CARE HOME ADULTS 18-65
Longcroft 58 Westbourne Road Lancaster Lancashire LA1 5EF Lead Inspector
Mrs Joy Howson-Booth Unannounced Inspection 3rd March 2006 10:00 Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Longcroft Address 58 Westbourne Road Lancaster Lancashire LA1 5EF 01524 64950 01524 844082 Longcroft@langleyhousetrust.org Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Langley House Trust Mr Joseph Costello Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The home shall accommodate a maximum of 14 Service Users in the category MD (mental disorder). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 27th September 2005 Date of last inspection Brief Description of the Service: Longcroft is registered with the Commission for Social Care Inspection to provide care and accommodation for up to 14 younger adults with mental health needs. The home is one of a number operated by the Langley House Trust, which is a charitable organisation. The home is situated close to Lancaster City Centre and within close proximity of a number of facilities and amenities. It is a substantial detached property set within its own well maintained grounds. Care is provided on a 24 hour basis including waking watch support throughout the night. The home works closely with professionals from other agencies including local probation and mental health services in meeting residents’ needs. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced so the registered manager, staff and residents at the home were not aware of the inspection. The inspection was carried out by two inspectors from the Commission. The purpose of this inspection was to assess the service against the key National Minimum Standards, which remain outstanding and also review actions taken following the requirements and commendations made in the previous inspection report. Two residents were spoken with, along with staff on duty. A selection of documents held by the home were examined, including care pathways, medication records, staff files, maintenance records and residents meeting minutes. A tour of some areas of the home was undertaken, although this was somewhat hampered by the redecoration and refurbishment work currently underway. Feedback received from residents indicated that they felt very well looked after at the home and were supported by the staff. What the service does well:
The service continues to support residents to regain balance to their lives and this support is clearly given with respect and in a non-judgemental way. Care plans are comprehensive and detailed and residents are involved and contribute to these and their reviews. As detailed in the previous inspection report, the residents who live at Longcroft are deemed to be at risk of committing offences and as such, their support needs to be carefully planned. During this inspection it was again evidenced that records of all risks and measures required to reduce them are made and included in each resident’s care plan. Communication and interagency working also takes place with the police and probation services. Residents take part in a range of appropriate activities which gives them opportunities for personal development, gaining skills and experience. Support is provided for this by staff on duty. Meals appear to be particularly appetising and very well enjoyed by the residents. The area of medication is very well managed and input is provided from a range of specialist healthcare professionals.
Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 6 From talking with two of the residents, they feel that they are listened to and consulted about their care and feel the home is well managed. Support and training for staff is well organised, with a number of pertinent courses being provided. Staff are also trained in abuse awareness and there are procedures in place should abuse be suspected. Staff are also trained to ‘de-escalate’ situations and in the management of aggression. Incidences are dealt with promptly. The staffing of the home is maintained at a satisfactory level with additional staff being brought in as activities and demands arise. The health and safety of the residents and staff is treated seriously, with action taken promptly should an area of safety, etc., be identified. What has improved since the last inspection? What they could do better:
Once completed, the ongoing redecoration and refurbishment work will greatly improve the communal areas of the home. The Langley House Trust should develop a rolling programme to ensure the home is maintained to an good state of repair in the future. A thorough recruitment procedure is followed but records examined during this inspection did not evidence all the required information. The registered manager felt the missing documents would be held by the head office. The registered manager was reminded of the requirements of the Care Homes regulations which require recruitment documentation to be held at the home. It was suggested that a recruitment checklist may be useful to indicate when documents are requested, obtained and whether these have been passed onto the head office. Although medication is appropriately and safely dealt with in the home, recommendations were made, as follows : To implement a controlled drugs book so that should any controlled drugs be prescribed the home has the required record book ready and on hand. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 7 To contact the local pharmacy to see if computerised MARS (medication administration record sheets) are ready printed to save time and also to ensure accuracy. To record the actual medications that arrive at the home so that there is a clear audit trail if needed. To obtain the patient information leaflets for medication which can be put into one file so that staff and residents, as appropriate, can access and read. To implemented a policy for individuals who are on PRN medication so that staff are clear as to the circumstances when this medication should be administered. From residents meetings held, the home clearly consults over the service provided. However, the home should continue to implement a formal quality assurance system in the home, which will consolidate the existing consultations in place. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2, 3 and 4 were assessed and met at the previous inspection EVIDENCE: Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 There are clear and very comprehensive care documents in place which mean staff know and understand areas of risk and how to meet resident’s needs. Residents to feel consulted and make decisions about their lifestyles and feel listened to. EVIDENCE: Three care plans were examined and found to be very well structured and containing comprehensive information over the needs of the residents and how the staff support these to be met. From the files examined and from discussion with residents, it is clear the home works in partnership with both the resident and also other professionals, with evidence of resident involvement and regular reviews taking place. The care plans examined also evidenced that there are clear protocols in place and, from discussion with one resident, these are discussed, agreed and implemented as required.
Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 11 The care plans also contained extremely detailed risk assessments with clear actions to take for responses. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 The arrangements to ensure residents are provided with opportunities to have a balanced, quality of life are very good indeed which means the residents can feel valued and are able to develop their skills. There are excellent arrangements and planning to ensure residents are provided with nutritional and appealing food to maintain a health lifestyle. EVIDENCE: At the previous inspections, the inspector recorded that residents at the home benefit from the opportunity to take part in a good variety of activities. Residents are encouraged to develop hobbies such as gardening and bike riding. Within the home, residents are offered activities such as karaoke nights and quizzes. Residents also have use of a computer which has been provided for activities such as games and word processing. As well as the usual in-house activities (TV, music, etc.) the residents are currently upgrading one of the downstairs rooms into a games room. This will provide a good environment to interact by playing pool, listening to music,
Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 13 making tea or coffee and to play pool, listen to music, make tea or coffee and generally unwind and relax. At the time of the previous inspection, several residents were involved in the newsletter which is produced on a regular basis. Some residents carry out roles as roving reporters conducting interviews and writing stories. Others are involved in the publishing and production side of the magazine. It was previously noted that residents have enjoyed caravan holidays with staff and two residents have attended a National Conference for residents held by Langley House Trust. There are opportunities for the residents to enjoy the local community, with staff support and within their own protocols. From the records examined, and from talking with the residents, it was seen that residents have enjoyed adult education classes, garden activities, educational activities and trips and one-off outings like a canal boat trip. Residents are also encouraged to look at voluntary work – it was noted that some residents are working in a local animal care centre, collecting and delivering furniture, re-cycling bicycles. Again these activities are undertaken with staff support. Residents spoken with during this inspection confirmed that they are happy with their lifestyles and the support they receive and feel they are provided with opportunities for personal development. The home has menus that run on a 2 weekly basis and residents are encouraged to make suggestions as to different meals. Minutes of residents meetings also document that residents are asked about suggestions. The menus were seen and found to be satisfactory. Discussions with the residents all confirmed that the food provided is very good indeed. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 There are safe systems in place to ensure that medication is kept secure and administered appropriately to residents by staff trained to do so. EVIDENCE: Medication records were examined and found to be accurately maintained. Only trained staff administer medication to the residents. Medication is securely stored in the main office. A requirement was made following the previous inspection that a signed disclaimer and completed risk assessment must be held in respect of residents who are managing their own medication. The registered manager confirmed these are now in place. Advice was given as follows : Recommended a controlled drugs book be implemented so that should any controlled drugs be prescribed the home has the required record book ready and on hand. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 15 Recommended to contact the local pharmacy to see if computerised MARS (medication administration record sheets) are ready printed to save time and also to ensure accuracy. Recommended to record the actual medications that arrive at the home so that there is a clear audit trail if needed. Recommended to obtain the patient information leaflets for medication which can be put into one file so that staff and residents, as appropriate, can access and read. Recommended to implemented a policy for individuals who are on PRN medication so that staff are clear as to the circumstances when this medication should be administered. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The arrangements for dealing with complaints are good. Residents can speak up and feel that they are listened to. Residents are protected from abuse by trained staff who are supervised by a competent manager EVIDENCE: The home has a written complaints procedure which is included in information provided to residents at the time of admission to the home. There are residents meetings which are held on a regular basis. Minutes of residents meetings were read and there is clear involvement of those residents who wish to do so. Residents have access to their own key worker to discuss any concerns or issues or, if needed, the registered manager. The home has a formal policy and procedure for responding to allegations of abuse. Staff training provides information on abuse awareness and also information on the management of violence and aggression, self harm and boundaries for staff involvement. The home has a ‘no restraint’ and ‘non-contact’ policy in place but equips staff through training to de-escalate situations. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Standard 24 was assessed at the previous inspection with requirements being made Longcroft is generally a safe place for people to live in although some improvements are still required. Residents feel safe and their accommodation is comfortable. EVIDENCE: Previous requirements were made at the last inspection to ensure that all parts of the home to be kept clean and in a reasonable state of repair. Urgent repairs, for instance, cracked windows to be dealt with promptly and a building improvement plan to be forwarded to the Commission. The registered manager confirmed that the specific repairs/hazards identified in the last inspection report have all been addressed and were now safe. The only remaining issues were the lounge carpet and the stair carpet. The lounge carpet is still in place although the stair carpet has been removed. Both are to be replaced once all the redecoration work has been completed. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 18 The home is still in the process of being redecorated and refurbished but it is anticipated this work will be fully completed by the end of March 2006. Confirmation is required from the home once all the work has been completed. As recommended at the last inspection, once the current refurbishment work is completed, the home should develop a rolling programme of routine maintenance to ensure the home is maintained to a reasonable state of repair. The home was not toured fully during this inspection due to the redecoration and refurbishment work being carried out but it was noticeable that this was making a marked improvement to the fabric of the building. The residents and staff are currently developing a new games room downstairs which will provide an additional welcome in-house resource. There were no major issues seen regarding cleanliness of the home but it is anticipated a full cleaning overhaul of the communal areas will take place once all the work has been completed. Individual rooms that were seen were clean and tidy and providing a personalised space for the residents to use. Residents who were spoken with were satisfied with their rooms and contributed to keeping these clean. A recommendation was made at the last inspection that information in relation to the use of CCTV cameras within the home should be included in the Service User Guide. The registered manager confirmed this has now been done. The registered manager also confirmed he is aware to notify the Commission if a resident who has a single room for any length of time is then asked to share. The home is also working towards each resident having a single room. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 The level and calibre of staff is very good. Residents are cared for by a team of trained and dedicated staff. EVIDENCE: The staffing rota was examined and evidenced that a good level of staff on duty to meet the needs of the residents both during the day and at night. As well as the support staff there are ancillary and administrative staff who work at the home. Langley House Trust has a formal recruitment procedure which involves input from both Longcroft and the main head office. For the three staff files examined it was found that although each file was organised and tidy, some of the expected documentation was not in place. For example, there were no health declarations on file, only one application form in evidence, a record of interview was only found for one person and only one person had proof of identity on file. This was discussed with the registered manager who felt that the missing documentation would probably be held at the head office. The registered manager was reminded of the requirements of the Care Homes regulations which require recruitment documentation to be held at the home. It was suggested that a recruitment checklist may be useful to indicate when
Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 20 documents are requested, obtained and whether these have been passed onto the head office. Confirmation was seen that Criminal Record Bureau checks had been obtained for these three staff prior to commencement of work. Langley House Trust arranges training for staff who work within their organisation and there is a 12 month planning period which is paid for in advance. Internal courses include – basic staff information, induction workbook, health and safety, etc. Other courses include – sex offender awareness, management of violence and aggression, basic welfare benefits, self harm, debt management, basic staff training, disability benefits, boundaries, providing consistency, de-escalation techniques, support planning, understanding mental health and celebrating diversity. Staff who work at the home have their own PDP (personal development plan) and a small selection of these were examined. It was evidenced that staff attend both internal and external courses. All staff are provided with a code of conduct and, on a practical level, staff are provided with communication devices and alarms. As recommended in the last inspection, the registered manager confirmed that exit interviews are now held with staff who leave the service – these are carried out by the Human Resources (HR) department of Langley House Trust. In addition, a system has been developed by the HR department to monitor staff retention figures. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Experienced and qualified management run the home. Residents live in a well managed home which ensures their involvement and makes sure the environment is safely maintained. EVIDENCE: The current manager is registered with the Commission and has the necessary experience and training to undertake this role. From observations made and from speaking with residents at the home, the home is very well managed with residents feeling supported and valued. There are residents meetings which are held every 2 weeks and, from reading minutes of these meetings, resident’s contributions are welcome over changes and ideas for the future. The registered manager has outlined a business plan for the home for the next twelve months which included a SWOT (strengths, weakness, opportunities
Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 22 and threats) analysis. Preparations are also underway to apply for the Investors in People award which will be helpful in providing an external and formal assurance system for the home. A selection of maintenance records were examined and demonstrated that the home takes seriously the need to ensure the health and safety of both the residents and its staff. Risk assessments are carried out, as required, on safe working practices although these are usually included within individual residents’ protocols. The staff have also a daily maintenance record book which enables them to report any issues that need repair/attention. Once addressed, these issues are signed off and dated. The home’s accident book was seen which was appropriately completed. The home’s policies and procedures are currently being reorganised into separate handbooks which should make these more accessible for staff to use. Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 3 X 3 X X 3 x Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 23 Requirement The building improvement plan currently underway must be completed, along with replacement of carpets previously identified. Once all the work is completed the Commission must be informed. A record of all the required recruitment checks must be maintained in the home Timescale for action 31/03/06 2 YA34 19 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations Following the home’s refurbishment a rolling programme of routine maintenance should be developed to ensure all parts of the home are kept in a reasonable state of repair. Single places should be made available to all residents who require them. A controlled drugs book be implemented so that should
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Longcroft YA25 YA20 any controlled drugs be prescribed the home has the required record book ready and on hand. To contact the local pharmacy to see if computerised MARS (medication administration record sheets) are ready printed to save time and also to ensure accuracy. To record the actual medications that arrive at the home so that there is a clear audit trail if needed. To obtain the patient information leaflets for medication which can be put into one file so that staff and residents, as appropriate, can access and read. To implemented a policy for individuals who are on PRN medication so that staff are clear as to the circumstances when this medication should be administered. 4 5 YA39 YA34 To implement a formal quality assurance system in the home A recruitment checklist may be helpful to identify when documents have been sent for, returned or passed to the head office of Langley Trust Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Longcroft DS0000009993.V283221.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
