Looking At The Carer Prospects Of Foster Care Social Work Essay
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Published: Mon, 5 Dec 2016
This project is based on a foster care assessment of a prospective carer undertaken as a student social worker. It gives an overview of my assessment from allocation to closure due to concerns. Although immediately allocated another more fruitful assessment, I have chosen to look at this unsuccessful assessment as I believe it taught me more as a student about my practice.
An agency description is firstly provided to give the reader a picture of the team which should put my role into context. This is followed by the background and objectives of my work. The main text follows the natural progression of my work from planning to evaluation. I will analyse my work identifying the social work themes, issues and theories that guided my practice. Reflection acknowledges that we are part of what we are experiencing (Schon, 1983); looking at our relationships with service users beneath the surface (Payne, 2002). I will therefore reflect throughout this project, rather than purely at the end, as this is what I naturally did in my practice. This will lead to a reflective evaluation of my practice and the implications it had for both me and the service user.
The agency I was placed with was a statutory foster care team within the local authority’s children’s services. Although the team works more directly with foster carers it serves children in need between the ages of 0 and 16 and is therefore classified as a Tier 4 service as shown below.
Fostering services in this local authority were originally integrated amongst other service user groups, regulated by the Boarding-Out Regulations (1955). These regulations caused ambiguity by encouraging foster carers to treat foster children as their own (Triseliotis et al., 1995). In the 1970’s, with the changing emphasis to the professionalisation of fostering, the team gradually became a separate division. The 1955 regulations were eventually updated with the Boarding-out of Children (Foster Placement) Regulations (1988) which were subsequently absorbed into the Children Act (1989) regulations. Only a few years later the Foster Placement (Children) Regulations (1991) were introduced which changed the focus of assessment from households to individual foster parents. However, what both regulations were lacking was met in the establishment of the Fostering Services Regulations (FCR) (2002) and National Minimum Standards (NMS) (Department of Health (DoH), 2002). These come under sections 22 and 48 and 23 and 49 of the Care Standards Act (2000) respectively. This changed the regulation of the agency from the local authority itself to the National Care Standards Commission (NCSC). The NCSC inspects how the agency recruits, assesses, supervises and trains foster carers. These four areas describe my role as a supervising social worker within the team.
Background to the Case
Monica is a 55 year old female who had contacted the fostering agency with an interest in becoming a foster carer. The process from public interest to approved foster carer is complex and thorough. Each local foster care service will have a similar but slightly different procedure and the team I was placed with used the process shown in figure 1.
Initial Home Visit
Application form sent and completed by Applicant
Full Assessment by Social Worker leading to Fostering Panel
Approved Foster Carer is allocated a Social Worker and begins fostering
Figure 1: The Fostering Assessment Process
When trying to visualise the assessment process for the reader, I felt a pyramid was the most appropriate. This is firstly because the wideness represents the greater personal investment a prospective carer must put into the fostering process and secondly the deeper into their life a social worker will and must go. At each stage a prospective candidate may have a different social worker. The initial home visit with Monica was conducted by another social worker. The purpose of this visit was to get a snap shot of Monica’s suitability and motivation to foster. The social workers report is then presented to senior staff with recommendations and a decision is made as to whether an application form should be sent. Once returned, the next step is to go through a process that combines elements of assessment and preparation (McColgan, 1991). This is where my involvement with Monica began.
Objectives of the Work
‘As well as strong attachments to family members, foster carers or residential care workers are really important for children in care, as these are the people who have the most impact on their day-to-day experiences’ (DCSF, 2008, p.11)
‘Foster carers are central to many children and young people’s experience of care. It is essential that we value and support them and ensure that they are properly equipped with the necessary range of skills’ (DfES, 2007, p.8-9)
When assessing Monica I held the two statements above firmly in my mind to use in times of uncertainty but also lucidity. It is well known that the recruitment and retention of foster carers has been consistently problematic for local authorities (Association of Directors of Social Services, 1997; Bebbington and Miles, 1990; Colton et al. 2008; Hill, 2000; NFCA, 1997). Despite this, Quality Protects (DoH, 1998) and the government’s launch of Choice Protects in 2002 (see everychildmatters.gov.uk) continually attempt to raise the quality of fostering provision to improve placement choice and stability. The green paper ‘Every Child Matters’ (DfES, 2003) and more recently ‘Care Matters’ (DfES, 2007) argue that foster care services need carers with the skills to look after vulnerable children.
In some countries, such as Australia, the selection of foster carers still has no empirical base beyond criminal record checks and suitable accommodation (Kennedy and Thorpe, 2006). This was the past picture in the UK, however the National Foster Care Association (NFCA), now called The Fostering Network (TFN) introduced the ‘Codes of Practice’ (NFCA, 1999a) and ‘National Minimum Standards’ (NFCA, 1999b) for assessing foster carers. My assessment of Monica would consider her skills, experience, values, knowledge and overall suitability to foster children for the local authority. This was based on assessing her on four competencies (caring for children; providing a safe and caring environment; working as part of a team and own development) broken into 18 units (Appendix A).
More recently the Children’s Workforce Development Council (CWDC) has developed 7 standards for foster carers (2007) (Appendix B). The team had only begun using these alongside the competencies (NFCA, 1999a, 1999b) when I started Monica’s assessment. The standards support a three stage training framework for foster care (pre-approval; induction and foster carer development). Pre-approval was my objective with Monica linked to section 27(1) of the FCR (2002) (Appendix C), and other relevant legislation (Appendix D). Although the FCR (2002) are the legislative force, it was the NMS (DoH, 2002) under section 17 which gave me a more detailed understanding of the areas (caring ability, sexual boundaries, religion etc) needing assessing with Monica (Appendix E).
Brown (1992) observes that a fostering assessment has two interrelated aspects: (a) Evaluation of prospective carer’s strengths and weaknesses and (b) the assessment of their capacity to learn, adapt and change. These objectives are still relevant to assessing foster carers today. Whilst I was assessing Monica on the competencies and CWDC standards, there is no standardised way of obtaining the evidence for these. I therefore felt I had a lot of discretion in my assessment. I decided multiple knowledge sources (research, intuition and experience etc) would guide my assessment. Webb (2001) argues that Evidence Based Practice (EBP) cannot work in social work as the parting of facts and values inherent in EBP undermines professional judgement and discretion. I disagreed and felt the use of both evidence and my own intuition was needed to obtain an accurate assessment of Monica. For example, research states a need for carers committed to training after approval (Hutchinson et al., 2003). However, I knew that just because a carer agreed to training after approval that my intuition or practice wisdom (Stepney, 2000) may tell me otherwise. Further, Sinclair’s (2005) research emphasising the need for improvements in foster carer selection, I felt, justified my use of multiple knowledge sources to reach my objectives with Monica.
Planning for the Work
When first allocated the assessment of Monica, I was in the first week of my placement and admittedly had little understanding of what actually made a good foster carer beyond my own common sense. This lack of knowledge and understanding left me feeling out of my depth and anxious. I therefore decided that before making any contact with Monica I would gather all available information and use my existing knowledge base to see how it fitted with the fostering assessment. Brown (1992) suggests that when approaching a fostering assessment we should ask ourselves a range of questions. The three I found myself asking were: what knowledge do I need; is the assessment discriminatory or oppressive and what skills and values do I need.
Assessment is at the centre of all good social work practice (Bartlett, 1970; Milner and O’Byrne, 2002) and therefore my planning was crucial as ‘failing to plan is planning to fail’ (Trevithick, 2005, pg.140). I wanted to use Monica’s initial home visit report as my starting point, as assessments are rarely, if ever, value free (Rees, 1991). Therefore before I understood any more about the fostering process I wanted to identify and check any bias I may have that could affect the assessment undertaken (Clifford, 1998). However I was surprised by the reports lack of detail and therefore spoke to the social worker who completed it. He couldn’t give me any additional information which frustrated me as the report, in my opinion, failed to give the intended snapshot of Monica.
This didn’t help relieve my anxiety, however reading the guidance ‘Assessing foster carers: A social workers guide to competency assessments’ (NFCA, 2000) increased my confidence of what I was expected to achieve in my assessment with Monica. Using this guidance coupled with the NMS (DoH, 2002) and colleague information placed the assessment of Monica in my mind as task centred practice (Doel, 1994, 2002; Reid and Epstein, 1972). This was because the tasks involved were not just activities but held meaning because of what they represented overall (Coulshead and Orme, 2006); the fostering of vulnerable children. As fostering assessments vary in length, typically between 4 months and a year, I saw the assessment as a continuous process (Hepworth et al., 1997). Therefore although my assessment visits would be based around specific tasks and information gathering, my assessment of Monica would follow the ASPIRE model (Sutton, 1999). This was because during my assessment I would continually plan, intervene, review and evaluate the assessment with Monica.
Oppression and Control
From all available information sources, one issue rose within me. This was how intrusive the fostering assessment appeared, and how for me, it epitomised the care vs. control dichotomy. Triseliotis et al., (1995) believe that nowhere else are such questions asked with greater persistency than in the assessment of prospective foster carers. They acknowledge that ways are being sought to make the process less intrusive and fairer to applicants. Although I saw the competencies and standards as one way of achieving this with Monica, I still felt that I had a lot of power in her assessment. Davis et al., (1984) believe that the unequal power relationship between social workers and applicants may promote the development of ‘a relationship of dependence’ rather than the type of open partnership required in fostering today.
I viewed this open partnership as being based on Monica’s self determination which to be met began with Monica voluntarily accepting my intervention (Spicker, 1990). My original thinking was that oppression only applied to vulnerable groups. However, I knew I should avoid complacency as oppression could happen to anybody, including Monica. In fact Monica had begun a ‘Skills to Foster’ preparation group and I had asked the facilitator of the group for some feedback. She described Monica as ‘an interesting one’ commenting that she looked like she was about to drop dead. I discovered this judgment was based purely on her use of a walking aid. Understating the impact of labelling (Becker, 1963; Lemert, 1972), I didn’t want this judgment to impact on me as I wanted to go into Monica’s assessment with an anti-oppressive, non judgmental and accepting attitude (Biestek, 1961).
Reflecting on my skills and values
Central to our knowledge base is the need to know ourselves (Dominelli, 2002; Crisp et al., 2003). Effective assessment depends on the deployment of key skills such as Engagement (Egan, 2002), communication, negotiation, decision making (Watson and West, 2006) and administrative skills (Coulshead and Orme, 2006). I felt I already possessed the skills needed and found it was my values in relation to this assessment that were more difficult to pinpoint.
As already stated, I didn’t want to label Monica but I did see her as an ‘expert by experience’ rather than a ‘service user’, which is descriptive not of her as a person but of our relationship (McLaughlin, 2009). Although participation in social work is determined by context (Kirby et al., 2003; Warren, 2007) I saw our relationship as reciprocal. I found the exchange model (Smale et al., 2000; Fook, 2002) of assessment was particularly relevant in assessing Monica’s ability to foster children, as she would obviously be more of an expert on her abilities. This actually made me feel quite anxious and powerless. This was, on reflection, because as a man with no children, I questioned my ability to assess an experienced ex-childminding mother. I took this to supervision and through discussion I understood that my virtue ethics (McBeath and Webb, 2002) based on judgment, experience, understanding, reflection and disposition; coupled with staying client centred and respecting Monica as an individual (Dominelli, 2002; Middleton, 1997) would guide my assessment. I saw myself as a hermeneutic worker acting in a reflective interpretative process between myself and Monica (Gadamer, 1981).
I had telephoned Monica and arranged to meet at her home. As the majority of my visits would be two way conversations between me and Monica I saw them as interviews with a ‘specific and predetermined purpose’ (Barker, 2003, p. 227).
Eyes of a child
When undertaking Monica’s assessment, I tried to see everything not only from the eyes of a professional but also that of a child. I understood that children in the care system would have diverse needs and backgrounds (Schofield et al., 2000) with possibly a complex history of moves (Ward et al., 2006). However I also knew that care can be a ‘turning point’ and opportunity to lift children, enabling them to fulfil their potential (Rutter, 1999; Schofield, 2001; Schofield and Beek, 2005). Young people have commented that it is a foster carer’s personality that makes the difference (DfES, 2007b). Therefore by thinking like a child, I wanted to feel confident that by recommending Monica to the fostering panel I could see she would be of great comfort and benefit to vulnerable young people.
Upon arrival at Monica’s I was greeted by two aggressive dogs jumping and barking at the door. A tall stocky man, who I later learnt was her son, appeared from the garage and asked what I wanted. When asking for Monica he replied ‘who wants to know’. This hostility was soon alleviated when I explained who I was, upon which he opened the door, called for Monica, and left me with both dogs jumping up at me. I felt that a child entering Monica’s home was likely to be experiencing a range of emotions, including anxiety and from the eyes of a child this would be scary. Despite not the best of starts, I was determined not to make a judgment at a superficial level (Lloyd and Taylor, 1995) and to keep an open mind about Monica’s assessment.
Building a rapport
Aware of the care and control dichotomy I wanted Monica to feel relaxed with me. I therefore invested time in getting to know about her as a person before explaining the assessment process. Although genuine rapport can be questionable (Feltham and Dryden, 1993) I felt my interest in Monica was non-tokenistic, as I admired and respected her for wanting the challenging role of fostering (Kant, 1964). I believe this was transmitted to her an enabled her to trust me.
Monica talked about her family including the separation from her husband. She also spoke about caring for her sick mother that caused her serious back problems. Monica explained that she had a spare room and couldn’t think of any better use then for children in need of a loving home. Interestingly she went on to add ‘well they might not want to come here, I’m a mad lady and they might ask: how would I fit into her world’. I found this expression strange but following a gut feeling decided not to explore at this point. I did this firstly because I didn’t want to appear authoritarian but secondly I felt my assessment would later provide sources of information that my intuition would be tested against (Munro, 1996).
I explained the fostering assessment process to Monica including the competencies (NFCA, 1999a) and standards (CWDC, 2007). I used a mixture of interpretative, descriptive and reason giving explanations (Brown and Atkins, 1997) to ensure Monica was clear of our future work together. I commented ‘you might be thinking how a young man without children of his own can can assess me in looking after children’. This elicited laugher from both Monica and me. As Kadushin and Kadushin (1997) explain ‘laughter is an equalizer. It deflates pomposity. Workers’ capacity to laugh at themselves without embarrassment or shame communicates genuineness in the relationship’ (pg. 225). I also believe it served a social purpose (Foot, 1997) to shift power to Monica and make my next statement easier to deliver. I explained that in the fostering assessment it was expected that prospective candidates were as open and honest about their past experiences. I explained about confidentiality and that whilst not everything would be included in the fostering panel report, I couldn’t guarantee absolute confidentiality (Evans and Harris, 2004; Millstein, 2000; Swain, 2006). I explained I would always inform her if I needed to disclose information and that personal information with no relevance to her fostering ability would remain confidential. I believe this explanation built the required trust (Collingridge et al., 2001) essential for our relationship to progress (Leever et al., 2002).
Due to being my first visit, no specific tasks had been set to discuss. Therefore reflexively I thought about the group facilitators earlier comments about Monica ‘dropping dead’ as I had noticed her walking aid. I wanted to reflexivity challenge how I made sense of Monica’s fitness (White, 2001) by creating more knowledge about this (D’Cruz et al., 2007) and keeping the power balanced towards her. We therefore completed a required medical questionnaire. Monica stated, ‘this is the bit I was worried about’. Homing in on this anxiety and understanding that she may feel criticised (Lishman, 1994), I used reassurance to display respect (Clark, 2000). I explained that I was not trying to categorise her as either eligible or ineligible (Fook, 2002) but a medical was expected of all carers. Monica explained that she was diabetic and was controlling this without her medication and GP’s knowledge. I explored this with Monica and the potential impact for a vulnerable child, stating I would need to discuss with my supervisor. Whilst going through the medical questionnaire Monica didn’t mention her mobility problem and therefore I probed about this. This achieved its desired effect (Egan, 2002) as I learnt that Monica was registered disabled and hadn’t been able to work for two years. Monica exclaimed ‘that’s it now isn’t it’. I really valued Monica and thanked her for being honest with me. I stated that I was actually more concerned about the diabetes then her disability. My own values were that as long as a child was safe, then any person regardless of disability should be able to foster. I set Monica the task of constructing her chronology to discuss in our next visit and left her home.
Supervision is not only to aid practitioner’s development (Hawkins and Shohet, 2000) but also the needs of service users (Pritchard, 1995). I raised my concerns surrounding Monica’s diabetes. I also raised concerns surrounding the general state of Monica’s home which was extremely run down, covered in dog hairs and had particularly poor air quality. Using the hierarchy of heeds (Maslow, 1954) I saw how important the house would be in meeting the child’s basic needs and therefore its potential impact on a child reaching self actualisation. Risk has assumed increasing importance in social workers daily activities (Webb, 2006) and I found my supervisor and senior practitioner recommending we close the assessment based on risk. However I viewed the situation from a preventative risk perspective (Corby, 1996) and felt that with work and support Monica could still foster.
I put my case to the team manager from a Disability Discrimination Act (1995) and Equality Act (2006) perspective, stating that there is a dominant ideology of disability where services tended to focus on incapacity (Prime Minister’s Strategy Unit, 2005; Thompson, 2001). However I saw potential in Monica due to raising her son independently and her childminding experience. I was granted to continue with my assessment if Monica could address her health and household issues. Dalrymple and Burke (2006) believe that critical debate about personal, professional and organizational values is essential in dealing with ethical dilemmas. Although colleagues will have different viewpoints (Watson, 2006), I felt my colleagues were acting habitually seeing Monica’s assessment as unworkable. However I saw my role as also ‘moral worker’ (Hyden, 1996) and felt, with the care vs. control and anti-oppressive practice in my mind, that Monica deserved the opportunity to make the necessary reasonable adjustments.
Discussion around issues
On the second visit I discussed the issues surrounding Monica’s diabetes and she agreed to visit the GP and begin to control this again. Her acknowledgement that she was ‘just being stubborn and thought she knew best’ I believe showed that my actions were with her best interests in mind. I also raised the subject of the cleanliness of her home. Monica didn’t feel there was an issue as she and her son had lived there with no concerns. At first I questioned my values and whether I was imposing them upon her. I reflexively began thinking about the Human Rights Act (1998) Article 8 ‘Right to Respect for Family and Private Life’. However I also thought about how I felt when I had left after the first visit and again took my viewpoint from a child who would potentially be less healthy than me. Under Article 27 of the UN Convention on the Rights of the Child (1990) ‘children have the right to a standard of living adequate to their physical, mental, spiritual, moral and social development’.
I explained to Monica that I was not trying to impose my values and believes upon how she lived and using motivational interviewing (Miller and Rollnick, 2002) asked her to compare her house with her friends homes. I had used this method in my first placement and believed its use in identifying discrepancies was transferrable. My use of this method obtained its acquired affect as Monica stated that she knew her house could be a lot cleaner but because of her disability she couldn’t maintain it. Exploring this with problem solving (Howe, 2007) identified the need of her son to help maintain the home, but Monica stated she didn’t want to inconvenience him. I was having difficulty understanding how Monica’s son fitted with her fostering. From a systems theory perspective (Goldstein, 1973; Specht and Vickery, 1977) I saw this as important to Monica’s assessment as he was her main support and therefore his behaviour would impact upon both her and children placed with her. When thinking about the assessment of foster carers we should be addressing whether or not the family system is ‘closed’ or ‘open’ (Shaw, 1989). An open family system is one that is accepting of change and more likely to offer successful placements. Monica explained her son was indifferent but supportive of her fostering. I explained that I would need to interview him separately to address this issue at a later point in the assessment.
I had asked Monica to complete her chronology which provides a history of significant events in her life (Parker and Bradely, 2007). This was to assess one of the competencies looking at how our own experiences can affect us (NFCA, 1999a). Monica discussed her life events but nothing from her childhood. I asked her about her childhood and she said it wasn’t important. I used challenging to aid further self reflection and understanding (Millar et al., 1992). Monica asked me about my comments in our first meeting about being open and honest and whether I needed to know everything. I stated I only needed to know things that would impact on her ability to foster.
Monica began crying and started to explain to me that she had been sexually abused in childhood by her uncle. The information elicited took me by complete surprise and made me anxious. I sat and listened to understand, empathize and evaluate what Monica had disclosed (Smith, 1997). Counselling techniques can be used across many social work situations (Seden, 2005) and I felt I demonstrated the core/basic counselling skills (Rogers, 1951; 1961) required of social workers (Thompson, 2002). However with something so entrenched and deep I felt I wasn’t in the position to explore this. Monica stated she wanted to continue and I therefore asked Monica her it’s impact on her current life. She stated she still had the occasional ‘black’ day where she couldn’t get out of bed. Care Matters (DfES, 2007) states that we need carers who can ‘stand in the child’s shoes’ (p.46) to help them regulate their feelings. Monica positively identified that she could empathise with a sexually abused child but then worryingly said that by talking to a child about their issues would help block out her own depressing feelings. Anxiety can enrich the identity of social work practice (Miehls and Moffatt, 2000). On quick reflection this anxiety I felt enhanced the understanding between me and Monica (Ruch, 2002) and empowered her to tell me that she still had her own issues to address. Monica acknowledged that she hadn’t thought about the abuse for forty years believing her disability caused her depression. I talked with Monica whilst waiting for her friend to arrive to ensure she was safe before I left and stated I would soon be in touch.
After the visit I compiled my notes using a funnel approach to refine my information (Parker and Penhale, 1998) into a report for senior staff. I used theory to offer accountability to all involved, including Monica, in my decision to close her assessment (Payne, 2005). This was based on standard 6.1 of the NMS (DoH, 2002) in making available ‘carers who provide a safe, healthy and nurturing environment’ (p.11). My colleagues supported my decision and said to send Monica a closing letter which I found insensitive and unacceptable. I wanted a more moral face to face closure with Monica rather than a procedural closure (Lloyd, 2006) as Monica had disclosed something extremely personal to me and I respected her for this. Endings are planned from the beginning (Kadushin and Kadushin, 1997). The natural ending would have been presenting Monica’s assessment to the fostering panel. Instead our ending was on different terms in which I provided Monica with a range of local agencies that could offer help or counselling to address her own issues.
As stated at the beginning of this report, I decided to choose this unsuccessful assessment to analyse rather than my later successful assessment. This may seem strange to the reader as the latter carers are now approved and fostering. However although I could write in equal length about the more successful assessment, it was Monica’s that taught me more about social work and about myself.
I felt Monica’s assessment demonstrated the acquisition and deployment of my knowledge, skills and values over the past two years. The broad range of literature presented in this report pulls on old and new resources, demonstrating the need to consistently update my knowledge in an ever changing profession. Without this knowledge I would never have been able to work with Monica. I believe my assessment, communication and interpersonal skills demonstrated my competence (O’Hagan, 1996). This ensured a natural, almost unconscious, use of the ASPIRE model (Sutton, 1999) throughout and meant I could adapt to the situation and respond eclectically to Monica’s situation due to its complexity (Cheetham et al., 1992). Integrity (BASW, 2002) has been the most significant value throughout my training. I believe it incorporates all values such as Biestek’s (1961) principles. My integrity ensured that I fought for the continuation of Monica’s assessment at one point; working anti-oppressively, non-discriminately and fighting against social injustices (BASW, 2002).
However despite my strengths, I appreciate that self knowledge is central to becoming a reflective practitioner (Dominelli, 2002); requiring an openness and ability to be self critical (Trevithick, 2005). With Monica’s assessment I was reminded of how practice isn’t straightforward and can constantly change (Parker and Bradley, 2007). I went into this assessment feeling that everything would be clear-cut because Monica had been seen by another social worker and therefore she must have been a certainty for fostering. However my complacency and reliance on other workers judgements didn’t prepare me for the information I was later to receive. Uncertainty is an inevitable part of human interaction and decision making (Roy at al., 2002) and is something I need to appreciate more and continually address within myself. I feel another area that I could have improved upon was focusing more on Monica’s strengths as she demonstrated an inner resource in responding to the daily challenges in her life (Kisthardt, 1992). I feel that although my decision would not have changed, in future practice I need to keep a firm grip on service user strengths to appreciate that there is room in assessment to focus on the cognitive skills, coping mechanisms, interpersonal skills and social supports that can be built on as strengths (Pierson (2002).
Although the assessment hadn’t gone as planned for Monica, I still believe it had some positive impact upon her. Monica’s childhood had been traumatic and I viewed this afterwards using the Johari window (Luft and Ingram, 1955) in figure 2 below. At first I had wondered whether Monica’s abuse was just an aspect of her hidden self. However what struck me afterwards was that Monica stated ‘I haven’t thought about that in over forty years’. I hadn’t attached any significance upon this statement, probably due to the emotiveness of the situation. However upon reflection I feel that Monica’s childhood abuse was part of her unconscious self that
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