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text: SOUTH LONDON & MAUDSLEY NHS TRUST DIRECTORATE OF NURSING & EDUCATION MODERN MATRONS 3rd YEAR EVALUATION REPORT 1.0 1.1 1.2 2.0 2.1 3.0 3.1 3.2 3.3 3.4 3.5 4.0 4.1 4.2 5.0 6.0 Introduction Background About this Report Progress against last years Priority Actions Progress Report table Review of Matron Activities 2004 - 2005 Matron's Charter Think Clean Day Clinical Leadership Forum National Modern Matron Conference and Developmental Group Patient Environment Action Teams Matrons Today What are Matrons in SLaM doing? Matrons Role and Impact Conclusion Recommendations 1 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST MODERN MATRON/QUALITY SERVICE NURSE 3rd YEAR EVALUATION REPORT Introduction 1.1 Background The Modern Matron role was introduced to the NHS to improve the patients experience of health care. A key focus of the Modern Matron was to give a voice to front line staff which would enable them to meet the fundamentals of care for patients. The original guidance document outlined three key strands of the role. 1. Securing and assuring the highest standards of clinical care by providing leadership to the professional and direct care staff within the group of wards for which they are accountable. 2. Ensuring that administrative and support services are designed and delivered to achieve the highest standard of care. 3. Providing a visible, accessible and authoritative presence in ward settings to whom patients and their families can turn for assistance and support. South London and Maudsley NHS Trust introduced Modern Matrons in 2002. Since that date all service areas have access to individuals whose role encompass elements of the Modern Matron. The names of these individuals vary and include Modern Matron, Quality Service Nurse / Manager, Clinical Co-ordinator, Lead Nurse / Nurse Advisor. For the purpose of this report the term Matron will be used to include all these groups. 1.2 About this Report This report differs from its predecessors. In the previous two evaluation reports Matrons surveyed were asked to complete a self assessment tool and comments were sought from Service/Ward Managers and Directors. The information gained from this was used to identify where impact was being made and where further work was required. This report looks at the years 2004 - 2005 activities that Matrons have been involved in. It also contains information gained from discussions with twelve service users on one hospital site and 83 members of staff based on four different hospital sites, comments gained a from patient group in one service area. It also highlights examples of Modern Matrons diaries, providing some insight into the life of a Matron within SLaM. 2 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST 2.0 Progress against last years Priority Actions The second year evaluation report identified six key Priority Areas. Over the past year Matrons have worked well with others to progress a number of the actions. 2.1 Progress Report Table Priority Action Progress The Clinical Leadership Forum in partnership with the Clinical Governance Department to devise a strategy to roll out the Essence of Care Benchmarks across the Trust. Head of Clinical Governance attended Clinical Leadership Forum to present Essence of Care. Matrons have participated in Essence of Care Benchmarks which have been rolled out across the Trust. Matrons with Ward Managers are leading the process at ward level. The Client Environment Board to devise A robust internal PEAT programme has an internal PEAT assessment been implemented. Matrons are involved programme. in assessments. Clinical Leadership Forum to identify Individual Matrons continue to work with examples of good practice in relation to carers in various ways. Good practice meaningful engagement with carers examples have not been posted on the post these on the good practice website. "Good Practice website. The Trust Executive to agree key Priorities have been set around PEAT priorities in relation to improving the assessment scores. patients environment agenda. To commission the Consultancy service The Consultancy service has continued to to do a piece of work which helps to work within Directorates and some of their clarify the key roles, responsibilities and work has included role clarity. Specific objectives of the Modern Matron and role work with Matrons will need to be Service Manager posts addressed. For each Matron to devise an action Clinical Leadership Forum is used as an plan to improve their self assessment. opportunity for Matrons to discuss particular areas of concern, obtain feedback and solutions. 3.0 3.1 Review of Matrons Activities 2004 - 2005 Matron's Charter In October 2004 a new Chief Nursing Officer (CNO) was appointed to the Department of Health (DoH). The CNO"s top priority was to improve hospital cleanliness and tackle the rising MRSA and other hospital infection rates. On her appointment the Health Secretary, John Reid, made it clear that the CNO role was vitally important and that her first concern was to ensure all NHS hospitals came up to the standards of the best when it came to cleanliness and infection control. 3 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST To coincide with her appointment and priority focus, the Department of Health in partnership with other key bodies published The Matrons Charter: An Action Plan for Cleaner Hospitals. Described as a "no nonsense" guide for hospital staff, the charter made it clear that all have a role to play in ensuring hospitals are clean. The document clearly states that Matrons must take the lead in setting standards. "Matrons must lead by example and by making changes when things aren't up to scratch" (CNO 2004). Since the introduction of the Matron role it is clear that the public look to Matrons to uphold standards of cleanliness. The charter acknowledges their role in this but also recognises that cleanliness is everybody"s business and not just the domestic staff. All individuals have a responsibility to work tidily and clean up after themselves. The Purpose of the Charter The Charter is aimed at all NHS staff and should also be shared with patients, carers and partners. It sets out ten broad commitments which should be:1. Discussed at all levels of the Organisation to provoke debate and encourage reflection on the importance of cleaning. 2. Used to encourage audits of practice in respect to inputs, output, culture and philosophy. 3. Used as a foundation for service ideals. 4. Used as a tool to enable local targets for improvement to be set. The Ten Broad Commitments are: Keeping the NHS clean is everybody"s responsibility The patient environment will be well maintained, clean and safe Matrons will establish a cleanliness culture across their units Cleaning staff will be recognised for the important work they do. Matrons will make sure they feel part of the ward team 5. Specific roles and responsibilities for cleaning will be clear 6. Cleaning routines will be clear, agreed and well publicised 7. Patients will have a part to play in monitoring and reporting on standards of cleanliness 8. All staff working in health care will receive education in infection control 9. Nurses and infection control teams will be involved in drawing up cleaning contracts, and Matrons have authority and power to withhold payment 10. Sufficient resources will be dedicated to keeping hospitals clean 1. 2. 3. 4. The Matron"s Charter sets out the demands Matrons will make of staff to ensure a culture of cleanliness is maintained. 4 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST Throughout the document thought provoking questions are asked of staff to support raising the cleanliness agenda and also to consider longer term impact for example:Does your Trust involve infection control nurses in refurbishment and new build projects? Before you buy new equipment do you have a system in place to ensure it can be cleaned? Do you have a rapid, reliable way of responding to patient comments? Do all staff promote the principles of a clean environment at all times? The document also provides good examples of practice and outlines the responsibilities of individuals from the Chief Executive to the Ward Housekeeper. For a summary of the Matrons Charter, (see Appendix One). The full document can be found on the Department of Health website. 3.2 Think Clean Day In February 2005 the Trust participated in Think Clean Day. This was an initiative between local Trusts and the Department of Health and other key bodies to raise the profile and importance of cleanliness. The purpose of the day was to focus attention on cleaning and demonstrate what could be achieved in a short time. In addition Trusts were asked to audit a ward or department and develop solutions to cleanliness problems. It was envisaged that everyone from Consultants to Cleaners would be involved. As part of the preparation for Think Clean Day a presentation was made to the Senior Leaders Group by the Client Environment Board which included information about the Matrons Charter. A representative from the Think Clean Campaign informed Senior Leaders about the initiative and the types of activities others across the country would be conducting. Senior Leaders were split into service area and corporate area groups. These groups were led by Matrons and Estates and Facilities staff. The purpose of this was to enable groups to begin to plan their days. Each group was asked the following:What do you want 28th February 2005 to look like? Who will you involve? How will you involve service users? What needs to happen from today? Who will lead the work? How will you incorporate the ICNA Audit tool kit? 5 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST 28th February 2005: Think Clean Day. Most clinical sites took part in the Think Clean Day and so did a number of corporate departments. Below are examples of what took place. i. Education and Training Centres Hand washing posters were displayed in all centres and the poster stating "Cleanliness is everybody's business" was also displayed. Staff were encouraged to be extra vigilant about the overall environment. Lambeth A series of posters were displayed across Lambeth sites. Each ward demonstrated a particular theme related to cleanliness. In addition wards were encouraged to de-clutter and tidy bed areas and office spaces. Lewisham Led by Billy Govinden (Modern Matron) and Sue Fisher (Facilities Manager) a series of activities took place. The day commenced with an infection control audit. A display board was set up in the Ladywell Unit reception detailing NVQ courses in cleaning, posters on hand washing and food hygiene. Staff joined patients on the wards for lunch. A competition was held titled "who has the tidiest room" which was won by Wharton Ward service users. Bethlem Hospital A Think Clean roadshow was held in the Community Centre and services were encouraged to display information and also collect information to share with ward staff and service users. Monks Orchard House Housekeeper, Ann Allen, worked with service users on the day. They generated ideas about what would make a difference, made posters and displayed these around the unit. They made good use of a photograph to show litter in a bedroom to encourage service users to use the bin. They also produced before and after photos of an unmade bed and some untidy workspaces to show how these are a hazard and obstruct cleaning. ii iii iv v Overall the day proved successful and demonstrated that with concerted effort that much can be achieved in one day to improve the environment. 3.3 Clinical Leadership Forum The Clinical Leadership Forum continues to provide an opportunity for Matrons across the Trust to meet. The meetings have focussed on improving the patients experience / environment and the Matrons role within this, i.e. Essence of Care, PEAT, Housekeepers. In addition, presentations have been delivered demonstrating where Matrons and Estates and Facilities staff have worked well to improve the patient environments and the challenges which exist within the role delivery. 6 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST 3.4 National Modern Matron Conference and Developmental Group Six Matrons attended the first National Mental Health Matrons Conference. The conference provided Matrons with the opportunity to review the different perspectives of the role, obtain information about the national picture and develop terms of reference for the developmental group. Some of the objectives of the national group include: Responding to Legislative drivers Influence national policy Inform local policy development Plan and facilitate national events Create an environment which supports opportunities for growth and development 3.5 Patient Environment Action Teams (PEAT) Matrons continue to be involved in PEAT activities across the Trust. Over the past year in order to raise the importance of the PEAT process, Matrons, Estates and Facilities and other clinical and non clinical staff were invited to participate in PEAT training. Three training days were provided which concentrated on understanding the PEAT documentation and agreeing on what was an acceptable standard. Individuals were asked to consider what they expect whilst a patient in hospital. It is envisaged that internal PEAT assessments will be conducted by one clinical and one non clinical member of staff. Internal PEAT inspections were conducted in July and action plans were devised by clinical services. At the time of writing this report the Trust is preparing for the next round of internal PEAT assessments scheduled for December 2005. 4. 4.1 Matrons Today What are Matrons in SLaM doing? In order to obtain a flavour of what types of things our Matrons are involved in over a period of one week, Matrons were asked to provide a weeks diary activity. Below are examples. Matron 1 Week of 17th October Monday Tuesday Wednesday Thursday Friday Saturday Reviewing clinical cases, CPA meeting Planning national conference via conference call Supervision of staff Training day (KSF) Research meeting Carers skills workshop 7pm - 9pm Teaching session for team members Available for support / respond to emergencies Provided advice and support to another Trust re: treatment. Spoke with a relative. Lunch with residents at off site Trust facility E-mails - no time in the week available 7 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST Matron 2 Monday am pm Week of 24th October Tuesday am pm Wednesday am pm Thursday am pm Chaired site security meeting Supervised site service managers meeting about cost of CCTV Meeting re: swipe cards Meeting with infection control Check beds. E-mail On call 17.00 - 09.00 Walked the site, checked emergency log book, phone calls, e-mails Chaired service user liaison meeting Meeting to agree complaints training OPS meeting On call 17.00 - 09.00 Bed management meeting Chaired environmental meeting Meeting with Health and Safety advisor Meeting with Clinical Governance Ward managers forum Phone calls, e-mails On call 17.00 - 09.00 Project board meeting - 2 hours Scheduled PEAT walk round with Estates and Facilities, identify concerns On call 17.00 - 09.00 Phone calls, e-mails Meeting re: smoking policy Walk the wards with Health and Safety checking windows, ligature free bedrooms Meeting with ISS Mediclean, walk wards Friday am pm 8 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST Matron 3 Monday Case review meeting providing advice to team re: care Meeting with team to discuss record keeping Benchmark re: Essence of Care Meeting with client to discuss complaint Pan London meeting reviewing respite care in the capital Contract meeting at local commissioners Interviewing for team member PCT including presentation to Tuesday Wednesday Thursday Teaching at local University Research group meeting Meeting with voluntary groups to discuss patient needs Client appointments Attend outpatient appointment with client Meeting with service manager of an external service provider Friday Other Matrons described involvement in: Formulating recovery plans re: overspending Business planning Chair ward based meetings Chasing referrals Following up complaints Staff management issues Recruitment Supporting / advising staff re: care and risks Staff supervision Chasing up maintenance works and liaising with Estates and Facilities Highlighting poor physical environments to management Attending community meeting - dealing with complaints locally as required Further examples can be found in Appendix Two 4.2 Matrons Role and Impact Matrons or Quality Services Nurses were intended to be high profile figures, visible to patients and visitors and to more junior staff. Their role was to encompass significant involvement in ensuring a cleaner and more therapeutic clinical environment and help to drive up standards of care and treatment. In practice, the matron"s role has developed in diverse ways across the Trust. In order to see what impact was being achieved a decision was made to go out on to the wards. 9 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST In practice, this involved visiting twenty-four units on the four major hospital sites (BRH, Maudsley, Ladywell and Landor Road) over a two day period and talking to a random sample of staff on duty at the time. (Wards were informed that visits would be taking place but not precisely when). In total 83 people (a mean of about 3.5 per unit) ranging from ward managers / team leaders to Health Care Assistants and ward clerks and domestics were met. It was originally intended to ask a selection of both staff and patients whether they knew who their matron (or local equivalent term) was and then to ask about their impact on environmental and clinical issues. In practice, initial attempts at asking patients about matrons resulted in much confusion and, apart from the odd reference to Hattie Jaques, no useful information was gained. It was therefore quickly decided to restrict the survey to staff. A further complication developed in that significant numbers of people were unable to tell, immediately, who their matron was, but knew of the person when the name was given to them. Staff were then asked whether they recognised the name and, if so, whether they could describe the role that individual played. The subject was then further explored by specific questions on their visibility to / involvement with patients and clinical issues and their impact on the ward/unit environment. The results obtained were as expected. Almost 90% of staff asked did indeed recognise the name of their matron and 11% did not (see Appendix 3). When asked to describe the role, less than three quarters (71%) were able to do so in any detail. The responses given could be questioned as to whether what was described was actually "Matron duties" for example:"Wearing many hats and I thought the role would be more practical, the role is not what I expected" "Involved in drug errors, reports and investigations". "Collecting Data for external sources " "Role to broad and has no authority Too much bureaucracy and meetings" "Workload wise where do I start? Getting bogged down in management issues" Although the figures were not analysed by grade, it appeared that the more senior the staff the better they were informed and the more contact they had with the Matron, which challenges the "highly visible" aspect of the original role description. In the follow up questions, less than half (48%) of respondents considered the "matron" to have significant patient contact (or to be known to the client group). This is particularly significant as it includes areas where the matron was based on a unit or had a joint role as either the ward / unit manager or nurse advisor. Given that these scored between 80 and 100% on this question. There were other areas where the matron was not seen to have a clinical role at all. 10 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST The figures are clearer on the environment questions, with only a third (33%) of those asked agreeing that the matron had a significant impact on living and working conditions on the unit. Only one service area scored higher than fifty per cent on this question and one area came in at 7% and zero respectively (see appendix 4). It should be said that on virtually all the areas visited, staff were clear about who was responsible for environmental issues. Most felt that these concerns were best managed in house, whether by a dedicated charge nurse on one ward or by ward housekeepers on another. It should also be noted that some respondents explicitly cited help they had received from the "matron" in delivering major improvements or refurbishments and it may be that the value of the role is indeed in these major and relatively unusual events. It should also be said that the overall impression received from staff was that where people did know the "matron" they were generally quite positive about the role that person played in the unit. The concern, however, is that that role is too broad which was not the intention when they were established, having been diluted by other elements of service management. 5.0 Conclusion Over the past year Matrons have made progress on their priority actions and have been involved in a number of national initiatives. The Think Clean Day was a great success and demonstrated how team work can achieve great results for patients, carers and visitors and enabled staff to recognise their role in the cleanliness agenda. The revamped internal PEAT process has provided an opportunity for clinical and non clinical staff to get involved in assessments and ensure that our environments are fit for purpose. This report identifies that there is little commonality between Matron roles across the Trust. The examples of Matrons diaries demonstrated that most have significant managerial responsibilities, which are time consuming. This can often leave little time to concentrate on the array of Matron related issues which may arise and also impacts on their visibility on wards. The visits to the ward proved useful and clearly showed that the Matron role has variable impact on the environment and visibility to patients. Most staff did not know who their Matron was but recognised the name of the individual when this was provided. Most staff viewed the Matron as a manager and as such described management tasks when asked about the role. The environmental issues appeared to be dealt with locally and the Matron"s involvement requested when progression is halted. 11 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST The Trust has a significant number of senior staff whose role encompasses that of the Matron. This report has shown that due to the way posts have been configured and the increasing demands made by DOH, Trust and Local services the Matron role has been diluted. Even in some of the services where the Matron role follows the guidance "responsible for a group of wards" the Matron focus has been diverted. At a time when the National Health Service is concentrating on Standards for Better (PEAT, hospital cleanliness, better hospital food, evidenced based care and refurbishment of patient environments). The Trust has the potential through the Matron role to ensure that standards are high and that the patient"s experience of care is improved, but instead we may be creating another tier of service management and duplication of effort. 6.0 Recommendations 1. Re-focussing the Matrons role in order to release service management aspects and strengthen the original Modern Matron principles. 2. Consultancy service to work with Matrons around role clarity. 3. Nursing Directorate to create a development programme for clinical leaders. 4. Repeat the review in six months time. 5. Report to the Board in six months to 1 years time. Report Compiled by Elaine Rumble Deputy Director of Nursing November 2005 12 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST APPENDIX ONE MATRONS CHARTER SUMMARY The public look to Matrons to uphold standards of cleanliness. Cleanliness is everybody"s business. The Charter is aimed at all NHS staff. It sets out 10 broad commitments, which should be:1. 2. 3. 4. Discussed at all levels within the Organisation Encourage audit activity - culture/philosophy development The foundation for service ideals Act as a tool to enable local targets for improvement to be set The Charter should be shared with patient, carers and partners Ten Commitments are 11. Keeping the NHS clean is everybody"s responsibility 12. The patient environment will be well maintained, clean and safe 13. Matrons will establish a cleanliness culture across their units 14. Cleaning staff will be recognised for the important work they do. Matrons will make sure they feel part of the ward team 15. Specific roles and responsibilities for cleaning will be clear 16. Cleaning routines will be clear, agreed and well publicised 17. Patients will have a part to play in monitoring and reporting on standards of cleanliness 18. All staff working in health care will receive education in infection control 19. Nurses and infection control teams will be involved in drawing up cleaning contracts, and Matrons have authority and power to withhold payment 20. Sufficient resources will be dedicated to keeping hospitals clean Everybody's Responsibility Everyone should clean up after themselves. Matrons have a clear role in improving cleanliness standards. Questions to ask self:(a) (b) (c) Do you take active steps to keep your work area clean and tidy? Do you pick up odd pieces of litter, for instance in corridors and public places? What could you do to make it easier for cleaning staff to do their job? Leadership Leadership is important. The Charter suggests that the campaign should be led by the Chief Executive. The Charter asks all NHS staff to be more vigilant to the environment they work in, for example, clear away clutter, and ask do I have adequate storage? 13 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST Matrons Role Matrons are asked to take the lead in establishing a cleanliness culture across organisations. The Matrons must have the authority, credibility, drive to communicate a vision of cleanliness, challenge poor practice and recognise good practice. The Charter cannot be delivered without good working relationships with Support and Estates and Facilities staff. Cleaning staff need to be viewed as part of the ward team. In order to achieve this, regular domestic staff should work on wards. This will help them to feel part of the ward team. Roles and Responsibilities The Chief Executive is responsible for standards across the whole Trust. Trust Executive Directors are responsible for: (a) allocating budgets with due attention to infection control and cleanliness (b) understanding the implications of the funding decisions they make Matrons are responsible for: (a) leading and driving a culture of cleanliness in clinical areas (b) setting and monitoring standards in conjunction with others Infection control teams are responsible for: (a) advising on contracts for cleaning (b) educating staff about the need for good hygiene standards Nurses in charge of wards and departments are responsible for: (a) agreeing cleaning standards for their area (b) making sure that standards are met (c) working with local cleaning staff to help them fulfil their roles Contract managers are responsible for: (a) making sure that contracts (including in-house SLA"s) deliver high standards, and value for money (b) establishing a spirit of partnership and teamwork with service providers Cleaning service managers are responsible for: (a) ensuring there are enough staff, with the right skills to do the job (b) making sure there is an appropriate supply of equipment, including cloths and chemicals 14 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST Some things regularly slip through the cleaning net, with no-one taking responsibility. Patient equipment (for example, drip stands and commodes) is a case in point. Who cleans such items is a local decision - but whatever the solution, Matrons need to ensure that someone knows that this is their job, and takes it seriously. Patient Involvement Local feedback mechanisms need to be organised in relation to the environment. First port of call for concerns will be ward/unit managers, Matrons, estates staff. Infection Control This is everyone"s business. All staff, whether clinical/non clinical staff need regular, on-going education re: infection control. Records of updates should be kept. Cleaning Contracts Nurses, Matrons and Infection Control teams need to be involved in the drawing up of/review of cleaning contracts. Clarity re: expectations important. Resources Adequate resources need to be spent in order to achieve/maintain cleanliness standards. The Housekeeper role can assist with this. An NHS model contract contains relevant information re: this. Support Trust to plan how to invest in cleanliness and to make sure that investment delivers real improvements in standards. This is a summary of the Matrons Charter. Full copies can be obtained from the NHS Estates website:- www.nhsestates.gov.uk 15 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST APPENDIX TWO Matron 4 Monday am Week of 24th October pm Tuesday am pm Wednesday am 7 Borough Commissioning meeting 9-12 BRH. Presented all the activity, answered queries on the contracts and service provision for the 3 units to all 7 borough joint commissioners and dat coordinators. Presented 2 new bids for inpatients. One for increasing the establishment of the admissions team to cope with the demands of 2 week wait target and one for a physical liaison team on the AAU. Laid some seeds for increasing the establishments for all 3 units for 2007/8 Checked emails, Oh dear! Too Many to count! 12-45. Leak on WPH and staff were getting no joy from works. Clients getting agitated re the laundry room having to be closed. Team Leader at WPH on leave. Called works met with the clients to explain what was happening. 1pm-3pm. Penny Brown visiting the Bethlem units to look at action plans arising from PEAT. Shown round WPH and Alex and given the paper trail of reqs and risk logs to show that we had assessed ourselves and raised the alarms but had failed to get any works completed. 4pm. Called works again re the leak on WPH. Told to get a laundry assistant by works! Had a heated discussion. Plumber arrived eventually at 5pm! Sent emails to everyone re the leak! Arranged for clients to use Alex One laundry facilities until leak fixed. 6ish. Late shift staff member impromptu clinical supervision following a difficult group 9.30 -1.30 Clinical Leadership Meeting Maudsley Popped into AAU to see staff. Impromtu supervision with acting team leader. Checked data with unit administrator. Checked bathrooms as floor had collapsed and builders in attendance. Found three builders smoking in said bathroom. Had a lovely heated discussion with them about how smoking is extremely bad for their health in more ways than one, called Mr Reynolds to let him know. Drove back up to Bethlem….. 2-4pm. Admission Team Leader Appraisal Checked WPH laundry, staff updated me re the failure of the plumber to fix the problem. Called Barry Reynolds, left messages and emails with every relevant party. Arranged the next addictions no smoking policy meeting. Spoke with Recruitment re the last of the Band 5 awaiting start dates Admissions needing some advice re the difficult referral. Miscellaneous: couple of calls from VJ and Matt, long discussions re standards for better health, recruitment and EoC meetings. 9-11ish Completed the Healthcare Commission Improvement Review Forms for all three units. Checked through the post numbers/ management accounts with Alex One Team Leader. Met with Martin Brown who at last agreed to fix the laundry room on WPH. Went through a new design for the laundry facilities with him. Met briefly with clients to inform them. Administered some methadone on WPH, as other qualified was in group. Drove to Maudsley ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST 16 pm Thursday am pm Friday am pm 1pm-3pm. AAU Charge Nurse Appraisal Checked on bathrooms while there, work in progress will need to close 2 beds temporarily to find where the long standing problem leak is! Informed service manager, admissions team and commissioners re wait time target being effected. Drove back to BRH, checked emails! BIG mistake….left late 10-12. Addictions User Involvement meeting Maudsley Chaired this strategy meeting. Mostly looked at organising an event for Southwark addiction services. Meeting changed to monthly as the group would like to map the needs of service users and staff in relation to improving user involvement in every borough. Finished off 2 bank staff management cases for disciplinary hearings which had come from formal complaints from clients. Sent them off to HR for proof reading 2-3pm. AAU Unit Meeting 3-4pm. Supervision with AAU Team Leader Brief chat with late shift before leaving AAU, checked progress of bathrooms. Left message with Barry Reynolds re rest of the AAU refurb Drove back to BRH 5-6pm. Supervision with Charge WPH Nurse Checked emails. Will I never learn? Stayed late. 10-11 Management Supervision with senior band 5 on WPH. Sickness and lateness. Responded to 7 Dat Co-ordinators re improvement reviews and DoH returns 12-2pm WPH Unit Administrator Appraisal Wrote a report re service user involvement for the Addictions Clinical governance meeting for Monday. Checked and responded to emails. Left the unit at 4, attempting to take some time back! Off to Plymouth for the weekend! This diary does not include the impromptu visitations from staff at my office for a " quick chat" nor the numerous calls to and from HR, my line manager, finance, payroll, nurse advisor, consultants, management accounts, contracts, referrers, an x client wishing to re open an old complaint, complaints office, SUI Office, requests from other addiction services re protocols, service provision, advice re the regimes, staffing numbers, dat co-ordinators looking for impromptu info re activity 17 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST Matron 5 Monday Tuesday am Week of 12th October 9:30-16:00 Facilitation: tissue Viability Audit and Link worker Training 9:30-11:30 Meeting with Service Director BRH Review and Feedback Nursing Exec Agenda and MHOA Nursing Issues 13:30-16:30 HR Maudsley- Bullying and Harassment investigation: interview of witnesses (This matter has been ongoing for one year, as victim was dissatisfied with preliminary investigation. In addition victim and perpetrator had long periods of sickness which also prolonged the investigation. Management report expected after interviews of 4 potential witnesses 10:00am-12pm Chair: MHOA Clinical Team Leaders Forum Feedback from Nurse exec and discussion of topical issues that impact practice 13:00hrs-14:00hrs Facilitation of Band 5 Peer Supervisions on AL2 15:00hrs MHOA SUI Panel review of outstanding SUI and recommendations. 9:30-12pm MHOA Executive Monthly meeting Administration: And completing a lengthy LMI(into the 3rd week of the investigation and interview of witnesses and reading patients case notes dating back over 10 years) Answering Telephone Adhoc queries 9:30 am Should have attended the Modern Matron steering group this morning but have to complete LMI report which is part of a joint Social and health investigationdeadline end of September before I go on leave. Above ongoing . Break to plan diary for next week for supervision and clinical visits, any action expected from other forum meetings, End of life policy development, addressing adhoc Telephone queries And Drop-in clinicians who have queries This list is by no means exhaustive as built into is being able to respond as a matter of urgency to any untoward clinical event, serious complaint as well as providing advice supporting managers with staff development programmes. As a Senior Nurse my diary should include Research time for literature searches and reflective practice .I"m working on including this in my diary. pm Wednesday am pm Thursday am pm Friday am pm 18 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST APPENDIX THREE Overall Results for Each Question Visibility to Patients Impact on Environment Awareness of Role Name Recognition 0% 10% 20% 30% 40% 50% Yes No 60% 70% 80% 90% 100% 19 ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST APPENDIX FOUR Comparison by anonymised area (% respondents agreeing) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Area 1 Area 2 Area 3 Area 4 Area 5 Area 6 Area 7 Overall Name recognition 20 Awareness of Role Impact on Environment Visibility ER/MM REPORT NOVEMBER 2005, SLaM NHS TRUST

subset: commoncrawl


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Building money-smart childrenSeptember 22,2013I have always wondered what makes a kid smart about money. When I was a kid, I remember going to the bank with one of my parents, usually my mother.
She was a devoted mother of her day, what we now refer to as a stay-at-home mom, and yes, she did, and still does, make really good chocolate chip cookies. We would go to the bank and while my mother was writing on one of those paper slips in the neat little bins on the tall glass table, my sister and I would see who could take more of the paper slips in our little hand so we could play bank when we got home. (Our hands were small so we werent thieves, just little bandits!)
I recall watching grown-ups write checks, hand them to someone at the bank and get large stacks of money back. Same thing with credit cards. Id watch my father pull one out of his pocket, give it to a cashier, sign a receipt, stuff it in his pocket and we would walk out of the store with our purchases.
Wow, now that was easy. Give someone a card and get stuff. Write something on a piece of paper and get money in return. Finance and commerce can look pretty simple to a youngster. What I never saw was these same grown-ups paying bills, borrowing money and worrying about their paychecks. I guess they did that after I went to bed.
Kids get smart about money by watching money-smart adults and getting good life lessons from the time they are old enough to count. Heres a few to get you started.
Lesson 1. Buying on a whim can have long-term effects. If you see kids getting what they want when they want it, you can label them as overindulged (or worse) but the more important reality is they may well grow up to be impulse shoppers. Its like going grocery shopping when you are hungry. As an adult, try to limit trips to the store or mall so they are treats and do not become a lifestyle.
Lesson 2. As seen on TV fills a need, for the moment. If you see kids in the store and they say to an adult, thats the one I saw on TV, I just really, really want it and they get it, that can lead to a shopping addiction where fulfilling ones need is more like a fix than a need. And why is it that just about everything thats seen on TV is never that cool in real life?
Lesson 3. Theres nothing like their own money. If a child wants, really wants, something, have them buy it themselves with an allowance. I remember one of our sons wanting something all his life and he was only 7. He bought it with his allowance. When you are 7, two months is an eternity. He asked for something a few weeks later and we told him that he had spent his allowance and didnt have the money for the second item. The first toy he desperately needed was still intact but its allure had lost some of its luster. It was hard to watch him want other things and say no to him but he soon got the picture and became more selective in his purchases.
Lesson 4. Managing money can be fun. Saving money and learning about money need not be boring. A colorful piggy bank, a play cash register can show kids how money works, how to save and what happens when you spend it. Try the Allowance Manager app. Its a great tool to teach kids about money and its fun.
The truth is that most parents love their children unconditionally and want to give them the world. Just remember that the world includes giving them a sense of responsibility. While not as much fun as buying them a new beloved toy, its a beloved life lesson that will pay them dividends many times over the course of their lives.
Money-smart kids become money-smart adults when financial decisions really matter.
Karen Paul is a financial services consultant based in Burlington.MORE IN National / World BusinessWASHINGTON Conservatives should stop the fight over Common Core and instead consider the... Full StoryWASHINGTON The central bankers meeting this week at their annual conference in Jackson Hole, Wyo. Full StoryHEXIGTEN, China Deep in the hilly grasslands of remote Inner Mongolia, twin smoke stacks rise... Full Story
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Fantasy: What's a keeper league?
Keeper leagues are fantasy leagues in which owners can hold onto a number of players, usually at a cost, for the following season. An example: I paid $44 for LaDainian Tomlinson in a $100-cap auction league last season. This year if I want to keep him on my team and out of the draft, I'd have to pay five-dollar keeper fee and he'd cost me $49. Of course I want him, but is he worth almost half of my total cap space? That's the twist that keeper leagues add for auction drafts. In traditional, wrap-around drafts, a popular way to penalize keepers is for every player you keep, you are penalized in two rounds of drafting by picking at the end of those rounds or losing a pick altogether. So if you keep one player, you pick last in Rounds 1 and 2, or forfeit your first round pick. Leagues considering the keeper option should establish that rule before their league draft. Deciding to enact the keeper rule after the rosters are set would be unfair because they were not built with next season in mind.
The positives: More like the NFL, and trades tend to have more meaning. Savvy drafters are rewarded.
The negatives: Some of the best players won't be in your draft, and the teams in your league might start to look the same each year.


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Gabriela from TX, February 07, 2011
I purchased these stickers for the pledge leaders who do our morning announcements. They are big enough to hold their "I led the pledge" ribbon and are bright and colorful.


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L.A. Jewish Symphony: Cultural Collaborations Concert
* Additional fees apply.
All offers for Cultural Collaborations Concert have expired.
The last date listed for Cultural Collaborations Concert was Sunday August 25, 2013 / 7:30pm.
Currently at Ford Amphitheatre:
Big!World!Fun! at the Ford: Saturday Morning Music & Dance for the Whole Family
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Gather the family for a Saturday morning full of dance, music and activities at Ford Theatres' Big!World!Fun! series. These hour-long music, dance and theatre performances are geared toward children ages 4 to 12 and their families. They're a great way of introducing your kids to a wide variety of sights, sounds and stories from around the world while building a strong foundation for a lifelong love of the arts. And the length of the event is just enough for an enticing peek without stressing those short attention spans. Arrive early and you'll be able to enjoy hands-on creative projects that you can take home. Please see the full event listing for the lineup of summertime shows. Learn More
Venue Details
I wore shorts and tennis shoes. I took a jacket but never used it. A beautiful night in the Hollywood hills. .Ballet Folklorico Ollin dress • Aug 16 2014 star this tip starred
The weather was cool and breezy.. I wore a Maxi dress..Forever Flamenco at the Ford Ampitheatre dress • Aug 11 2014 star this tip starred
Reviews & Ratings
Featured review from Albert Watts
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Fine music and dance regarding Jewish music and other traditions
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Interpretive dancers at the end were not my favorite. Tango dancers were wonderful though!
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Have never been to this theater, and was told to park on Ventura at metro station. Parking lot was full, but made it to the theater parking just in time, which was closer to theater entrance. Thank you, Goldstar for accommodating me with two...continued
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It was wonderful to see The Master Storyteller-- Theodore Bikel , Wonderful! Loved Kobi, truely a virtuoso and Rachel Reich Freed's lovely voice! Noreen did a great job with the LAJS/ melding everyone together. Didn't love the Tango
The sound in...continued
About the Ticket Supplier: Ford Theatres
The John Anson Ford Theatres is a center that fosters the excellence, diversity, vitality, understanding, appreciation and accessibility of the performing arts in Los Angeles County. Its programs nurture artists, arts organizations and community, and provide a gateway for the people of greater Los Angeles to discover and appreciate cultures of their region and the world.
The Ford strives to be a world-class community performing arts center that celebrates and reflects the diversity of the people of Los Angeles. As such, the Ford improves the health of community arts and cultural organizations through its programming, community partnerships, and the strength of the cultural richness of Los Angeles.


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Frank Phelan
Recent Comments
I have no idea what it might cost to see a concert at the new and improved Turf Club, but I do know that tickets to the new and improved Minn Orchestra can be had for as little as $15, and even less per concert with a subscription.
So there may not be much difference between the two price points.
Christ hated organized religion? He was an observant Jew, and participated in observances at the temple. Hours before His crucifixion, He marked the Passover. When merchants turned His Father's house into a marketplace, He blew his stack. In fact, it was the only time in the Gospels He did such. That would be odd behavior for someone who hated organized religion.
Religious hypocrisy, now that surely did raise his hackles, such as when the authorities were horrified he actually worked...
Religion in some respects reminds me of alcohol, in that when used incorrectly, it leads misery. When used properly, it can lead to great things. Like the abolition of slavery, and the end of Jim Crow laws. Those are the two greatest social advancements this nation has made.
Those who hope for a day when there is no religion would do well to remember those two great social movements were brought to us by people who took their Scripture seriously enough to go to jail for it, to be...
Where are those flip flops Geo. W. Bush supports used to taunt John Kerry during the '04 campaign?
Must be in McFadden's closet.
With these guys, everything, and they mean everything, is on the table. Except what isn't on the table.
Lambert missed an opportunity to point out that a big gubmit social engineering project (the Green Line) lured a private business from job Walkerstan to the Land That Hates Job Creators?
Must be time for a week at the lake. With a growler of micro beer.
Conservatives never talk about morality when it comes to the behavior of corporate persons? (At least the corporate persons who haven't renounced US citizenship in favor of Ireland or some other tax dodge.)
As if passing legislation and constitutional amendments to erect barriers to minorities voting is moral.
I guess this means Mills won't be able to run as an "outsider" now.
He'll have to rely on is credentials as as job creator.
Who said the GOP is devoid of new ideas?
It's just possible that the anger of the 99% is due to the fact that despite increasing employee productivity, all of the gains are going to the top. A rigged system, where heads I win tails you lose, is the source of the anger.
Is our societal bias toward staying in our homes as long as possible the best idea? Seniors are far more susceptible to depression when they are isolated. If someone can no longer drive and does not get out very easily, they may well be healthier in a setting with other people. Also, this allows more sets of eyes to catch someone whose condition is declining as well as making it easier for them to eat well.
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BFR Annual Peach Sales
Thank you so much for supporting peach sales this year! We are all sold out, but stay tuned for our upcoming citrus sales fundraiser!
Join us for a 5K Race to End Polio Now!
Check out our Facebook Page!
Boulder Flatirons Rotary is now on Facebook! Follow us to learn about upcoming events, see recently added club photos, and hear about Rotary news.


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Kingston Maurward tutor wins top place in horticultural competition (From Dorset Echo)
When news happens get involved. Send your pictures, views and video to us by text and email
Kingston Maurward tutor wins top place in horticultural competition
11:00am Tuesday 25th March 2014 in News By Rachel Stretton, Senior Reporter
SUCCESS is blooming at an agricultural college after a tutor scooped first place in a horticultural competition.
Amy Trayler, who is a tutor of horticulture at Kingston Maurward College near Dorchester, won the first round of the Young Horticulturalist of the Year competition.
She now faces the regional finals and if she is successful again, will go on to the national grand final in May.
Amy, pictured with students Georgina Allen and Ben Short, said: "The questions for the heats covered such a wide variety of horticultural topics, and tested all the contestants' knowledge to the extreme, so I was incredibly shocked to find that I had come out top but I am thrilled to have this opportunity and am excited about the regional finals."
Prizes valued at more than £10,000 are on offer, including the coveted £2,000 Percy Thrower Travel Bursary prize for the winner, provided by the Shropshire Horticultural Society which also sponsors the Grand Final.
The Bursary funds a study trip anywhere in the world. The competition is open to any horticulturist who is below the age of 30 on 31 July 2014 including professional horticulturists and anyone studying for a horticultural qualification.
National winner 2013, Jez Stamp, said: "It was an excellent competition that highlights all the exciting opportunities that horticulture has to offer as a career.
"Plants are my passion. I have thrown myself in 100 per cent and am proud to have won this competition.
"My travel bursary will give me a chance to continue my studies of woody plants and I will be looking at Western China and Taiwan as possible locations."
For more information about horticultural courses call 01305 215215 or go to kmc.ac.uk


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At the beach. In the woods. Or even within your own backyard. Find coin-sized objects up to 7" deep and larger objects up to 3' deep with this metal detector! From Bounty Hunter.
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Webinar | Making Teamwork Work in Nursing
Gannett Healthcare Group
Tuesday, January 22, 2013 from 7:00 PM to 8:00 PM (EST)
Everyone wants teamwork. In healthcare, it is vital to patient safety and outcomes. So how does the new nurse manager increase his or her chances of success when building a team? Using the example of a general medical surgical overflow unit as a case study, faculty will help participants identify the key factors that are present in an effective team, and the processes that are necessary to help workplaces progress toward a new identity and workplace effectiveness.
This is a Gannett Education CE event. Participants who attend the webinar and complete the post-test and evaluation survey will earn:
* Registered Nurses: 1.0 contact hour
Ruth Hansten, RN, PhD, MBA, FACHE
Ruth I. Hansten RN, PhD, MBA, FACHE is the author of six books and numerous articles. Her mission is to promote healing and wholeness, transforming organizations through relationship enhancement and skills development. With 36 years of experience in nursing, she brings both a practical and humorous approach to the essential work that nurses do. For the past 20 years her national consulting practice has worked with nursing care delivery models, critical thinking, delegation and leadership skills, and interdisciplinary team development. She has developed a care delivery model and philosophy called Relationship and Results Oriented Healthcare™ (RROHC) and this model had resulted in improved patient outcomes, clinical indicators, employee engagement, provider satisfaction, and healthcare employee retention. Her doctoral research focused on critical thinking and clinical judgment and she incorporates her research into her teaching and consulting strategies. In 2008 the 4th edition of her Clinical Delegation Skills: A Handbook for Professional Practice book was published, as was her Relationship & Results Oriented Healthcare™ Planning & Implementation Manual. She has served as adjunct faculty for the University of Washington and Seattle University School of Nursing, and has lectured or consulted at 160 organizations. She currently serves as a Board of Directors trustee at a Pacific NW medical center. Contact: http://www.hansten.com or http://www.rrohc.com
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Audience and Requirements
Registered Nurses
Course Completion Requirements and Awarding Certificate
After listening to the webinar presentation, complete the course test online. With a score of 75% or better and completing the evaluation, you may immediately print your CE certificate of completion or save a pdf of it for your records. You may also request a copy to be sent to you by mail. If your score is less than the passing score of 75%, you may retake the test. In the event of loss, there is no charge for a replacement copy of a CE certificate.
Jurisdictional Requirements
Continuing education licensing requirements vary by jurisdiction, are not well defined, and may change. We recommend you contact your licensing board or accrediting organization for the latest continuing education requirements of your state or territory.
Accommodations for Disabilities
Every effort will be made to accommodate your special needs. To request accommodation; please contact the CE office at (800) 866-0919.
Grievance Procedure
Gannett Education is committed to conducting all activities in strict conformance with accreditation agencies and boards. Gannett Education will comply with all responsibilities to be nondiscriminatory in activities, program content, and in treatment of participants. The monitoring and assessment of compliance with these standards will be the responsibility of the Executive Vice President, Gannett Education, Global Programming, and members of the continuing education division.
While Gannett Education attempts to assure fair treatment of all participants, we recognize grievances that may require intervention. Grievances are handled in the following manner:
When a participant, either orally or in written format, files a grievance, the Executive Vice President, Gannett Education, Global Programming, will evaluate the nature of the complaint. If it is meritorious, the Executive Vice President, Gannett Education, Global Programming, will instruct the staff to implement any necessary changes in the course. The complainant will receive a response from the Executive Vice President, Gannett Education, Global Programming, or designated staff within 5 working days.
You may file a complaint by telephone or email.
Telephone #: 800.866.0919
Email: email@example.com
Webinar Details
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The webinar will be hosted by GoToWebinar™. If you have not attended a webinar at GoToWebinar™ in the past, you will need to download and install the GoToMeeting software free of charge.GoToWebinar Attendee Quick Reference Guide
Continuing Education (CE)
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Disclosures to Participants:
Webinars must be attended in their entirety and the evaluation form must be completed to receive a certificate of completion.
The planners and presenter(s)/author(s) of this course have declared no real or perceived conflicts of interest that relate to this educational activity.
Gannett Education guarantees the content of these educational activities are free from bias.
Accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with this activity.
Course Completion Requirements and Awarding Certificate
After listening to the webinar presentation, complete and successfully pass the course test online. In the event of loss, there is no charge for a replacement copy of a CE certificate.
Nurse.com educational events are provided by Gannett Education.
Gannett Education is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
Gannett Education is also accredited by the Florida Board of Nursing (provider no. FBN 50-1489) and the California Board of Registered Nursing (provider no. CEP 13213).
In order to purchase these tickets in installments, you'll need an Eventbrite account. Log in or sign up for a free account to continue.


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30 Ways to Get Into the Spirit
From neighborhood strolls to seasonal concerts to live reindeer on the Avenue, when it comes to holiday time, there's no place like home
(page 3 of 3)
Light It Up!
Town Hall Tree Lighting Ceremony
This annual tradition dates back over half a century. Evolving from a Christian tradition to a more secular "Tree Lighting," the event kicks off with a welcome by Recreation Supervisor Frank Gabriele; and the first selectman will offer a holiday message to the multigenerational crowd this cheery event draws. The young set will be thrilled to find Santa, Mrs. Claus, Rudolph and Frosty offering free candy canes and mechanical reindeer rides. As always, the Greenwich High School Chamber Singers will entertain with holiday melodies. Chocolate chip cookies and cider will be served.
Date & Time: December 2, 3:45 to 4:30 p.m.
Place: Town Hall, 101 Field Point Road
Information: greenwichct.org
Old-Fashioned Night
First Light Festival, Old Greenwich
For seventeen years, the Old Greenwich Merchant's Association has organized this fun night of extended shopping hours, horse-drawn carriage rides, carols and much more. Each store offers something different, from wine tasting at Sam's Package Store to free roses at the flower shop. Kids will scope out the hot cocoa, face painting, magic shows and, of course, Santa! "Last year's First Light was extra special," says Richard Fulton, owner of Chilly Bear. "We honored all town departments that protected Greenwich during Hurricane Sandy." This year we also feature Family Centers' fundraising event in Binney Park with the lighting of thousands of luminaries. Luminary kits will be sold in stores in advance.
Date & Time: December 7, 6 to 9 p.m.
Place: Sound Beach Avenue & Arcadia Road
Shopping with Heart
Breast Cancer Alliance Holiday Boutique
In its fifteenth year, this event offers shoppers the opportunity to do their holiday shopping, find great gifts for friends and family, and feel good about spending—
15 percent goes to the Breast Cancer Alliance. Over forty vendors attend, including Stella & Dot, Glory Cashmere, Bellin House Portraits, Peaceable Hill Paperie, Stanton Sweets and East End Foodies.
Dates & Times: December 3, 6 to 9 p.m.; December 4, 9 a.m. to 5 p.m.
Place: Greenwich Country Club, 19 Doubling Road
Information: 203-861-0014, breastcanceralliance.org
Antiquarius Holiday Boutique
The Holiday Boutique, benefitting the Historical Society, moves to a new venue this year at Christ Church Parish Hall. Shoppers will enjoy exploring the wares of new vendors and perennial favorites, offering "a fabulous array of one-of-a-kind gifts." On opening night, shoppers can enjoy a cash bar and passed hors d'oeuvres from Meli-Melo while shopping. Those seeking a historical outing mixed with holiday shopping can combine the Holiday House Tour on December 11 with a visit to the boutique. Meli-Melo box lunches can be ordered in advance for pick up at the Boutique.
Dates & Times: December 10, 6 to 8:30 p.m. and December 11, 10 a.m. to 6 p.m.
Place: Christ Church Parish Hall, 254 East Putnam Avenue
Information: 203-869-6899, ext. 10; greenwichhistory.org; free admission; advance ordered box lunches, $25, available for pick-up from 11:30 a.m. to 2 p.m.
Greening the Holiday Baskets of Greens for Inspirica
Volunteers at this annual outreach event arrange baskets of fresh evergreens to donate to Inspirica (formerly St. Luke's Lifeworks) residents, who would not otherwise have holiday decorations. No talent or experience is needed, just bring "a big heart and help decorate. Your holiday will be enriched by your participation." A light lunch will be served.
Date & Time: December 4, 10:30 a.m. to 1 p.m.
Place: Garden Education Center, 130 Bible Street
Information: 203-869-9242, gecgreenwich.org; $20 donation requested


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Saturn Repair in Fremont
We found 102 Saturn service shops and mechanics in Fremont.
11 are RepairPal Certified.
Glenmoor Auto Repair
4270 Peralta Blvd
Fremont, CA 94536Map & directions
"I just am very happy with the service I got. Paul explained everything very well to me." - Neil, Fremont, CASee more real customer reviews
Autotron Service Center
3688-F Washington St
Pleasanton, CA 94566Map & directions
"Ryan has always been fair, honest, and fun. He takes good care of me and my vehicles." - Terri, Pleasanton, CASee more real customer reviews
Redwood General Tire and Auto Service
1630 Broadway
Redwood City, CA 94063Map & directions
"Great service and good people who care about their efficiency." - June, Redwood City, CASee more real customer reviews
A-1 Foreign Auto
1544 W El Camino Real
Mountain View, CA 94040Map & directions
"They have really good customer service. They always treat me well." - Nilton, Mountain View, CASee more real customer reviews
Woodside Auto & Tire
333 Woodside Road
Redwood city, CA 94061Map & directions
"I think they are honest and fair and do good work. Friendly too." - Katie, Redwood city, CASee more real customer reviews
Raymond Automotive
539 Claire St
Hayward, CA 94541Map & directions
"I've been going there for more than 10 years and have always had excellent work. The brothers are..." - Chris, Hayward, CASee more real customer reviews
R&C Auto Service
3596 Utah St
Pleasanton, CA 94566Map & directions
"I think their service is very good. You make an appointment and they keep it and take care of you." - Tom, Pleasanton, CASee more real customer reviews
Sease's Auto Service
1444 N 4th St
San Jose, CA 95112Map & directions
"They deliver their work on time and at the cost that was given. Also they are conveniently located." - Jean, San Jose, CASee more real customer reviews
Caspian Auto Care
6465 Clark Ave Ste A
Dublin, CA 94568Map & directions
"I just find they seem very honest and get the work done quickly." - Sha, Dublin, CASee more real customer reviews
Dave's Auto Repair
830 E Charleston Rd
Palo Alto, CA 94303Map & directions
"From the first phone call to the 6 years of premium service, Dave's Auto Repair has been more tha..." - Brian, Palo Alto, CASee more real customer reviews
Dublin Auto Repair
6429 Golden Gate Drive
Dublin, CA 94568Map & directions
"They were able to quickly diagnose a quirky cruise control problem that may have eluded many shops." - Scott, Dublin, CASee more real customer reviews
RepairPrice Guarantee for Saturn service near Fremont
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3972 El Camino Real, Palo Alto, CA 94306
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Upcoming Programs
Michael Medved Breaks Down America: From Politics, to Pop Culture, and Everything Between, featuring Michael Medved, Radio Host of the Michael Medved Show (GNSEA)
September 04, 2014, 6:00pm
As one of America's most popular and respected voices, nationally-syndicated radio host Michael Medved brings top-line news from politics and popular culture to millions. From his books and radio program, Medved has never been afraid to cut to the heart of a key matter, and will bring his famous analysis exclusively to Members of Gen Next Seattle on Thursday, September 4. He will take on everything from the midterm elections, to the U.S. reputation abroad, to the most ridiculous things appearing in the media. No one gives straight-forward, honest insights with the candor, humor, and wit better than Michael Medved.More Info
Eyal Aronoff, Co-founder of the Fuel Freedom Foundation (GNAZ)
September 10, 2014, 6:00pm
Energy Security is more than a global buzz-word: its impact is woven into our daily lives. Foreign policy, industrial growth, food costs, and transportation are inextricably tied to fuel sources. Members of Gen Next Arizona will delve into this important issue with Eyal Aranoff, Co-Founder of the Fuel Freedom Foundation. About Eyal Eyal Aronoff is a co-founder of Quest Software, one of the largest independent software ventures in the world. His current focus is energy and philanthropy. Eyal graduated summa cum laude in chemistry and computer science from Bar Ilan University in Israel and now lives in Newport Beach, California. More about Fuel Freedom: Fuel Freedom is a non-partisan campaign dedicated to breaking our oil addiction by removing barriers to competition and to promote the development of cheaper, cleaner, American-made fuels. Fuel Freedom means that gasoline, diesel, methanol, natural gas, ethanol and electricity compete on equal footing both at the dealership and at the pump. Achieving Fuel Freedom will lower fuel prices, create jobs, spur economic growth, reduce pollution, improve national and global security, and eliminate the need to send our sons and daughters to faraway lands to ensure the free flow of oil.More Info
Preserving the Arts for Future Generations with Sandy Kemper, Art Collector and Arts Investment Expert GNNY
September 11, 2014, 3:00pm
Preserving the Arts for Future Generations with Sandy Kemper, Art Collector and Arts Investment Expert The arts are more than an enjoyable evening out—collecting, preserving, and sharing art and culture are one of the most important educational legacies we can offer future generations. From small pieces with personal meaning, to more renowned creations, some of the greatest opportunities for children from all backgrounds to learn about our past, and create dreams of their own, come from art that is collected, appreciated, and shared with everyone. Art can also be a dual benefit—a meaningful investment opportunity as well as a public good. On Thursday, September 11, Alexander "Sandy" Kemper will speak to Members of Gen Next in New York about the value of art as both a way to learn and a way to invest. An avid collector of art, Mr. Kemper will share his thoughts on how individuals like the Members of Gen Next can acquire art and ensure it is valued and protected for future generations. In light of the important anniversary this month's program date falls on, we encourage Members of Gen Next to make a donation to the 9/11 Memorial here: https://www.911memorial.org/donations.More Info
Growing Business Advocacy Awareness in Silicon Valley, with David Chavern, President, Center for Advanced Technology & Innovation
September 11, 2014, 6:00pm
Growing Business Advocacy Awareness in Silicon Valley, with David Chavern, President, Center for Advanced Technology & Innovation In an industry where new companies appear in a nearby garage, and leaders emerge seemingly out of nowhere, the tech industry sometimes feels removed from the traditional American business model. Yet, the challenges this innovative and disruptive sector face are no different from other sectors: regulation, taxes, and barriers to evolution and expansion can hinder even the trendiest of Apps. The U.S. Chamber of Commerce has launched the Center for Advanced Technology & Innovation (CATI), a major effort to reach out to Silicon Valley and provide the support, engagement, and advocacy that has made it the center of business advocacy in Washington. On Thursday, September 11, Members of Gen Next in San Diego will hear from David Chavern, EVP of the U.S. Chamber and new President of CATI. Chavern will discuss the trends the Chamber has seen in Silicon Valley that led to CATI's founding, the challenges faced as the tech sector expands, and how the Chamber is developing new connections with an entirely unique sector.More Info
Ian Gardner, Chief Strategy & Investment Officer at Los Angeles Cleantech Incubator (GNLA)
September 24, 2014, 6:30pm
Details to be announcedMore Info
Wall Street: The New Security Battlefield, with Kevin Freeman, Author & Expert on Economic Warfare and Financial Terrorism
September 25, 2014, 6:30pm
When we think of threats from foreign enemies, the attacks we picture usually aren't hidden within our financial markets. Kevin Freeman, Economic Warfare & Financial Terrorism Expert, is concerned that the weaknesses that make us truly vulnerable as a nation aren't along our borders or in our defense systems. They are actually economic tools and tactics employed by rival nations to exploit weaknesses and pressure points on Wall Street and beyond, that could strain us financially to the point of no recovery. On Thursday, September 25, Freeman will meet with Members of Gen Next Orange County to discuss his work advising companies and the U.S. government on how we can detect our own weaknesses, and defend ourselves against the new battlefield: the financial markets.More Info
Dr. Yaron Brook, President of the Ayn Rand Institute (GNAZ)
October 08, 2014, 6:00pm
Details to be announcedMore Info
Leslie D. Michelson, Chairman and Chief Executive Officer of Private Health Management, Inc. (GNLA)
October 22, 2014, 6:30pm
Leslie D. Michelson has more than 20 years of experience as a founder, CEO, investor, advisor and/or director for a portfolio of entrepreneurial health care, technology and real estate companies. Michelson serves as a director of American Realty Capital Trust, a retail REIT (NASDAQ: ARCT); American Realty Health Care REIT, a public non-traded health care REIT; American Realty Business Development Corporation of America, a public, non-traded business development company; and American Realty Retail Centers of America, a public, non-traded REIT that invests in retail malls; and, Molecular Insight Pharmaceuticals, Inc, a biotechnology company that focuses on prostate cancer diagnostics and therapeutics. Michelson is also a director of the ALS Therapy Development Institute, a non-profit research and development institute focused on ALS. He also serves on the Los Angeles Mayor's Council on Innovation and Industry, a council assembled to help the city support emerging growth companies.More Info


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|OK - 32 reviews
When you stay at Hotel NC in High Point, you'll be in the business district and close to International Home Furnishings Center and High Point University. This motel is within the vicinity of Oak Hollow Mall and Guilford Technical Community College. Make yourself at home in one of the 104 air-conditioned guestrooms. Complimentary wired and wireless Internet a...
Overall Rating - OK - 32 reviews
Excellent 9.0
The price
I do not like the fact that the lower price room offered on Priceline is a smoking room.
Mediocre 4.0
I requested a non smoking room and was given a smoking room. Everything reaked of cigarette smoke. I checked in late and was tired and did not have the patience to walk around the entire hotel to get a different room. Accommodations were adequate other than that.
|OK - 121 reviews
Motel 6 High Point is conveniently located off I-85. Restaurants & the World Biggest Furniture Markets are within walking distance. Our amenities include Free Wi-Fi, Truck Parking, an outdoor pool all at the lowest rate of any national chain hotel
Overall Rating - OK - 121 reviews
Poor 1.0
The women who checked me in was friendly
Most everything. Many of The electrical outlets, the clock, the lights above the sink all didn't work, the remote for the tv back was missing, so therefore the batteries kept falling out and the hi fi internet didn't work. I was charged more than my sign
Poor 1.0
Nothing it was horrible.
It was dirty. The staff was rude. The location was bad.Horrible.nasty.piece of junk.
|Good - 24 reviews
Overall Rating - Good - 24 reviews
Good 6.6
The daytime receptionist was local and especially friendly. Shower and water pressure was good. The proximity to downtown was important for me. Clean for the most part.
Along with the value, guests must be willing to sacrifice luxury of current decor, wear & tear in bath/tile area, and unfortunately an undesirable neighbor who I would not have wanted my family to have to experience.
Mediocre 3.0
The free breakfast.
My nonsmoking room use to be a smoking room and had not been converted. I smelled like smoke and my belongings had that same smell when I got home.The motel is on a one way street so you have to circle around to get into the motel. It's not very safe feeling even though we had no trouble and the staff was nice enough. I will not stay again.


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05-12-2006, 05:57 PM #1Coordinator
- Join Date
- Dec 1969
- Posts
- 727
Asked of 500 Adults
Margin of Sampling Error for this question = ̱̉ 4.3%
The Minnesota Legislature is considering several proposals to fund stadiums for the Minnesota Twins, Minnesota Vikings and University of Minnesota Golden Gophers. In general, do you think referendums should? Or should not? be held before any sales taxes are imposed to pay for stadium construction?
63% Should
30% Should Not
8% Not Sure
Asked of 500 Adults
Margin of Sampling Error for this question = ̱̉ 4.5%
The state Senate passed a bill calling for a statewide sports memorabilia sales tax to fund a Gopher stadium at the University of Minnesota. The state House passed a bill that would fund the stadium through a naming rights deal, student stadium fees, and a land swap deal between the state and the U of M. Which plan do you think is better?
31% Memorabilia Tax Plan
51% Naming/fees/swap Plan
18% Not Sure
Asked of 500 Adults
Margin of Sampling Error for this question = ̱̉ 4.4%
The state House passed a Twins stadium bill that allows Hennepin County Commissioners to increase the Hennepin County sales tax by point one five percent to help finance a ballpark in downtown Minneapolis. The state Senate passed a combination Twins and Vikings stadium bill that would impose a half-cent sales tax in the 7-county metro area to pay for both stadiums and transit projects. Which of these plans do you think is better?
29% Hennepin County Sales Tax
57% Half Cent 7-county Tax
14% Not Sure
Asked of 500 Adults
Margin of Sampling Error for this question = ̱̉ 4.4%
The Minnesota Vikings are trying to get their own stadium plan approved that calls for a three-quarters of a percent sales tax increase in Anoka County to help finance a stadium. The plan also requires state money for infrastructure around the stadium and to pay for a portion of a retractable roof. Do you support? Or do you oppose? this plan?
37% Support
58% Oppose
5% Not Sure
Asked of 500 Adults
Margin of Sampling Error for this question = ̱̉ 4.5%
If only one of the three stadiums can be approved this year, which one would you pick? The Golden Gophers' stadium? The Twins' stadium? Or the Vikings' stadium?
29% Gophers' Stadium
41% Twins' Stadium
23% Vikings' Stadium
7% Not Sure
Asked of 500 Adults
Margin of Sampling Error for this question = ̱̉ 4.3%
Do you think taxpayer money should? Or should not? be used to pay for any professional sports stadium?
30% Should
65% Should Not
5% Not Sure
Breakdown of Results by Gender, Age, Race and Region
Statement of Methodology
̩̉ 2006 SurveyUSA / Contractual Obligations
The following statement conforms to the principles of disclosure of the National Council on Public Polls:
How this poll was conducted: This SurveyUSA poll was conducted by telephone in the voice of a professional announcer. Respondent households were selected at random, using Random Digit Dialed (RDD) sample provided by Survey Sampling, of Fairfield CT. All respondents heard the questions asked identically. Within the report, you will find: the geography that was surveyed; the date(s) interviews were conducted and the news organization(s) that paid for the research. The number of respondents who answered each question and the margin of sampling error for each question are provided. Where necessary, responses were weighted according to age, gender, ethnic origin, geographical area and number of adults and number of voice telephone lines in the household, so that the sample would reflect the actual demographic proportions in the population, using most recent U.S.Census estimates. In theory, with the stated sample size, one can say with 95% certainty that the results would not vary by more than the stated margin of sampling error, in one direction or the other, had the entire universe of respondents been interviewed with complete accuracy. There are other possible sources of error in all surveys that may be more serious than theoretical calculations of sampling error. These include refusals to be interviewed, question wording and question order, weighting by demographic control data and the manner in which respondents are filtered (such as, determining who is a likely voter). It is difficult to quantify the errors that may result from these factors. Fieldwork for this survey was done by SurveyUSA of Verona, NJ.
Thanks PurpleMafia
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
i wonder if the vikings would have gotten more votes if the sex boat incident didnt happen."There is good and there is evil. And evil must be punished. Even in the face of Armageddon I will not compromise."
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
TWINS Stadium got more votes...SCREW THAT!!!!BANNED OR DEAD...I'LL TAKE EITHER ONE
05-12-2006, 06:12 PM #4Coordinator
- Join Date
- Dec 1969
- Posts
- 727
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
Well I think if the last 4 years didn't happen, or the red mcCombs era, we would be a lot better off
Thanks PurpleMafia
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
"cajunvike" wrote:
TWINS Stadium got more votes...SCREW THAT!!!!
And if the Twinkies don't get a new stadium - they really are gone.
I personally think they need it more than the Vikes - which does not mean that the Vikes don't need a new one as well.
And I'm a Cubs fan - not a Twins fan.
Thanks to Josdin for the awesome sig!
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
freekin Minnesotans....oh my gosh, the word tax! No!!
How about a tax of the same amount to fund river otter studies? yeah!!!
Its half a penny for every dollar for major urban lifestyle enhancements. Its nothing!
These yokels will be the ones lined up and moaning for a new team when they cant take their sons or daughters to a baseball or football game.
My question is, wy not divert the tax already in place for the Dome, which is paid off, and reallocate it to the new efforts. Dummies.
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
Any referendum is a deal buster.
Any tax should be a user type tax. That is where the sports memorability idea came from.
The politicians know the tax revenue captured by these stadiums would be a great benefit, in the long run, to the government. But I was in Minneapolis the week before last and it appears the politicians all have their own little pet political agendas that interfere with some of the stadium proposals.
Maybe if they earmarked some of the future tax revenues from the stadiums to be used for property tax reduction in the counties where collected,they might find taxpayers a little more receptive.
My personal feeling is that Zigi's concept will be huge for Minnesota if he is able to get it accomplished.What takes a quarterback to the next level is not arm strength or mobility or any of that stuff. Its the ability to play on critical downs. Manage third downs, or red zones or four-minute or two-minute situations"
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
How many matches does a MN Football Team Owner need to get a new stadium?
Someone is going to have to burn the Dome down before the majority will see a need to replace it (for you pyros out there, this is a joke). :lol:
05-12-2006, 06:53 PM #9Jersey Retired
- Join Date
- Dec 1969
- Posts
- 6,535
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
Why didn't the local news agency's do a pole on some other issues?
What would the peoples response be to these questions?
Do you think tax money (200 million) should be used to help with the expansion of the Mall of America? Currently in the legislature.
Do you think that tax payers should have purchased the land (displacing 200 families) for the new Best Buy Corporate Headquarters in Richfield and giving them tax breaks of about a 100 million dollars?
Do you think that the Mall of America should have received tax breaks of over 100 Million dollars when it first opened? MOA has never payed any property tax in Minnesota.
Do you think that Minnesota should have given your tax dollars in a loan to Northwest Airlines for 750 Million, with no collateral that now is in default and has been for years, and it is being written off by Northwest Airlines in their Bankruptcy because there is no incentive to pay it back (no collateral was required)?
Which the loan was 10 to 12 years ago and in today's dollars would be about 1.2 Billion dollars.
Should your tax dollars have been used to build a new Guthrie theater for over 100 million dollars? Money that has no chance of ever being repaid to the state!
Should your tax dollars have been used to build a new 50 million dollar public library that is the ugliest building in Minneapolis, that has a 6 million dollar bridge that walks out from the 2nd floor for 300 feet and stops, so that a few people a day can walk out on it for no reason? It goes no where!
Should your tax dollars of over 1.2 Billion dollars been used to run the new light rail train 11 Miles (over 100 million per mile)? And that in the best case scenario will not even pay for 1/2 it's operating cost on an annual bases, and your tax dollars will be required to keep it running every year?
Why did they not put the question this way:
Would you support an investment of your tax dollars for a new Viking stadium that is part of a 1 and 1/2 billion dollar expansion, and the taxes that are used will be repaid by the benefits of having the Vikings in Minnesota, the taxes created from the new jobs and new developments in and around the area, the payroll of the athletes that is currently over 100 million and in 20 years should be almost 250 million for the Viking, in state income tax alone bring in over 12 million a year besides all the other tax generated by their living expenses and their spending in Minnesota?
Because the local media in Minnesota suck, and are short sited a$$holes!What we've got here is failure to communicate.
Re: KSTP POLL FOR NEW STADIUM, RESULTS ARE IN!!!!!!
"Webby" wrote:
My question is, wy not divert the tax already in place for the Dome, which is paid off, and reallocate it to the new efforts. Dummies.
The 1/2 percent sales tax was a referendum that the tax payers passed over 20 years ago for one specific purpose, to build a stadium. If the tax is still in place and a stadium is needed, use the money for what the taxpayers already approved, but don't allocate those funds elsewhere.
The true measure of a man is how he treats someone who can do him absolutely no good -Samuel Johnson - lexicographer
The word genius isn t applicable in football. A genius is a guy like Norman Einstein - Joe Theisman
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