortably knowing that you are using a fabric that’s safe for you and the environment. We take pride that our fabrics
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are environmentally friendly and safe to use by anyone, Sileather™ silicone fabrics are made with the same material as baby bottle nipples, so they are gentle enough even for babies’ skin. Sileather™ fabrics have ultralow VOCs, so it is among the healthiest fabrics, making it perfect for use around children, hospitals, ALL HEALTHCARE ENVIRONMENTS, hotels, boat cabins, trains, and any number of enclosed spaces.
Everything essential It’s our mission to bring you a healthy fabric that’s safe, hygienic and meets high standards that help to ensure your well-being. Thanks to the unique advantages of our proprietary silicone, Sileather™ fabrics are inherently: n Flame resistant. n Does not promote growth of mildew or mould. n Superior in hydrolysis resistance compared to vinyl and polyurethane fabrics. n Superior in UV and colour fading resistance. n Stain resistant to many substances found in healthcare facilities, including biro, iodine, betadine, blood and urine. n Resistant to liquids and fluids. n Easy to clean – common stains need only water, including biro. n Medical grade skin friendly and allergen free. n Highly abrasion resistant and durable with recovery ability to reduce sagging and wrinkling. n Luxurious soft touch. For free samples of this upholstery or to view sample furniture, please contact Sarah Thompson on 07495 471038 or email: sarah@sommer-rose.com
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Uxbridge nursing home appoints new manager
Advertiser’s announcement
Invest in long-term solutions SINCE the Government has announced that a grant of £600million will be provided to the care sector to help tackle the spread of Covid-19, many care homes are in the process of deciding how to allocate these funds for infection control. We believe that to tackle infections, the key is to invest in long-term solutions that will give you benefits and peace of mind for many years to come. An example of this? Think about how you’re restructuring common areas like the dining room; thinking of long-term solutions here means that you should invest in furniture that can accommodate social distancing as required. Dining room tables should be large enough to create space between residents. Spearhead’s Care Interiors can provide large rectangular tables, such
as 1500 x 750mm and 1800 x 750mm. Homes should invest in dining room chairs that can withstand being cleaned a lot more often than the usual, and with stronger chemicals. Consider the fabrics used in your furniture, these should be antimicrobial to offer protection against bacteria, mould, and other hazardous microbes. Care Interiors stock dining room chairs with anti-microbial upholstery fabrics that are Phthalate free and REACH compliant, which certifies that the fabrics feature no hazardous chemicals. Lastly, these chairs can be wipe clean and can even be cleaned with bleach. So, in thinking about how to further improve your home’s infection control, think about what can be done to improve the infection control properties of your furniture and interior design.
CANFORD Healthcare has appointed Shawndell Barker as the manager of Parkfield House Nursing Home in Uxbridge. Shawndell brings a wealth of expertise and experience to the role. Over the last 20 years she has worked in many areas of nursing, specialising in the care of the elderly. Having taught social studies and English language briefly in her native Guyana, South America, she realised that her real calling lay in nursing. Shawndell qualified as a Registered General Nurse and gained valuable experience as an intensive care and emergency nurse in a private hospital and, later, a nurse manager for a gynaecological clinic. Since moving to the UK she has held several senior managerial roles including deputy manager and registered home manager. Operations manager Caron SandersCrook added: “We are delighted to welcome Shawndell as the new manager of Parkfield House Nursing Home. “We believe that her knowledge, skills and experience, together with her energy, drive and passion for elderly care, will help establish Parkfield as an outstanding provider of residential, nursing and dementia care.” At Parkfield, Shawndell’s main priority is to ensure that residents continue to receive person-centred care tailored to their unique needs
Shawndell Barker and wishes. For her, this is strongly aligned to the home’s customer service promise – to deliver great care that enables people to live independent and rewarding lives – something that she is determined to influence positively as home manager. “We have a fantastic team who share my passion and drive and, together, we will help our residents to live happier, healthier, and more fulfilling lives,” she said. “I am excited to be part of the many positive changes taking place at the home. I also love spending time with the residents. “They have a wealth of stories and memories and always make me laugh.”
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Arnold based homecare service is Outstanding
Home hosts memorial event for Dame Vera STAFF and residents at Magnolia House care home in Cottingham took part in a remembrance afternoon in memory of wartime singer Dame Vera Lynn on the eve of her funeral. Songs by Dame Vera have sparked memories of times gone by for residents at the home for many years, so a memorial day was suggested as part of the home’s activities. Throughout the afternoon the residents and staff sang along to her classics before finishing the day of remembrance with tea and cupcakes. Home manager Lindsay Altoft said:
“I was saddened to hear of Dame Vera Lynn’s passing; she was a household name, and our residents spent a lot of their lives listening to her wonderful music. “The memorial afternoon gave the residents a chance to remember a great lady, but also time to reminisce about the past and the memories that Dame Vera’s songs brought back to them. “The afternoon tea was enjoyed by us all, but listening to the residents singing their favourite songs was definitely the best part of the day.”
A NOTTINGHAM domiciliary care service has been rated Outstanding following an inspection by the Care Quality Commission. Respectful Care, based in Arnold, was inspected in February and March. At the time of inspection the company supported 66 people living in their own homes. Some people using Respectful Care received personal care – the regulated activity CQC inspected at this service – which includes help with personal hygiene and eating. The inspectorate also considered the wider social care these people received. Deanna Westwood, CQC head of inspection for adult social care, said: “Our inspection team was very impressed by the level of care and support offered by Respectful Care. “People were treated with kindness and compassion, helping them enjoy improved health and wellbeing. “We heard how a relative of a person using the service saw a marked improvement in their family member’s outlook, following the care they received. “Helping people achieve the levels
of independence they wanted was central to the service’s approach. “We heard numerous examples of staff going above and beyond expectations to help people participate in the activities that mattered to them. “One person was supported to prepare their own meals, something they greatly valued. Another person was assisted to attend a wedding by a carer, who provided discreet support throughout the day. “For a registered deaf person, staff sourced a sign language interpreter to ensure their views were accurately recorded and acted upon. “An Outstanding rating is the result of considerable hard work, so I congratulate everyone who made this achievement possible.” Under CQC’s inspection programme, services are rated according to whether they are safe, effective, caring, responsive and well-led. In addition to its overall rating, Respectful Care has been rated Outstanding for being caring, responsive and well-led. It is rated Good for being safe and effective.
Group overhauls its health and safety policies to protect residents and staff CHD Living, which has 13 residences throughout Surrey and also operates two specialist rehabilitation centres and a domiciliary care business, has revealed new measures that they have implemented to safeguard residents, staff – and now visitors – following the introduction of garden and window visits. While the government have provided no official guidance on visiting, except for at end-of-life, the group felt compelled to balance the risk of social isolation against the low risk of coronavirus infection due to its high level of infection control policies and processes at its centres. Liaising with Public Health England and the Care Quality Commission for advice, the company has enabled families to reunite safely after months of restricted access. Outdoor visitor sessions are now being held regularly across the week at all of CHD Living’s care homes, with up to two visitors per resident permitted each time. Visitors are required to undergo a temperature check and to sanitise their hands upon arrival, and masks must be worn throughout the socially distanced visits, which are taking place in the gardens of homes where possible. Residents cared for in bed due to medical conditions will instead be able to reunite with family members through their windows, and residents cared for in beds above the lower floor are able to have bedside visits in line with an individual risk
assessment using the principles set out in the government’s guidance – as with end-of-life visits. Residents at CHD Living’s Brownscombe Lodge home, where most bedrooms have direct access to outdoor terraces and can be accessed via a courtyard, will also be able to host visitors in their room maintaining safe social distance and using screens for additional safety. To keep residents further connected with loved ones, CHD Living is in the process of upgrading the Wi-Fi across all homes, so that a strong internet connection is received in every communal and individual room. Other measures currently being taken by CHD Living, whose homes have been free of coronavirus for
more than one-and-a-half months with no symptoms present, include regular testing for residents and carers, and plenty of PPE. Head of hospitality and communications Shaleeza Hasham said: “The health and safety of our recipients of care, staff and visitors remains the utmost priority. “However, as a family business that recognises the importance of staying connected with loved ones, we fully appreciate that this has been a difficult time for many – particularly our residents who have been unable to receive visits as a result of the pandemic. “With this in mind we wanted to reinstate visits as soon as feasibly possible, without of course putting
anyone at risk while the virus is still very much active. “We have been following government guidance and adapting our operations accordingly and on an ongoing basis since March to help control the spread of coronavirus, and we are confident that with our extensive experience and precautionary measures in place that we can safely welcome visitors once again. “While this is welcome step forward, we will continue to review guidance and to adapt our protocols where necessary, taking account of changes in the emerging picture around coronavirus and to ensure the safeguarding of all.” To further safeguard residents and staff, the group – which welcomes admissions across its homes – is operating a quarantine period for new residents, whereby a coronavirus test will be carried out prior to admission and a 14-day period of self-isolation supported upon arrival at the home. CHD Care at Home, which offers 24/7 at-home support to those who need it most, is also welcoming new customers. With extensive control measures in place to minimise the risk of infection transmission to employees, clients, families and the communityat-large, in accordance with Health and Safety Executive regulations, the service continues to offer unrivalled assistance with everyday tasks, social activities and personal care.
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CARINGWEEKLY
Operator adds six trainees to Nursing Associate programme A SOUTH coast care home provider has opened the latest chapter in its investment in nursing. Six Colten Care team members are set to begin their first work placements on the nationally recognised Nursing Associate training programme. They join eight colleagues who formed the family-owned provider’s initial cohort of trainees last year in partnership with Solent University in Southampton. At a time of huge recruitment pressures in healthcare, the Nursing Associate role is designed to bridge a skills gap between carers and registered nurses. It involves two years of study and work placements ahead of formal registration as a Nursing Associate with the Nursing and Midwifery Council. Operations director Elaine Farrer said: “We care for many residents with severe frailty and complex needs. “To do that successfully, we employ excellent clinical leaders and highly skilled professionals to plan and deliver care. The Nursing Associate role helps us in two main ways. “As well as creating a career pathway for trainees who have typically been healthcare assistants or care leads, it means we can free up our registered nurses to focus on more complex
Resident John Arbor provided insight and advice on the trainee Nursing Associate selection day at Colten House in Ringwood, Hampshire. With him are nurse learning and development manager Sally Smith (left) and Ann Gorecki, senior lecturer in health and social care at the School of Sport, Health and Social Sciences at Solent University. clinical duties knowing they have at Newstone House in Sturminster the support of professionals who are Newton; Kelly Wills, senior care lead independently recognised in their at Belmore Lodge in Lymington; own right.” Agnieszka Ciok, senior care lead at This year’s cohort is: Kayleigh Fernhill in Ferndown and Nikolina Guppy, healthcare assistant Boncheva, healthcare assistant at at Abbey View in Sherborne; Woodpeckers in Brockenhurst. Stoyanka Ruzheva, senior care Because of Covid restrictions, this lead at Kingfishers in New Milton; year’s training programme has begun Pratik Gaikwad, senior care lead with virtual learning.
The walls of Avonbridge care home in Hamilton have been decorated with a brightly coloured mural of a high street for residents and staff to enjoy. Residents were asked what they would like to feature on the walls of the home to create a feeling of walking along a high street. The mural put together by staff showcases shops including a post office, hairdressers, café and grocery store, as well as nature scenes like cherry blossom trees. The art has sparked reminiscence in the home; residents have been discussing which businesses along their local high street they’re most looking forward to visiting when restrictions allow. Resident Moira Buchanan is pictured enjoying the grocery store mural.
Corinna promoted to deputy manager role Acts of kindness at homes for World Wellbeing Week FROM ice cream vans to webinars, Encore Care Homes delivered a thoughtful week of events in celebration of World Wellbeing Week. The operator has facilities in Bournemouth, Christchurch, Poole and Southampton and joined other health and social care settings across the world by providing emotional support and wellbeing webinars to employees. Throughout this week, care teams were treated to daily acts of kindness such as free flapjacks, ice cream and beauty products. The overall aim of the event was to help promote and encourage better understanding of health and wellbeing issues, which has been especially important during this current period of pandemic. Fiona Radford, sales and marketing director at Encore Care Homes,
said: “The team has wholeheartedly embraced the week’s activities. “It was lovely to be able to see everyone enjoying the favourite feelgood foods of ice cream and flapjacks. “We must never lose sight of the health and wellbeing of our care team and helping them feel positive, supported and valued.” Many of the treats were donated by local businesses. Rachel Dryden, chief executive of Encore Care Homes, added: “We have never had a greater sense of pride of working in the social care sector and the privilege of looking after our residents. “As an organisation we are fully committed to ensuring that every team member is fully supported and we provide access to emotional, financial, mental and wellbeing support
CORINNA Foster has been promoted to deputy manager at The Hamptons care centre in Lytham St Annes. In her new role she will support home manager Suzanne Scholz in the smooth day-to-day running of the home including taking care of the residents and the team, managing the employee rotas and resident medication plans and ensuring overall standards in every area of care remain exceptionally high. Having worked at the home for a number of years already, Corinna is particularly keen to use evidencebased practice and encourage reflection and learning with the team and will do this through her personal blend of ‘coffee and chat’ making time to listen to each individual member of staff and their feedback. After joining as a care assistant just over two years ago, she has developed her career with New Care progressing to senior care assistant and then team leader before being promoted to deputy manager. Corinna said: “I was drawn to New Care because of the company’s great reputation for outstanding person-centred care and for its culture and values around personal development and progression.
Corinna Foster “ I feel very lucky to have developed my career with such a caring and supportive company. “I love working at The Hamptons. Our home is a purpose-built property that provides a wonderful home-from-home environment and an exceptional quality of life for residents. “My aim is to do the very best job that I can in my new role.” Corinna is a non-clinical deputy manager, but is currently working towards her Level 5, Health and Social Care diploma.