Inspection on 19/01/06 for Ascot House

This inspection was carried out on 19th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Ascot House 28/07/06

Ascot House 05/09/05

Ascot House 25/01/05

Ascot House 28/04/04

Ascot House 11/11/03

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Ascot House Ascot Avenue Sale Cheshire M33 4GT Lead Inspector Helen Dempster Unannounced Inspection 19th January 2006 09:45 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 Ascot House DS0000032526.V275492.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. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ascot House Address Ascot Avenue Sale Cheshire M33 4GT 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) 0161 912 1212 0161 973 6780 Trafford Metropolitan Borough Council Mrs Lynne Crook Care Home 45 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (0), Old age, not falling within any other category (0) Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home provides accommodation for a maximum of 45 service users, 17 of whom require care by reason of old age (OP), 19 of whom are older people who require care by reason of dementia (DE(E)) and 9 of whom are older people who require care by reason of their mental ill health (MD(E)). Separate lounge and dining space is provided to meet the needs of the service users who require care by reason of dementia (DE(E)) and the needs of the service users who require care by reason of their mental ill health (MD(E)) There are currently 3 additional named older service users who require care by reason of old age (OP) and 2 additional named older service users who require care by reason of dementia (DE(E)). Should any of these service users no longer require accommodation at the home, the places will revert to the category (MD(E)). The Statement of Purpose must be maintained in line with the requirements of Schedule 1 of Regulation 4 (1) of the Care Homes Regulations. The Statement must be kept under review and updated. Any changes to the home’s purpose must be agreed with the Commission for Social Care Inspection prior to implementation. The staffing arrangements at the home must be maintained in line with the minimum levels set out in the guidance published by the Residential Forum, `Care Staffing in Care Homes for Older People`. This must be reflected in the Statement of Purpose. The home must be managed at all times in accordance with the guidance and regulations issued in respect of older peoples` homes by the Secretary of State for Health under Sections 22 and 23 (1) of the Care Standards Act 2000. The authority must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 5th September 2005 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Ascot House is a purpose built local authority residential home, which provides accommodation and personal care to 45 older people. The home is located in a residential area of Sale, Cheshire, close to public transport routes into the city centre and surrounding areas. The home is divided into 5 units, 2 of which accommodate 18 older people, 2 of which accommodate older people with dementia and 1 of which accommodates older people with mental ill health. Each of the 5 units has its own lounge/dining area and kitchen. The home is therefore able to provide a separate living area, with bedrooms located close Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 5 by for service users in each unit. Accommodation is provided in 45 single rooms. Forty-three of the 45 single bedrooms are over 12 sq. meters and could therefore accommodate wheelchair users. The remaining 2 bedrooms measure in excess of 10 sq meters. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s second inspection of the year and was unannounced. It was carried out on the morning of 19th January 2006. Time was spent discussing welfare matters relating to the residents the home supported and examining documentation in relation to the running of the home, staffing, care planning and the residents’ satisfaction. The term of address preferred by the users of the service was confirmed as “residents”. It was felt this best reflected the function and purpose of the service. The inspection only looked at a limited number of standards, so this report should be read together with the earlier report to get a full picture of how the home is meeting the needs of the residents living there. What the service does well: What has improved since the last inspection? What they could do better: There were things that could be done better at the home. Some of these things related back to previous requirements that had not been addressed and also included new concerns: The needs assessments and care plans did not always match up. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 7 Records of residents bathing patterns showed that baths were offered infrequently. The home was not monitoring the diets and health of residents’ well, including their weight, especially when weight loss was identified. The care of medication was not well managed by the home. Staff needed guidance to understand the cultural element of a care plan and issues around diversity. It was recommended that the residents’ meetings were held more frequently to obtain residents views. Staff applications were not always detailed. The home needed to carry out annual residents’ satisfactory surveys. Staff needed to be provided with regular supervision. The home needed to complete fire safety work. . 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. Ascot House DS0000032526.V275492.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 Ascot House DS0000032526.V275492.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 Contradictory and inaccurate information in needs assessments had the potential to put residents at risk. EVIDENCE: Four residents’ needs assessments and care plans were sampled. At the previous inspection, a requirement was made to the effect that the home must monitor and audit assessments and care plans to avoid contradictory and inaccurate information. However, on the records examined similar problems were noted and discussed with the senior on duty. One example was that of a resident for whom the assessment/care plan stated that they didn’t have poor balance, yet a care plan update dated 1/12/05 stated that they “ can become unsteady, staff have noticed some deterioration recently”. The home had failed to use this information to review and update the moving and handling assessment and risk assessment. The care plan profile, used as an overview of care needs, had not been updated since 23/10/02 and stated “walks independently at present time”, which does not reflect their unsteady walking. Furthermore, the day-to-day notes monitoring the care plan made many references to this individual’s constant “wandering”. This information had not resulted in a review or amendment of the needs assessment or care plan and a risk assessment had not been completed to assess the risk. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 10 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 and 10. The residents’ health and personal needs were not being fully assessed and recorded, which compromised their health and well-being. EVIDENCE: Four care plans were sampled and case tracked. At the previous inspection a requirement was made to the effect that care plans must provide information about medical history and health needs that required monitoring to ensure that health needs were met. Although information about medical history had been noted, the requirement had not been fully met by consistently recording information about health needs that required monitoring to ensure that health needs were met. For example, one resident whose care plan stated that they were “ at risk of weight loss” and needed prompting to eat and was prone to becoming distressed at mealtimes. There was no plan/strategy in place for dealing with this health issue other than weighing the resident periodically and charting food intake, which was not always filled in. The resident’s record showed that they had lost weight (dated 4/12/05). The record indicated that the resident had lost 4lb. The daily records for 8/1/06 note “food chart checked, refused a lot of meals this week”. Records for the week commencing 8/1/06 were incomplete on 5 of the 7 days of this week. The first of these 2 days records stated “refused breakfast” then there was no record of intake in Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 11 the afternoon and on the other days the record stated “evening- sandwich and yogurt”. On 18/1/06 the report noted that the resident had only had a very small amount. It was of concern that this resident was deemed to be at risk, yet their weight had not been checked according to records since 4/12/06, despite recorded problems with food intake. It was also of concern that the monitoring process was inconsistent and that there were no records to demonstrate that any action had been taken to address the concern about the resident’s health. When viewing the file of another resident, it was noted that they had continued to lose weight between 26/04/04 and 16/10/05 (a loss of 8.6 kilos) yet the care plan did not raise any concern/explanation about this weight loss. A further requirement was made accordingly concerning the monitoring of nutritional needs/weight. A requirement was also made at the previous inspection to the effect that the home must monitor and audit assessments and care plans to avoid contradictory and inaccurate information. This requirement was repeated because on the files sampled, examples of contradictory and misleading information continued to be a cause for concern. One example has been highlighted in the previous section of this report. A further example included one resident whose nutritional screening plan reported that the resident needed a low fat diet, yet the care plan reported that the resident was at risk of losing weight if this person didn’t eat their meals and that staff needed to encourage the resident to eat meals. This resident had a diagnosis of dementia, yet the records did not refer to this in the context of the risk of weight loss through not eating meals. Some care plans were incomplete. Examples included the activity profile for one resident admitted on 26/10/05, which stated “need to assess this”. This had not been assessed at the time of inspection. Changes in the care plan were not consistently dated e.g. a resident whose key holding care plan had changed. A requirement was also made at the previous inspection to the effect that baths must be consistently offered to residents and care plans must note when there is a problem with bathing. It was of concern to note that on all four residents’ files sampled, records indicated that baths had been given infrequently. There were numerous examples in the records of residents not having a bath for 2 weeks. For one resident the last recorded bath took place on 19/12/05, a month prior to the inspection. Another resident was noted to be “reluctant to bathe”. The bathing record did not indicate that any alternative to bathing was being offered to maintain hygiene when the resident did not want a bath. The bathing record for this resident stated that they had a bath on 30/12/05 and didn’t have another bath until 14/01/06. There was no record of refusing baths, or being offered a wash with assistance, between these dates. On 16/01/06 the district nurse visited this resident due to “skin rashes” including in the fold of the abdominal area. A fungal infection was diagnosed and the nurse recommended twice-daily washes. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 12 It was of concern that serious shortfalls identified at previous inspections about assessing, recording and meeting the health and welfare needs of residents had not been improved. A requirement has been reiterated for this to be remedied and all issues identified in this report must be addressed. A sample of medication records were seen. At the previous inspection, a requirement was made to the effect that staff must immediately question whether medication has been administered when they note a gap in the medication administration record and observe and record any adverse impact on the resident. At the time of this inspection, a number of gaps in the medication record were noted. The manager on duty and a senior carer discussed the method of alerting staff to an error. The staff said that a star was put against the error and that one entry had been starred when it was not yet due to be administered. Through discussion, it was evident that this method was not effective because staff did not find it helpful and stars were also used to highlight other issues on the care plan. In addition, when a gap existed, staff were not contacting colleagues that day to question what had happened, action which was in the best interests of the resident’s wellbeing. The original requirement was therefore repeated and a further requirement was made to the effect that the home must have a clear policy and procedure which outlines action to be taken to establish whether the resident’s medication has been administered when a manager or senior carer administering medication notes a gap in the MAR record. On viewing the medication record for one resident, it was noted that one or two Co- Codamol tablets were prescribed every 6 hours “when required”. On 18/01/06, the record indicated that these had been administered at 9am and 1pm, an interval of only 4 hours. A requirement was made to the effect that records must indicate the dosage of medication taken when one or two tablets are prescribed and medication must be administered at the correct intervals as prescribed. Tipex was being used to obscure/amend entries on the medication administration record. It was of serious concern that errors in the administration of medication continued to occur. A requirement has been made to ensure that medication is safely administrated. Failure to do this may lead to the Commission considering taking further action as previous inspections have identified the area of the care of medication as an ongoing problem. . Ascot House DS0000032526.V275492.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 and 14. Residents benefited from being able to make choices about aspects of everyday life, having some activities and having daily menu choices. EVIDENCE: The four care plans sampled made reference to residents’ religious and recreational interests. One resident’s culture care plan referred to “son living with mother all life”. It was evident that staff needed guidance to understand the cultural element of a care plan and issues around diversity and a recommendation was made accordingly. Care plans made reference to independence and how people chose to live, including reference to residents wanting to spend time in their rooms and other routines of daily living. There were activities in the home at the time of inspection, including art classes and a visiting hairdresser. At the previous inspection, it was recommended that the focus group meetings were held more frequently to obtain residents views. This had not been fully met and has been repeated. At the previous inspection, a recommendation was made to the effect that menu choices are documented. This had been met by senior carers establishing residents’ choices on a daily basis and documenting these choices. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 14 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 Residents benefited from having a clear complaints procedure. However, this would be enhanced by managers and staff having training in dealing with complaints and customer service. EVIDENCE: A complaints procedure and record was in place at the home. At the previous inspection, a requirement was made to the effect that managers and staff must have training in dealing with complaints and customer service. This had not been met and has been reiterated. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 15 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 and 26. Overall, the home was clean, tidy and comfortable, with a good standard of furnishings and fittings. Some aspects of residents’ health and safety were being compromised by furniture layout restricting safe moving and handling. EVIDENCE: The home has a good standard of furnishings and fittings and was clean and comfortable. In response to a requirement made at the previous inspection, liquid soap and paper towels were provided in all toilets and bathrooms. At the previous inspection, the layout of furniture in one lounge was restricting safe moving and handling and the need to complete a risk assessment to address this was the subject of a requirement. This requirement had not been fully met and has been repeated. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 16 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): 29. Recruitment practice, including not consistently checking employment histories, has the potential to put residents at risk. EVIDENCE: The home has a recruitment policy. Two staff files were audited. On one file, the employment history implied that the individual had jobs in 2 different countries at the same time and there were gaps in the employment history. References are held at the organisation’s head office. A requirement was made to the effect that employment histories are checked and that for all new staff, an information sheet is included in their file which indicates the date references were received and where they are held. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 17 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): 33, 36 and 38. Lack of regular staff supervision had the potential to impact negatively on the delivery of care to residents. The quality assurance package needed to be used consistently to obtain the views of residents and other interested parties. EVIDENCE: As noted at the previous inspection, the CSCI were awaiting the application for registration of the manager. The application has still not been received and must be forwarded without further delay. Standard 31 was not, therefore, assessed. The organisation has a quality assurance package. However, the last survey was conducted in November 2004 and the results of this survey had not been collated, analysed and put into a report. A requirement was made accordingly. At the 2 previous inspections, staff records examined demonstrated that staff were not having regular supervision and a requirement was made accordingly. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 18 It was of concern that this requirement had not been met and some staff had no supervision recorded for the past year, while some had 2 supervisions recorded. This is of particular concern in the light of problems/inconsistencies with care planning which could be addressed through meetings with keyworkers to monitor, audit and update care plans. The requirement was repeated for the second time and must be met without further delay. A requirement was made at the previous inspection to the effect that the home must complete fire safety work highlighted at the homes last fire authority’s visit. Just prior to the inspection, the inspector had met with senior managers from TMBC to discuss this issue. TMBC had costed the work to be done and were in the process of inviting tenders to complete the work. The requirement was therefore reiterated until the work commences. It is, however, acknowledged that TMBC are working towards meeting this requirement. Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 19 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 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X 2 X 2 Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 20 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 and 15 Requirement The home must monitor and audit assessments and care plans to avoid contradictory and inaccurate information. (Previously unmet timescale of 05/10/05). 2. OP8 13 and 15 The care plan must include a detailed record about the health needs of residents, which demonstrates that their health needs are monitored and reviewed. This includes: • Recording of weights and having recorded strategies where concerns about a resident’s weight are raised. • That records show how personal hygiene is maintained and safeguarded. (Previously unmet timescale of 05/10/05). 28/02/06 Timescale for action 28/02/06 Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 21 3. OP9 13 The home must ensure that the 28/02/06 management for the recording, handling, safekeeping and administration of medication are carried out safely to maintain the health of residents. (Previously unmet timescale of 05/10/05) 4. OP16 22 Managers and staff must have training in dealing with complaints and customer service. (Previously unmet timescale of 05/12/05). 28/06/06 5. OP19 13 The layout of furniture in one unit must be reviewed so that it does not restrict safe moving and handling. A risk assessment must be completed to address this issue. (Previously unmet timescale of 05/10/05). 28/02/06 6. OP29 19 Staff employment histories must be checked and for all new staff, an information sheet must be included in their file, which indicates the date references were received and where they are held. The home must review and develop their quality assurance system to provide a verifiable method, which involves residents, to audit the service and report on the findings. 28/02/06 7. OP33 24 28/06/06 8. OP36 18 All staff must receive appropriate 28/02/06 supervision. (Previously unmet timescale of 05/10/05). Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 22 9. OP38 23(4) All fire safety work highlighted at the homes last fire authorities visit must be addressed. (Previously unmet timescale of 05/12/05). 28/06/06 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 OP12 Good Practice Recommendations It is strongly recommended that staff are given guidance to understand the cultural element of a care plan and issues around diversity. It is recommended that the focus group meetings are held more frequently to obtain residents views. 2. OP13 Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Ascot House DS0000032526.V275492.R01.S.doc Version 5.1 Page 24 - 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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