Inspection on 02/02/06 for Longview Residential Home

This inspection was carried out on 2nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Longview Residential Home 20/05/09

Longview Residential Home 09/05/08

Longview Residential Home 15/05/07

Longview Residential Home 08/06/06

Longview Residential Home 04/11/05

Longview Residential Home 17/02/05

Longview Residential Home 14/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Longview Residential Home 66/68 Plymouth Road Plympton Plymouth Devon PL7 4NB Lead Inspector Jane Gurnell Unannounced Inspection 2nd February 2006 09:30 X10015.doc Version 1.40 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 Longview Residential Home DS0000003482.V269112.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 Older People. 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. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Longview Residential Home Address 66/68 Plymouth Road Plympton Plymouth Devon PL7 4NB 01752 337203 NO FAX longviewplttopenworld.com 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) Mr John Richard Underhay Mrs Isabel Margaret Underhay Mr John Richard Underhay Care Home 15 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (15) of places Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service users of the MD(E) category. Date of last inspection 04/10/05 Brief Description of the Service: Longview is a detached property situated in a residential area of Plympton close to local amenities. The home is registered to provide accommodation and personal care for up to 15 women over the age of 60 for reasons of old age and dementia. Accommodation is provided over 2 floors, offering 11 single rooms and 2 double rooms. A stair lift provides access to the first floor, however there is one step at the top of the stairs and also steps at the main entrance, making access difficult for residents with mobility difficulties. There is a large lounge room and dining room on the ground floor, both of which have doors opening onto the patio. There are three bathrooms, two of which are on the ground floor: one is fitted with a bath hoist but is in a poor state of repair. The garden is well maintained and attractive. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on 2nd February 2006. This report also incorporates the findings of 2 additional visits made to Longview. The first on 3rd January 2006, when the inspector spent the day at the care home with Mr and Mrs Underhay, the Registered Providers, to review the care planning processes, and the second, an unannounced visit made in the evening on 3rd February 2006 as there had been no care plans available for any of the residents at the time of the unannounced inspection the day before. An Immediate Requirement Notice was issued at the time of the visit on 3rd January 2006 as firstly, care staff had not received fire safety, first aid or manual handling training for some considerable time and secondly, the residents care plans did not reflect their current personal and health care needs. The Registered Providers had failed to make any arrangements to address these issues despite being made requirements in the inspection report dated 4th October 2005. At the time of the unannounced inspection on 2nd February 2006, there was evidence that care staff had received fire safety training on 13th and 18th January 2006, but the Registered Providers had not made any arrangements for care staff to receive first aid or manual handling training. There were no care plans available for any of the residents currently living at Longview. A further Immediate Requirement Notice was issued stating that by 5pm on 3rd February 2006, the Registered Providers must have a care plan for each resident accurately reflecting their care needs, as well as dates for staff to receive first aid and manual handling training. An unannounced visit was made to Longview at 5.30pm on 3rd February: the Registered Providers had failed to comply with the Immediate Requirement Notice and therefore the inspector gave notice that Statutory Requirement Notices would be issued in relation to these matters in accordance with Regulation 43 of the Care Homes Regulations 2001. What the service does well: Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 6 Residents said that they felt well cared for and that the staff were very kind. They also said that the food was very good. The home was found to be clean and tidy. What has improved since the last inspection? What they could do better: As noted above the Registered Providers must provide a care plan for each resident that reflects their personal, health and social care needs as well the action required by staff to meet these needs. Risk assessments relating to the health and wellbeing of the residents must be included in the care planning process. The care plan and risk assessments must be kept under review and amended to reflect the residents’ changing needs. Care staff must receive training in first aid; manual handling and infection control, as well as care issues relating to the needs of older people with dementia, not only to ensure they have the skills and knowledge to deal with emergencies but to provide the appropriate care and support for people with dementia. Those staff who have not received food hygiene training must do so. Adult protection training should also be provided. The induction training for new care staff should be amended to meet the National Training Organisation’s specifications. More structured daytime activities must be provided to ensure the residents are stimulated and provided with meaningful and enjoyable activities and interaction with staff. A programme of routine maintenance must be provided to demonstrate the plan of work to cover radiators and control hot water temperatures to ensure the residents are protected from the risk of burns and scalding. Door locks of a type that can be overridden by staff in an emergency should be fitted to bedroom doors to provide privacy and security. The ground floor bathroom must be made safe and provide a pleasant room in which residents may bathe. The laundry room floor must be sealed to ease cleaning and reduce the risk of the spread of infection. The Registered Providers must undertake training to ensure they have the necessary skills to manage a care home. A formal quality assurance process must be developed to enable residents, relatives and care staff to comment upon the quality of care and services provided and to identify areas for improvement. A copy of the most recent financial accounts relating to the care home must be provided to the Commission to enable an assessment of the home’s financial viability to be made. Residents who have money in the safe should have access to their money at all times. Care staff must receive formal supervision at least 6 times a year to address care practices and their own learning and development needs. Risk assessments relating to safe working practices must be undertaken to ensure care staff are aware of their responsibilities to protect themselves and the residents. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 7 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. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 Prospective residents cannot be certain that their care needs can be met at Longview, as care staff, although experienced, have received no formal training in caring for, or maintaining the safety of, older people. EVIDENCE: Those residents able to comment said that that they were well cared for and were happy living at Longview. Pre-admission assessments are undertaken by the Registered Providers to identify care needs and assess whether these needs can be met at Longview. At the time of the inspection the assessment for a resident admitted 3 weeks previously was not available, although care staff did confirm that it had been available at the time of the resident’s admission. As the resident did not have a written care plan, the assessment must be available to care staff at all times as this is the only information the care staff have to identify the resident’s care needs and past medical history. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 10 Although the majority of care staff had many years experience working in the care home, no staff have received training in relation to caring for older people or for those with dementia. A number of care staff have enrolled in NVQ training, which will address the principles of care practices, but not the specific needs of the residents Longview is registered with the Commission to provide care and accommodation for. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The health, safety and wellbeing of residents is being placed at risk by the failure of the Registered Providers to provide written care plans detailing residents’ personal and health care needs. EVIDENCE: Those residents able to comment upon their experiences of living at Longview said they were being well cared for and the staff were very kind. Residents appreciated living in a small and friendly home. The inspector witnessed those residents with dementia being treated respectfully by care staff. Service User Plans, or care plans, provide a description of the personal, health and social care needs of each resident as well as the action required by staff to meet these needs, and as such, these are essential documents that ensure care staff are aware of the needs of the residents. At previous inspections, it was identified that the care plans were out of date and did not provide sufficient detail of the residents’ care needs. At this inspection, and at the follow up visit on 3rd February, there were no written care plans available for any of the eleven residents living at Longview. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 12 Many of the residents living at Longview have dementia and there was no written information available to care staff regarding how the residents’ wellbeing and abilities is affected by this condition. Medication is stored safely and the medication administration records appeared to be in good order. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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, 14, 15 Poorly organised and limited leisure activities increase the likelihood that residents will be bored and this may lead to a more rapid deterioration in the mental health of those residents with dementia. EVIDENCE: Residents said that they enjoy living at Longview but that there is little to do during the day and they spend most of their day just talking to each other. They said care staff do organise Bingo games and they are able to listen to music. Entertainers come to the home once a month to provide musical entertainment. A reminiscence session organised through the local library was very successful and care staff said that this would be organised again. During the visit on 3rd January and this inspection, the inspector witnessed no interaction between care staff and the residents, other than tasks such as medication administration and being offered cups of tea. Many residents were seen to be sleeping during the day. Care staff said that Mrs Underhay organises some activities but in her absence no other staff take responsibility for this. As care staff undertake domestic chores and meal preparation and cooking, a member of staff should be identified as responsible for providing some stimulation for the residents. This lack of knowledge regarding the importance of stimulation for residents with dementia reflects the lack of training provided for care staff. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 14 Residents said that the food was very good, and drinks and snacks were always available. Records of the meals taken as well as any alternatives to the main menu were recorded. More detailed records were maintained to monitor the diet and fluid intake of residents with additional nutritional needs. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Residents and relatives can be confident that any issues of concern would be taken seriously and dealt with promptly. EVIDENCE: Residents said that the Registered Providers and care staff were very approachable and they felt that could bring any issues of concern to them. The complaints procedure and information regarding advocacy and advise agencies was available to residents and visitors in the main entrance way. Care staff had not received training relating to the protection of vulnerable adults. The Registered Providers had a copy of Plymouth City Council’s Alerter’s Guide for Adults at Risk and were aware of the procedure to follow should there be any suspicion of abuse. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25, 26 Residents live in a very pleasant, well-maintained home that is comfortable and warm. Bathing facilities require upgrading to continue to meet residents’ needs and reduce their risk of injury and scalding. EVIDENCE: The home was very clean and comfortable, well maintained and free from offensive odours. One of the ground floor bathrooms is in urgent need of repair and refurbishment. The Registered Provider had commenced this work but no progress had been made since 3rd January 2006 and the room was in a very poor state of repair and an unpleasant environment in which residents bathe. As this is the bathroom that is fitted with a bath hoist, it is the bathroom most used by the residents and must be repaired as a matter of urgency. Bedroom doors are not fitted with locks and therefore residents are not able to ensure their privacy or the security of their possessions. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 17 Radiators were not covered and the temperature of hot water was not controlled posing a risk to residents of burns and scalds. The laundry room floor required sealing to ensure ease of cleaning and reduce the spread of infection. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Staff are employed in sufficient numbers to meet the needs of those currently living at Longview, but they do not have the required training to ensure the health and welfare of residents is fully protected. EVIDENCE: The majority of the care staff have worked at Longview for many years and as such have a great deal of experience in caring for older people. Residents and relatives said that the care provided at Longview is very good. Staff have received no formal training relating to the care needs of older people or those with dementia, standard 4, nor have they received the required statutory training in first aid, manual handling and the control of infection, standard 38. This lack of training means that staff respond to emergencies or to anxious or agitated behaviour in the way they see fit rather than having a consistent approach adopted by the whole staff team. Inconsistency can lead to further anxiety and frustration in people with dementia and places an undue burden on care staff to “do the right thing” when they don’t have the training to deal with these situations. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36, 37, 38 Failure by the Registered Providers to address health and safety issues has put at risk the welfare of the residents. EVIDENCE: Neither of the Registered Providers have NVQ 4 in Care or the Registered Manager Award, although they do have several years experience in caring for older people with dementia. The Registered Providers have failed to address significant health and safety issues particularly staff training in first aid, manual handling and the control in infection. Care staff must be provided with the knowledge to enable them to respond to health emergencies and accidents. Four care staff were identified as requiring food hygiene training to enable them to safely prepare meals. Residents said the Registered Providers are in the home frequently and they have the opportunity to speak with them. There is no quality assurance Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 20 process at Longview to enable the Registered Providers to formally consult with residents, relatives or staff about the quality of the care and services provided and identify areas for improvement. Care staff do not receive formal supervision regarding care practices and their own learning and development needs, but say they are able to speak to the Registered Providers when they are in the home. At the previous inspection in October 2005, the Registered Providers said that they would forward a copy of their financial accounts to the Commission once received from the accountant. This has not yet occurred and the Registered Providers must provide a copy of their accounts to enable the Commission to assess whether the home is financially viable. Money is held for safekeeping in the home’s safe for a number of residents. Individual records are maintained however the inspector was unable to check that these were correct as only the Registered Providers and one senior member of staff have access to the safe and neither were on duty at the time of the inspection. Care staff said that could not access money for residents unless they knew in advance. Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 1 X X 2 2 1 STAFFING Standard No Score 27 1 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 2 2 1 2 1 Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement Pre-admission assessments detailing residents’ care needs must be available to care staff at all times until such times as a written care plan provides this information. Care staff must receive training relating to the care needs of older people with dementia. Each resident must have a care plan providing a detailed description of their care needs and the staff action required to meet those needs. Care plans must be kept under review to ensure they reflect the changing needs of the residents. Residents health care needs must be recorded in the care plans. Residents must be provided with stimulating and meaningful activities. The Registered Providers must provide a programme of routine maintenance detailing when works will be carried out in relation to covering radiators DS0000003482.V269112.R01.S.doc Timescale for action 17/02/06 2. 3. OP4 OP7 18 15 30/06/06 27/02/06 4. 5. 6. OP8 OP12 OP19 12 16 23 27/02/06 31/03/06 30/04/06 Longview Residential Home Version 5.1 Page 23 7. OP21 23 8. OP25 13 9. OP25 13 10. 11. OP26 OP31 13 10 11. 12. OP33 OP34 24 25 13. 14. 15. 16. OP36 OP38 OP38 OP38 18 13 13 & 18 13 & 18 and controlling hot water temperatures to baths and sinks. . The Registered Providers must complete the repair work and making safe the ground floor bathroom. The radiators and pipe work must be covered or have guaranteed low temperature surfaces. Design solutions must be in place to ensure that water is stored at a temperature of at least 60 degrees centigrade, distributed at 50 degrees centigrade and delivered at close to 43 degrees centigrade. The laundry room floor must be sealed. The Registered Providers must undertake appropriate training to ensure they have the skills necessary to manage a care home and as such must seek advice from their training provider regarding NVQ 4 in Care, the Registered Managers Award and training in relation to the care needs of older people and those with dementia. The Registered Providers must introduce a formal quality assurance system. The Registered Providers must provide the Commission with a copy of the most recent accounts relating to Longview. Care staff must receive formal supervision at least 6 times a year. Care staff must receive manual handling training. Care staff must receive training in first aid. Care staff involved in food DS0000003482.V269112.R01.S.doc 28/02/06 30/06/06 30/06/06 31/03/06 31/08/06 31/05/06 30/04/06 30/06/06 07/04/06 07/04/06 07/04/06 Page 24 Longview Residential Home Version 5.1 17. 18. OP38 OP38 13 & 18 13 preparation must receive training in basic food hygiene. Care staff must receive training 30/06/06 in health and safety and the control of infection. Risk assessments relating to 30/06/06 safe working practices must be undertaken to safeguard staff. 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. 2. Refer to Standard OP18 OP30 Good Practice Recommendations Care staff should receive training relating to the protection of vulnerable adults. The Registered Providers should provide induction training to newly appointed staff that meets the National Training Organisation’s specifications. Care staff should have an individual training and development assessment and profile. Door locks of a type that are accessible from the outside by staff in an emergency should be fitted to bedroom doors. Residents should have access to their money at all times. 3. 4. OP24 OP35 Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Ashburton Office 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 Longview Residential Home DS0000003482.V269112.R01.S.doc Version 5.1 Page 26 - 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. 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