Response to Covid-19 (Coronavirus) 

Update to Home Status Regarding Visits

Last Update: 10th June 2020 

We are writing to you with an update regarding visits to see your loved ones.  You may be aware, that the government guidelines on shielding remain in place for those at high risk until the end of June. Although, with the governments lifting of restrictions, it would appear that infection and death rates are decreasing, we feel it would be prudent to maintain our residents isolated in our homes until we can be sure that the downward trend is consistent. As a result, we are aiming to be able to start facilitating visits in two weeks’ time (Monday 29th June 2020). We believe that this will give us enough time to implement further training and robust systems to ensure the highest level of infection control.

In addition to the ‘new normal’ that was outlined in our previous letter to you, we would like to provide you with a summary of the further training and systems we are currently implementing;

In order to increase staff awareness all of our staff in Cedar Care are:

  • Currently receiving Covid19 specific infection control training, in addition to frequent briefings reflecting new government guidelines as and when they are updated.
  • Being tested and retested (when test scores are below 100%)
  • Our staff are creating their own home-specific Covid19 ‘Oath’, which they will use to remind them of their commitment to protect our Residents.

In order to prevent the virus from entering into the home we are;

  • Finalising a robust & stringent system to enable families and friends to visit their loved ones in a risk-free environment
  • Creating bespoke Access & Egress areas for each individual home – where staff can change into clean uniforms and footwear before entering the home
  • Implementing top to toe decontamination of staff with disinfectant spray before they enter the home

In order to prevent the spread of infection inside of the homes we are;

  • Increasing the working hours of the domestic teams to allow for nightly cleaning and disinfecting schedules to be completed
  • Continuously sourcing and replenishing PPE stocks at home level and head office level (for redistribution)

And finally, continuous daily internal audits and weekly external audits are being carried out to ensure compliance at all times.

We hope that the above information will help you to identify why we feel it would be counteractive to allow home visits at this stage. We feel that once the above systems are running and all necessary training has been completed, we will find ourselves in a far safer and risk-free environment to allow the home visits to take place.

Once again, thank you for your co-operation during these unprecedented times.

 


Last Update: 15th May 2020

Quarantine Success

We would like to reassure you that despite the impression given by the media and government that care homes across the UK are not in control and struggling against the fight of COVID19, this is not the case for Cedar Care. We are very much in control of the virus and our homes are coping well with pressures inflicted by it. We would like to share with you company-wide analysis of how the first wave of COVID19 has affected Cedar Care.

Sadly, as would be expected some of our residents succumbed to the virus. In the line graph below, we have displayed the number of recorded deaths across our 17 homes since the 26th March 2020 (national lockdown) until the 3rd May 2020. Please note that all the deaths recorded may not necessarily have been caused by COVID19.

As you can see, we experienced a peak in the middle of April. Over the last three weeks we have seen a rapid decline and now find that we are in a stable position in all of our homes.

As is clear above, the national percentage of deaths in care homes is currently increasing week by week. Whereas the incidents of deaths peaked in Cedar Care on the week commencing 6th April 2020.

We currently have 14 suspected cases of COVID19 across our 17 homes.  We do feel that our success in containing the virus was due to the quarantine system which was implemented in most of our homes around the time of the national lockdown.

Changes in Quarantine

In the majority of our homes the quarantine system is still in place and has been greatly beneficial in keeping our residents safe during this period. At present, we believe that it might be detrimental to lift the quarantine, as we cannot assume that there will not be another national wave of COVID19. We strongly believe that now is not the time to become complacent and relaxed because the lifting of social restrictions and the re-opening of certain types of businesses is likely to increase the prevalence of infection.

We are currently consulting with our staff on the ‘new normal’ at Cedar Care;

The ‘new normal’ is based on the widely accepted theory that this virus is unlikely to be controlled until a vaccine is developed. Our aim is to keep the homes in quarantine for this period of uncertainty as we just do not wish to risk the well-being of our Residents where it can be protected. However, we have taken into account that staff can become fatigued, especially towards the end of the quarantine where they are remaining in the home for seven days. In consultation with our staff we are proposing three options:

7 days in / 7 days out: staff will stay in the care home on their ‘days in’ and have been asked to self-isolate in their own homes as much as possible on their ‘days out’

4 days in / 4 days out: staff will stay in the care home on their ‘days in’ and have been asked to self-isolate in their own homes as much as possible on their ‘days out’

4 days in / 3 days out: staff will return to their own homes at the end of the shift and return the next day for four consecutive days. Although this will not provide the level of protection as the above options, it will greatly reduce the number of different people entering the home and therefore reduce the level of viral load on a daily basis. This will also reduce the risk of staff becoming infected on their days off.

The staff in each if the homes will collectively choose which option they prefer.

Additional Measures

  • Transport

As far as possible staff will not be using any form of public transport to get to and from work. In cases where staff members do not have any means of transport, we are supporting them to avoid reliance upon public transport.

  • Donning and Doffing

When staff enter the home, uniform donning and doffing areas for staff will be set up outside of the home. Staff will follow strict procedures in donning and doffing of both uniforms and PPE. Most of these processes have been in place since the beginning of the quarantine at the end of March.

  • All staff will present for duty in the designated staff entrance for health screening and infection control process.
  • There will be a tray/container outside the building with a disinfectant solution in that staff are able to stand in prior to entering.
  • Staff will have temperature checks prior to entering the building.
  • Staff will wash their hands and use alco gel immediately on entering the building or in the designated areas outside.
  • Staff will bring full uniform including shoes (in a sealed bag) into the building.
  • Staff will then change into their uniforms in male and female designated areas before reporting for duty.
  • We are also providing the option for staff to have their uniforms washed on site by the laundry staff if they prefer or they can be taken home in a washable bag/pillow case which can be transferred straight into washing machine without removing.
  • All staff will be bare below the elbow. No rings or watches.
  • All staff will wash their hands before and after any contact with each resident and after use of toilet etc
  • All staff will wear PPE as per our normal infection control protocol.

PPE Provision

Cedar Care Head Office has allocated the responsibility of continuously sourcing, distributing and storing PPE equipment to a designated member of staff. Because of this, we are glad to announce that we are not experiencing any type of shortage in PPE equipment. We currently have a company-wide supply of 6,500 disposable face masks, 160,000 aprons, and a large enough supply of gloves to last all of our homes for up to 4 months. As mentioned these reserves are being continuously replenished through various suppliers.

Further to this, our Cedar Care training staff are visiting the homes (donning complete PPE) to provide on-site infection control refresher training over the next two weeks. This training is necessary to review and reiterate new stringent infection control measures and ensure compliance.

COVID 19 Testing

“So far, very few staff across Cedar Care have contracted COVID19, although with the lifting of restrictions, we may experience an increase. Fortunately, testing for our residents and front line staff has now become more accessible. You will be pleased to know that we have already ordered test kits for each resident and staff member at Cedar Care, and we are currently awaiting delivery. As per government guidance we will be testing all of our staff and resident regardless of whether they are symptomatic or not. This will enable us to establish if those who are not symptomatic may be carrying the virus. Our plan is to test residents as soon as they are received and staff will be tested when they arrive for their quarantine period. Thus completing all tests within the time span of one week. Following this we will test staff and residents again if and when they start showing symptoms.

Upon Receiving Test Results

As far as we are aware it may take a minimum of 4 days to receive results. When we receive the results, we will contact you to inform you. We would respectfully request that you do not call the home asking for results as this will inundate the already pressured staff.

Thank you!

We would like to take this opportunity to say thank you for all that you have done to aid us in our continuous battle against COVID19. We know that this situation is difficult for everyone, some more than others. So many of you have been so supportive to our hardworking staff and management teams by cooperating with us in our approach and systems which we have implemented. We acknowledge that our success in battling the first wave of the virus would not have been achievable without your support, patience, and cooperation. Thank you for believing in us. Together, we will defeat COVID19.

 


 

Last Update: 13th May 2020

We are currently working on the system to allow you to visit your loved ones. Please check back for more information.

Last Update: 7th May 2020

Dear friends and family of Cedar Care,

As you may be aware, the Prime Minister is scheduled to give an announcement this coming Sunday (10th May 2020). We are all anticipating the changes to social distancing measures in his update. These new rules will need to be considered in order to adapt our strategy going forward to ensure the safety and well-being of our residents. Once the announcement has been made, we feel that we will be in a position to discuss openly with the homes and yourselves the best way forward.

For the time being, we would like to share with you company-wide analysis of how COVID19 has affected Cedar Care.

In the line graph below, we have displayed the amount of deaths across our 17 homes since the 26th March 2020 (national lockdown). Please note that the deaths recorded may not necessarily have been caused by COVID19.

 

As you can see, we experienced a peak in the middle of April. Over the last two weeks we have seen a rapid decline and now find that we are in a stable position in all of our homes.

As is clear above, the national percentage of deaths in care homes is currently increasing week by week. Whereas the incidents of deaths peaked in Cedar Care on the week commencing 6th April 2020.

We currently have 17 suspected cases of COVID19 across our 17 homes.  We do feel that our success in containing the virus was due to the quarantine system which was implemented in a majority of our homes around the time of the national lockdown.

The quarantine system is still in place and has been greatly beneficial in the role of keeping our residents safe during this period. We are sure that you are aware of the national crisis in care homes consistently reported by the media and more recently by the Prime Minister. Therefore, at present, we believe that it might be detrimental to lift the quarantine, as we cannot assume that there will not be another wave of infection. We will, however, be informed by the new guidelines when they are announced. 

For the time being please be aware that our visiting restrictions still apply. Once we have looked at our homes individually, we will of course update you and welcome the opportunity to discuss the best way forward.


Last Update: 20th April 2020

Thank you for the kind and supportive messages posted to our staff during this difficult time. We want you to know that they have been shared on our private quarantine Facebook group and your messages continue to encourage and inspire our teams; so please do keep posting these.

We are extremely proud and humbled by the continuing commitment shown by our staff in caring for our Residents, being away from their families and at considerable risk to themselves. The words of appreciation and many gifts received from you are overwhelming and heart-warming as we all come together in what is possibly the most challenging period in our lifetime.

Needless to say, with the extended ‘lockdown’ nationally, visiting restrictions to our homes will be maintained whilst we continue the staff quarantine in 13 of our 15 sites. We can inform you that although we have had some confirmed Covid19 cases in our homes, most of them remain unaffected. Where we have had confirmed cases, we have promptly sent detailed letters to the relevant families and friends and will continue to do so as the situation unfolds. In this respect, it really is the case that “no news is good news”.

These are uncertain times; situations are constantly changing within our homes and government guidance and provisions are frequently updated. Recently, the media has taken up the cause of the difficulties faced by care homes and whilst this is reassuring and supportive, it is inevitable that many of you might worry about how we are coping.

We would like you to know that we continue to ensure the safety and well-being of our residents and are able to overcome most of the difficulties pertaining to Covid19. Our staff remain well equipped to protect themselves as we have sufficient stocks of PPE which we regularly monitor. We are also sourcing and purchasing items, in addition to those provided by the government, to ensure that we do not fall short in case government sources falter.

Over the last four weeks, we have experienced some staffing shortfalls due to staff becoming infected and needing to isolate and recover, but thanks to the quarantine system, the impact has been marginal, and we have managed to maintain safe staffing levels.

We feel that the best channel to provide general updates in response to media coverage is through our social media outlets; you can follow us on Facebook (by searching for Cedar Care Homes) or on Instagram (by searching for @cedarcarehomes). If you prefer not to use social media please email us on info@cedarcarehomes.com stating that you would like to receive email updates.

As mentioned, the social media updates will be general, specific information about the home where your loved one resides will be sent to you directly as necessary. Apart from this, if you would like to read more about everything we are doing to keep your loved ones safe and well, please see below.

Last update: 20th April 2020

As always the safety and wellbeing of our Residents remains at the heart of everything we do. In responding to the threat of the coronavirus pandemic, we have put in place robust measures to minimize as much as we possibly can, its impact on our Residents and staff. Our plans are regularly reviewed and updated as circumstances change and as advised by the Public health authorities.

Restriction of visitors

Following the World Health Organisation declaration of the coronavirus to be a pandemic, the UK government moved to “Delay” protocol from the “Containment” protocol which previously existed. On 13th March, we took the decision to “Lock Down” each of our homes.

Since then, all external visits have been restricted unless absolutely necessary. Additionally, any outdoor activities have been cancelled, along with any externally provided activities.

Healthcare professionals may still visit the homes, but most consultations are currently conducted remotely using a range of suitable devices. Therefore, we continue to regularly share information and consult healthcare professional to manage health risks.

Where visits are essential, visitors are required to follow strict infection control processes and provided with the necessary Personal Protective Equipment. Access is restricted only to specific areas that the visitor needs to enter.

We are painfully aware that you have been unable to visit your loved ones for a number of weeks now.  Although it would please us immensely to give you some indication about when this restriction can be lifted, we are not able to predict this, and we hope you understand that this sad situation prevails purely in the very best interests of our staff and residents, and in compliance with public authority advice.

Staff ‘living in’ in the homes

In an effort to further minimize exposure, on the week commencing 16th March 2020 we started an organization wide consultation with our managers and staff to discuss the possibility that our staff could move into the homes. This was a bold step, but we were overwhelmed by the numbers of staff who chose to quarantine themselves into the homes to keep our Residents safe.

Subsequently, 13 out of our 15 homes went into full ‘Quarantine’ over a period of a week starting on the 20th March 2020, prior to the national lockdown.

Each of the homes divided their staff into two teams that would alternatively quarantine themselves in the home for a maximum of 14 days: team 1 worked while team 2 isolated at home. After 14 days, team 2 replaced team 1 which returned home to rest and isolate.

After the initial four weeks, the maximum quarantine period has reduced from 14 to 7 days.

The quarantine system works on a voluntary basis. Those who are unwilling or unable to do so, work normal shifts in two of our homes that have not quarantined. Where staff have not quarantined in the homes and do not have their own means of transport we are providing transport in our own mini-buses so that they do not have to use public transport, thereby minimising the possibility that they may get infected whilst travelling to work.

All staff complete a health screening questionnaire and are checked for body temperature, before entering into quarantine. Body temperatures are taken everyday whilst the staff are in quarantine.

Infection Prevention Control

Personal protective equipment is readily available and stocks are regularly monitored to ensure that they are replenished before they run out.

Part of these heightened Infection Control Protocols also involves disinfection of surfaces that are regularly handled and high traffic areas are also frequently cleaned and disinfected. We are ensuring that required stock levels of disinfectants and detergents are available. The handling of laundry for any suspected or confirmed cases is required to be kept in a secured designated area for 72 hours before washing.

Our staff are fully aware of Covid19 symptoms and remain vigilant to determine if our Residents or they are themselves showing symptoms. They are also fully aware of protocols to follow should there be symptoms.

Covid19 monitoring, testing and response

As a basic precaution, body temperature, oxygen saturation and pulse are monitored for all Residents on a daily basis to detect early signs.

Staff are monitored for typical Covid-19 symptoms and if they present any symptoms, they immediately leave the premises.

In these circumstances, however, we cannot guarantee that the virus will not enter our homes and that our Residents will remain unaffected. We have dealt with positive cases and outbreaks in some of our homes, and in doing so feel well prepared and confident that we can act swiftly to minimize the spread of the virus, where there are positive or suspected cases:

If Residents are confirmed Covid19 positive or suspected to be infected:

  1. Affected Residents representatives will be informed immediately.
  2. We will write to inform the relatives and friends of the affected home as soon as possible.
  3. Affected Residents are isolated and looked after in their own rooms.
  4. Where possible we are segregating them to a specific area in the home and they are looked after by specific members of staff who remain contained in the area whilst on duty. They do not provide care to Residents who are not suspected.
  5. Staff are fully aware of infection control in nursing, personal care and cleaning procedures. Public Health England guidelines are reinforced by signage and posters they have issued for easy reference and reminders throughout the home.

It is important to explain the current approach in suspecting Covid-19 cases. Previously at the first onset, Public Health England guidelines allowed the testing of a maximum of 5 Residents in the home. More recently Public Health guidelines now require all symptomatic residents in care homes to be tested.

As you may be aware, it is not unusual for our Residents to become unwell: historically, they are known to show cold / flu like symptoms, diarrhoea, and other forms of infection or delirium. In response to the threat of Covid-19, we are now advised, by PHE, that any symptoms of illness should be suspected Covid-19 symptoms. As a result, the number of suspected cases in the home can appear to be alarmingly high.

You will be assured to know that, in some of our homes, the subsequent tests for Covid-19 have returned negative results and the symptoms displayed have not been Covid-19 related. Furthermore, many of our residents who have displayed symptoms have recovered.

In any case, this results in the highest protective measures being implemented in anticipation and prevention of the outbreak becoming more widespread.

Nutrition

Food and beverage supply remain plentiful; our Residents (and staff) continue to enjoy our usual planned menus and choices.

We do not expect this to change but are well stocked with non-perishable foods in the unlikely case that there is an unexpected shortage.

New admissions to the home

In compliance with government guidelines and our own public responsibility to support the national effort in combating the pandemic, our homes remain open for new admissions to relieve the pressure on the NHS.

Please be assured, however, that a rigorous consideration of the home’s status and the needs of the people being referred is conducted before any new admissions take place.

All newly admitted Residents are isolated in their rooms and barrier nursed for a minimum of 14 days. For all admissions from hospital, residents are tested for Covi-19 at the hospital. Whilst we await results all newly admitted residents are isolated in their rooms for a minimum of 14 days.

Keeping in touch and health updates

We are currently providing communication via Skype, Face Time and WhatsApp for relatives and friends to keep in touch with loved ones.

Nevertheless, we acknowledge the worry and uncertainty that you must feel – especially as you are not able to meet your loved ones. Understandably, you will want to ensure that your loved one is well and not affected. In our experiences to date, the landlines in the home can become relentlessly busy and we kindly request that some consideration is given to the frequency of calls.

For this reason, please be reassured:

  • If your loved one is well, the home may not contact you: no news is good news.
  • However, if your loved one becomes unwell, the home will promptly inform you. Following this they will call you between 2.30 pm and 4.30 pm every day to update you.

Our staff

We have not experienced staffing shortages so far, however, there has been a marginal impact as staff have become unwell and needing to isolate.

The recent government provision of testing for care home staff will ease the pressure as staff will know for certain if they must isolate for 7 or 14 days and as importantly, will identify those who have already contracted the infection, recovered and have developed anti-bodies against further infection.

Due to the ‘Quarantine’ scheduling, we anticipate that staff sickness will continue to have a marginal impact and that we can maintain safe staffing levels.

We are extremely proud of the commitment our staff have shown by going into quarantine and are providing them with small comforts to express our gratitude:

  • Twice a week we provide a free takeaway of their choice
  • Extra snacks and goodies are delivered once a week and are available for the staff at all times
  • An essentials package to take home when they complete the quarantine
  • An alternative accommodation to self-isolate if they are worried about exposing their family
  • A Cedar Care booklet for emotional and psychological support has been issued and contains information about government hotlines and provisions as well as our own for staff members

In addition to the above, the words of appreciation and many gifts received from you are overwhelming and heart-warming as we all come together in what is possibly the most challenging period in our lifetime.

We have also set up a private Facebook page for quarantined staff to receive your messages and share their experiences and activities with our Residents. Please be aware that this group is strictly for the use of Cedar Care staff members only. Any attempt from external users to try to join this group will be declined.

We have tried to describe to you as concisely and accurately as we are able, the current situation, but we hope you will appreciate that these are extremely uncertain circumstances and things can change very quickly.

We feel that the best channel to provide general updates in response to media coverage is through our social media outlets; you can follow us on Facebook (by searching for Cedar Care Homes) or on Instagram (by searching for @cedarcarehomes). If you prefer not to use social media please email us on info@cedarcarehomes.com stating that you would like to receive email updates.

If you have any further questions regarding our arrangements or efforts, please email us at info@cedarcarehomes.com.

We would prefer to respond via email, but if you are unable to email please feel free to call out Covid-19 Operations Control Centre: 0117 946 7216 Ext: 3101 (Monday to Friday, 11.00 a.m. to 3.00 p.m.)


26th March 2020

Update to Home Status Regarding Visits

As you know, we previously issued the alert that we would ask all relatives and friends of our residents to limit their visits to those that are absolutely necessary.

Given the accelerating nature of the spread of the Covid-19 Coronavirus, we have introduced a quarantine system in 12 of our Homes.

This system is intended to ensure that residents in these homes, along with the staff that provide the range of care services, are isolated from the open risk of infection by “locking-down” the home with the staff who have volunteered to assist us in implementing this system.

This “lock-down” will be for an initial period of 14 days. During this time, other staff that work at the home have agreed to self-isolate at their own homes, in preparation to replace their colleagues on day 15.

As a result, we feel it appropriate to close our Homes to all relatives and friends.

We shall of course continue to allow access to visiting medical professionals.

In addition, residents that are on the “End of Life” Pathway, will be permitted visits from close relatives.

We apologise for having to take this action, but the safety of our residents and staff during these difficult times are of paramount importance and we hope that you understand our reasons for imposing these restrictions.


19th March 2020

Update to Home Status Regarding Visits

As you know, we previously issued the alert that we would ask all relatives and friends of our residents to limit their visits to those that are absolutely necessary.

Given the accelerating nature of the spread of the Covid-19 Coronavirus, we have introduced a quarantine system in 6 of our Homes.

This system is intended to ensure that residents in these homes, along with the staff that provide the range of care services, are isolated from the open risk of infection by “locking-down” the home with the staff who have volunteered to assist us in implementing this system.

This “lock-down” will be for an initial period of 14 days. During this time, other staff that work at the home have agreed to self-isolate at their own homes, in preparation to replace their colleagues on day 15.

As a result, we feel it appropriate to close our Homes to all relatives and friends.

We shall of course continue to allow access to visiting medical professionals.

In addition, residents that are on the “End of Life” Pathway, will be permitted visits from close relatives.

We apologise for having to take this action, but the safety of our residents and staff during these difficult times are of paramount importance and we hope that you understand our reasons for imposing these restrictions.


13th March 2020

As you will be aware, the World Health Organisation has now declared the coronavirus to be a pandemic and the UK government has moved to “Delay” protocol from the “Containment” protocol which previously existed.

In response to this, you were informed that we had taken the decision to “Lock Down” each of our homes.

It is important to stress that there are no diagnosed, nor suspected cases of the Covid-19 (Coronavirus) at any of the Homes and we have taken this decision as a protective measure. We are sure that you are fully aware that each of our residents is in the very highest risk category and the government, as of Wednesday, has conceded that the pandemic cannot be contained.

Our decision is based on this announcement and the critical category into which our resident fall.

This means that we are restricting visitors to visits that are absolutely necessary and we recommend that you do not visit.

Where your visit is absolutely necessary, you will notice an increased level of infection control. You will be asked to wash your hands and go directly to your relative’s room and exit directly via the same route. Toilet facilities within your relative’s room, along with washing facilities should be used in favour of the public areas.

Additionally, any outdoor activities have been cancelled, along with any externally provided activities.

Medical professionals (i.e. GPs, CPN, CSN, social workers and other MDT members) will still be coming to the homes but will be subject to the same infection control procedures as other visitors.

We will continue to regularly review and share resident information with all GP surgeries and continue to monitor the medication that they receive.

We have and will continue to provide on-going support and up to date information to staff members about the development of Covid-19 and the protocols they must follow in relation to heightened Infection Control protocols.

Currently this involves regular hand washing, avoid touching frequently touched surfaces (and to be conscious of the need to wash hands following such contact) and avoid touching eyes, mouth and nose.

However, should a case be suspected (or worse, diagnosed), we will need to move to a full “Lock Down” whilst we identify the extent of the outbreak.

Part of these heightened Infection Control Protocols involves disinfection of surfaces that are regularly handled and increased laundry of residents’ clothing. We are reviewing required stock levels of disinfectants and detergents to support this increased usage.
Regular updates to conditions within each Home will be displayed on our website and you can email us through the website should you want any specific information and are having difficulty contacting us by telephone.

We are currently making provision for the introduction of communication via Skype, Face Time and WhatsApp. Details of how this will be implemented will be posted on our website when the process has been defined.

We have a public responsibility to continue to provide an effective social care service and make it available to assist the NHS to the best of our ability; your understanding of our situation will assist us in achieving our responsibility. For the same reason, we will continue to receive admissions throughout the period. On admission, there will be a 14 day isolation period of all new residents to validate their condition.

We understand that this is a difficult time for everyone, and we have taken this short-term action to allow us time to make more compassionate provisions.

If you have any questions email us through the website.


Support Messages:

We are very proud to have such a committed personnel who are isolating themselves along with Residents in order to keep everyone safe. Our staff need support more than ever, so every little heart-warming message that we can pass on to the homes under lock-down, will be greatly appreciated. Please fill out the form below to brighten up their day:

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Thank you!