Inspection on 07/06/05 for Longreach

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Longreach 25/04/07

Longreach 28/10/05

Longreach 06/01/05

Longreach 13/07/04

Longreach 25/02/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Chandos House

Cherry Orchards Camphill Community Ltd

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Longreach 7 Hartley Road Plymouth Devon PL3 5LW Lead Inspector Brendan Hannon Announced 7 June 2005 th 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 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 Stationary 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. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Longreach Address 7 Hartley Road, Hartley, Plymouth, Devon, PL3 5LW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01752 788699 01752 789980 Broadreach House Ms Wendy Van Der Niet Care Home 20 Category(ies) of Past or present alcohol dependence (20), Past or registration, with number present drug dependence (20) of places Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Female only Age 16-64yrs Date of last inspection 06/01/05 Brief Description of the Service: Longreach is a large unit providing second stage treatment for women between the ages of 16 and 64 years of age who are pursueing rehabilitation from drugs and alcohol. Longreach does not provide a detoxification service. Treatment is by means of counselling and mutual support. The service requires total abstinence from all clients throughout their stay. The unit can accomodate up to twenty clients at any one time. The unit is housed in a large detached house and a seperate cottage building. The house has the majority of the accomodation which is made up of six double bedrooms and one single bedroom. The cottage is completely seperate living space including a kitchen and lounge and can accomodate up to five clients in two double bedrooms and one single bedroom. The cottage is usually reserved for clients moving towards the end of their stay at Longreach. There is a large garden to the rear of the building. There are a number of offices and purpose built counselling rooms seperate from the homes two main lounges. Longreach is located in the Hartley area of central Plymouth. It is close to Mutley Plain shopping precinct and there is easy access to the central area and other parts of Plymouth by bus. The home is part of the Broadreach charitable group. The organisation provides a variety of alcohol and drug rehabilitation services in Plymouth but is open to people from all over the country. The Broadreach group is part of EATA, The European Alcohol Treatment Association. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced. Preparation for the inspection included analysis of the pre inspection questionnaire, the previous inspection report and contact with the home over the last 12 months. An inspection plan was developed from this information. The inspector was in the home from 9.45am to 2.30pm. The inspector spent time with or spoke to all of the fourteen clients, with particular attention being given to two clients whose care was looked at closely. The clients requested that they were all spoken to as a group although two clients also requested to be spoken with individually. The whole of the building was inspected. The registered manager, three counsellors, the senior support worker, the office administrator, the maintenance man and the cook were all spoken to during the inspection. The registered manager was spoken to at length. Client files including care planning, support worker notes, medication records, and health and safety records were inspected. What the service does well: The home provides good information about the service to potential new clients and their representatives so that they can make an informed choice to use the service. One client said ‘I went on the waiting list to come here because it looked so good’. They also said that they felt their treatment had been very good because ‘you get out what you put in’ The service carries out thorough assessments for all potential clients before admission and this helps to ensure that all the clients needs can be met and that the likelihood of successful completion of the treatment programme is good. The delivery of resident’s care and treatment is supported by the homes care planning and individual client risk assessments. In addition to the assessment of needs the unit now uses risk assessment effectively so that a judgement can be made on whether the unit can meet a potential clients individual risk issues. The unit has stated clearly the restrictions that must be agreed to by potential new clients and these are signed for before admission in a contract of terms and conditions. This includes the grounds on which the treatment programme might be ended. However despite the restrictions necessary for a successful treatment programme the clients’ quality of life is good and as much individual freedom as possible has been given. This has helped to maintain clients existing skills and independence. This respect for client’s rights combined with the treatment programme, and further development of groups, such as parenting skills, cooking and nutrition, enables the unit to successfully support clients to manage in the wider community after their treatment is complete. Clients are supported by the organisation’s resettlement officer at the completion of their Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 6 treatment at the unit, and the organisation has also begun to offer after care outreach in Plymouth. The clients are provided with plenty of, varied, good food. The unit consults with the clients on the menu, takes into account preferences and is now working effectively to support clients with eating disorders. The clients benefit from homely, comfortable, clean and well maintained buildings that meet their needs. Client’s medication and any personal care needs are well met by the unit. Clients’ needs are met by competent, qualified, properly vetted, and well trained staff. The standard of the training for the counsellors and support staff is very good. In group the existing clients said to the regulation inspector that the staff were excellent and very supportive. The management of the home is effective and the quality of the service continues to develop so that clients needs continue to be met successfully. What has improved since the last inspection? What they could do better: 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. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 8 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 standard(s) 1,2,3,4,5 The home provides good information about the service to all potential new clients and their representatives. This enables potential clients to make an informed choice to use the service. The service assesses the potential clients needs before admission and recognises the needs that it can meet. These processes increase the likelihood of successful completion of the treatment programme. EVIDENCE: The service has updated the Service Users Guide with the latest additions to its service including EMDR (Eye Movement Desensitisation and Reprocessing) for alleviating post traumatic stress, auricular acupuncture detoxification, parenting skills groups and management of eating disorders. The home carries out a thorough admission assessment process before admission is agreed, involving both consultation with the care manager and usually a meeting with the prospective service user. An assessment pack is jointly sent to both parties. A general risk assessment is carried out for all prospective service users. The pre admission process is of very good quality and the unit has exceeded standard 2. The clients usually make initial visits to the unit as part of the assessment process but assessments can be carried out by phone if necessary. A new contract between the home and the client has been developed which very clearly states all the restrictions agreed as part of treatment at Longreach. This document includes the grounds for ending the treatment programme before it is complete. All clients sign for these conditions at admission to the unit. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 6,7,8,9 The delivery of client’s care and treatment is well supported by the homes care planning and individual client risk assessments. The clients quality of life is improved by receiving as much freedom and choice as possible within the necessary restrictions of the treatment programme. EVIDENCE: The unit operates both a general care plan and a treatment plan. This works well to identify all the areas of need and to direct both support workers and counsellors to address all the client’s needs. Risk assessments in place clearly showed that these identified risks had been acted upon. The unit has been particularly proactive in addressing mental health issues. Identified mental health issues were supported by contingency mental health planning from the purchasing authority area. Mental health risk assessments are reviewed as required by the counsellor group during the treatment programme. The active use of risk assessment to enable clients interests to be protected has exceeded the standard required by standard 9. Clients are also supported to manage their own daily routines and personal decision making within the restrictions of the treatment programme. In the latter stages of treatment active change is made to the treatment programme to give more time to the client to fill with learning activities and leisure as they feel will help their development. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 11,12,13,14,15,16,17 Clients have enough leisure activity to ensure a good quality of life while living at the home. Clients have considerable access to opportunities for personal development, which will help during and after the treatment programme. Clients receive plenty of, varied, good food. EVIDENCE: Throughout the inspection information both on the leisure activities and the personal development activities engaged in by the clients, was given by the clients, the registered manager, the staff team and was shown in records. The inspector was informed by the clients that the Broadreach minibus is now regularly available to the clients at Longreach one weekend in four and that there is a regular volunteer driver. Last weekend eight of the clients went, using this minibus, to Looe in Cornwall and enjoyed their day out of Plymouth. I was also told by two clients of a five-day yacht sail training group that they had been involved in during their stay, which they had enjoyed and which they felt had helped them to work together within a small group. The clients are given free bus passes for travel within Plymouth at arrival in the home. This helps them to access facilities and services in the city including Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 11 NA/AA sessions, the gym, and various workshops including computing at an activity centre. Within the home arts and crafts, yoga, aerobics, cooking and nutrition, and gardening sessions take place as well as the opportunity to look after the recently introduced chickens that have an extensive chicken run in the rear garden. Clients proudly showed off the chicken eggs gathered the morning of the inspection. The Broadreach group has developed a number of new support systems over the past months, which the clients at Longreach are actively using to assist their rehabilitation. A new Broadreach centre at Wyndam Square is providing parenting skills programmes and a crèche as well as outreach for clients following leaving treatment. Parenting skills sessions are being delivered to the clients weekly, supporting the clients skill development in this area. The combination of the treatment programme, which was praised by the clients throughout the inspection, and the opportunities for personal development made available to the clients, has exceeded the standard required by standard 11, skills development opportunities. Broadreach are also now working with a housing association to provide a number of sheltered flats in Plymouth which can sometimes be accessed by clients after leaving the Longreach treatment programme. This accommodation and outreach from Wyndham Square help in the transition to unsupported living in the community. When clients complete treatment at Longreach they are supported by a resettlement officer from the Broadreach organisation. Longreach continues to provide good quality food with good variety. There is regular consultation with clients taking into account clients preferences and special dietary needs, including eating disorders. The cook has now become qualified to teach basic food hygiene to the clients in support of their food preparation for the group at the unit. The cook also takes weekly cooking and nutrition groups which has improved the quality of client food provision to the group and supports clients development of, basic living skills and parenting skills. The home continues to be recognised as having exceeded the required standard for Standard 17, provision of food in the home. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 18,20 The clients health is maintained by meeting clients personal care needs and by well managed administration of their medication. EVIDENCE: Clients at Longreach have minimal personal care needs. Should support be needed this is available from the counsellors and support workers. All the clients present in the home at the time of the inspection were seen. All personal care issues are being met. Self-administration of medication is restricted in the home. Only some inhalers are released into the care of clients based on risk assessment. The amounts of medication being prescribed to clients is maintained at a low level and it is a requirement of admission that all clients are assessed, and their medication reviewed, by a GP within six weeks of admission. Due to the limited quantity of medication and the independence of the clients the home does not operate a monitored dosage system of medication administration. The home does not ‘repot’, secondary dispense, any medication. During the inspection clients were seen coming to the office, and requesting their prescribed medication. The homes medication storage facility is appropriate for the homes needs and was clean and ordered. The Medication Administration Record (MAR) sheets were reviewed and were adequate. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 22,23 Complaints are properly managed by the home protecting the welfare of the residents. EVIDENCE: There is a good complaints procedure in place, which is clearly displayed in the home, and attached to the service users guide. Details of how to contact the CSCI locally are clearly stated in the procedure. The service users guide is given to all new clients entering the home. The Broadreach organisation has developed a new ‘protection of adults at risk’ policy, which clearly states how an allegation or disclosure of possible abuse would be managed. Awareness of abuse is a central part of counsellor’s clinical training and new support workers induction. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 24,27,30 The clients benefit from homely, comfortable, clean and well maintained buildings that meet their needs. EVIDENCE: The buildings and gardens of the home were inspected and no repairs were noted. The quality of the living environment and the standard of decoration in the home is generally good. The home was clean and odour free. There has been considerable refurbishment of the communal lounges, the service users bedrooms and the hallways of the building during the past two years. In the communal lounges all the seating has been replaced and in the two main lounges the floors have been sanded and polished. In the bedrooms the wardrobes, chests of drawers and bedside cabinets have been replaced. Half of the bedroom carpets and some of the corridor area carpets have been replaced. Further refurbishment of bedrooms and hallways is planned to happen during the coming year. This refurbishment has helped considerably to give the building a more domestic atmosphere and a better quality of living environment for the clients. The availability of useable space in the bedrooms is adequate to meet the needs of the service users even almost all are double rooms. It is important to note that the service users are only in residence for approximately three to six Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 15 months. Personalisation of rooms is also limited because of the short stay nature of the service. However clients have made the rooms homely. All the double bedrooms have a mobile screen available for client privacy. None of the bedrooms have locks due to the needs of the treatment programme. Personal valuables can be secured using one of the individual lockers that are offered to all new clients at admission. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,43,35,36 Resident’s needs are met by enough competent, qualified, properly vetted and trained staff. EVIDENCE: The homes record of the hours worked by staff was checked and this showed that there continues to be the staffing level which has been in place since 2002.The registered manager is happy that there are enough counsellors in post to provide a thorough treatment programme and enough support workers covering evenings, nights and weekends to meet the clients needs. There is a duty system operated by the homes counsellors to ensure that there is always counsellor support available in an emergency. Approximately half of the staff team are NVQ2 or above, qualified. A thorough training programme for NVQ qualification is run by the organisation to ensure that the level of qualification of the staff is maintained. The organisation has also been involved in the development of national drug and alcohol training for support staff and is keen to begin training in this area as soon as the DANOS qualification is available. However the existing induction delivered by the Broadreach organisation is thorough and gives a good set of basic skills to all new support staff. This training enables staff to successfully meet resident’s needs when they begin work with the organisation. Over the past year all staff have received, all of the mandatory basic training, as well as safe handling of medication, and fire awareness training. Additional training has been given to groups of staff during the past year including, Mental Health Awareness, Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 17 working with self harm, and child protection. Other examples of specialist courses followed included auricular acupuncture, supervision, advanced EMDR, and interventions for eating disorders. Longreach also supports a number of student placements including at present two student counsellors. Longreach has a commitment to training that exceeds the requirements of standard 35. The pre inspection questionnaire was written by the management of the home and stated the dates of return for all of the staff Criminal Records Bureau clearances. Personnel records and training records are available in the home for inspection as well as at the organisations head office. A programme of individual support worker supervision sessions is being carried out and supervision minutes were seen. Counsellors receive regular clinical supervision. This monitoring helps to ensure that the quality of staff practice delivered to the residents is maintained. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,41,42 The management of the home is effective and continues to develop the quality of the service so that clients needs continue to be met. EVIDENCE: The registered manager, Wendy Van Der Niet, has been in post for the past three years. Good working relationships were seen between the counsellors. support staff, clients and the registered manager. These good relationships will promote better quality support for the clients. The organisation has an existing quality assurance system based upon questionnaires. Clients fill out these questionnaires when they are about to leave the unit, the information given is then analysed and returned to the registered manager as quarterly figures. This system is being redeveloped so that information is no longer delivered only as figures and is based on information from either a six month or one year period. The system is being changed because the figures supplied by the original system could be misleading. The unit and organisation does collect statistics on completion rates of the treatment programme. The records seen throughout the inspection were being adequately maintained. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 19 Health and safety is generally well managed in the unit. The record of fire protection checks and fire awareness training is well maintained. The accident record is thorough and is well maintained. Checks have been carried out during the last year, as noted in the pre inspection questionnaire, including gas appliances, Legionella infection and electrical equipment. Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 3 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 4 3 3 3 3 3 4 Standard No 31 32 33 34 35 36 Score x 3 x 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Longreach Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x 3 3 x D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 21 no 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Longreach D52-D04 S3446 Longreach V223223 070605 Stage 4.doc Version 1.30 Page 23 - 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!