Inspection on 07/02/06 for Ashbourne House

This inspection was carried out on 7th February 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

Ashbourne House 08/06/07

Ashbourne House 06/05/06

Ashbourne House 03/10/05

Ashbourne House 23/03/05

Ashbourne House 15/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

SignHealth

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Ashbourne House 230 Lees New Road Oldham Lancashire OL4 5PP Lead Inspector Michelle Haller Unannounced Inspection 7th February 2006 09:15 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 Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 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. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashbourne House Address 230 Lees New Road Oldham Lancashire OL4 5PP 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) 01616241013 0161 665 2413 Werneth Lodge Limited Care Home 35 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (17), of places Physical disability over 65 years of age (4), Sensory impairment (4) Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 17 OP, up to 18 DE (E), up to 4 PD (E) and up to 4 SI (E). 3rd October 2005 Date of last inspection Brief Description of the Service: Ashbourne House is a large detached property, set in it’s own grounds, located on the outskirts of Lees, approximately three miles from Oldham town centre. The home is registered to accommodate up to 35 people aged 65 years or above. The majority of rooms are single and have en-suite facilities. The home has three lounges a dining room and a room used for functions. Werneth Lodge Ltd owns the home. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection; this means that the home was not informed that the inspection would take place. The inspection was conducted over a period of 7 hours. In the course of the inspection five-service users files and other records concerning the support and care of service users were examined fully. Policies, procedures and other documents concerning the running of the home were also assessed. Two service users, two service user representatives and one member of staff was interviewed. The interactions between service users, their representatives and staff were also observed. In addition a tour of the private and communal areas of the building was undertaken. The overall impression of the home is that improvements are inconsistent and certain aspects of care and support improving while others concerning the environment of the home have deteriorated. What the service does well: What has improved since the last inspection? The main improvement in the home is the improvement in the increase in the detail provided in care plans and risk assessments, resulting in clear and precise information for staff, providing instructions about the actions they must take to meet the needs of service users. These care plans have been reviewed and updated to meet changing needs. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 6 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. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 7 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 Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 8 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): 1,2 and 3 The homes statement of purpose and service user guide is detailed, however the information does not fully relate to what actually happens in the home. This can lead to disappointment for a minority of service users. The home provides service users with a terms and condition of contract ensuring that they have legal documents informing them of the services and facilities to they are entitled to receive from the home. The needs of service users are more fully assessed prior to and immediately following admission ensuring that the home fully understands and can meet the needs of service users. EVIDENCE: In order to assess the homes ability to ensure that service and their representatives make an informed choice about the home the care files of five service user files were examined, three service users and two relatives were interviewed and in-depth discussion with the deputy manager was undertaken. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 9 The files chosen included the most recent admission, the longest admission, a service user who had made a complaint, the most frail service user and one other of the manager’s choice. The majority of files examined contained assessments that had been completed by the social worker or care manager prior to admission to Ashbourne House. The information varied in detail according to type of assessment format that was used. The home also completes its own admission checklist that further highlights the physical, social and psychological needs of service users. The information from the assessment and checklist is then brought together through development of a care plan and, on occasion, risk assessments. The assessments for the most recent admissions were detailed and provided a full picture of the needs of the services users including special diets, emotional care and specialist nursing or medical needs. Copies of the service user guide were noted in a number of bedrooms. Discussion with service users and observations made throughout the day demonstrated that information about the activities, in particular, was now inaccurate, and one service user commented on this whilst been interviewed. It must also be noted, however, that friends and relatives who were interviewed were keen to testify that the home made every effort to help service users to settle and feel at home. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 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 11 The information contained in care plans consistently provides sufficient information so that care-staff know what actions to take in order to promote the health and wellbeing of service users. The homes policy and procedures for dealing with the administration and storage of medication is safe, however these guidelines are not followed and therefore service users are at risk of being given the wrong medication. Service users who are dying are treated with care and compassion ensuring that they are pain free and any distress alleviated or kept to a minimum. EVIDENCE: In the course of this inspection five service users files were examined, along with other reports and records concerning the wellbeing and welfare of service users living in the home. Service users, relatives and a member of staff were also interviewed. Observations, throughout the day, of the interaction between service users, staff and other visitors to the home were also completed. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 11 Information in the care plans and daily record sheets demonstrated that, the majority of routine health care including dental care, opticians, podiatry, influenza vaccine, personal physical care and visits to outpatient appointments were met to a satisfactory standard. Records and correspondence also confirmed that the staff followed specialist advice. Service users were observed wearing glasses, hearing aids and using walking aids such as sticks and Zimmer frames. Specialist health care monitoring and the response to this monitoring have improved. Records, daily reports, care plans and risk management assessments and guidance, demonstrated that the most frail service users, and those at risk of pressure sores, falls or with other specialist needs, were now well monitored, with intervention put in place to promote health and reduce any risk. Actions taken included, prompt referral to the district nurses, falls clinic, continence nurse, physiotherapist or other relevant specialist. Care plans that were examined had been updated on a regular basis and changes made in response to the changing needs and expectations of the service users. The service users and relative who were interviewed stated that the care and support had been discussed with them and they had agreed with actions detailed in the care plans. Examination and observation of the homes practice in distributing medication highlighted two potentially serious lapses in following medication procedure, firstly; the failure to have pictures of the service users in the medication files that would assist with identification, and secondly, the failure to have sample signatures of all staff who administered medication that would assist with identifying who had administered medication during each shift. This was discussed with the provider who agreed to rectify the problem immediately. Discussion with staff confirmed that service users receive good palliative care at Ashbourne House. Staff described the training they had received in respect of identifying levels of pain and distress. Staff also identified the role of district nurses and doctors in the process, stating that the district nurses and doctors visited the service user on a daily basis for as long as was necessary. Staff explained the importance of a calm environment and to direct all conversation to the service user. Care staff also indicated that palliative care included oneto-one support at all times, and on occasion extra staff have been rostered to ensure that this has been provided. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 12 General comments included: ‘Staff are very pleasant with you at a traumatic time; they listened to me and allowed …to play whatever music he liked to help him settle. -…seems to, like and says the meals are good’. Service user comments were either very enthusiastic, ‘I’ve no problems here, they really look after you’. Or a little lukewarm such as ‘Yes –all personal help is provided in private, staff are alright’. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 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 15 The home does not provide adequate opportunities for service users to participate in a variety of social activities and events and so there is a possibility of boredom in the home. The dietary needs of service users are well catered for with a balanced and varied selection of food available that meets the service users tastes and choices. EVIDENCE: One service user expressed concern and disappointment over the lack of activities provided by the home. Discussion with staff confirmed that though plans were in place for meaningful activities to commence the occurrence was infrequent and sporadic, this was discussed with the provider who recognised the problem and was discussed with the manager to increase and improve activities in the home. Age concern have been involved in the home supporting some services users to complete life story books, however, there is little in respect of games, chats and outings. Staff have attended the Age Concern activities in residential homes course but there was little evidence that this had improved the activities in the home. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 14 Service users and relatives stated that visiting could be at any time that was convenient to them. During the inspection it became evident that visits took place either in the lounge areas or bedrooms, according to the wishes of the service users. It was clear that the admission process identified that service users were called by their preferred names. Random checks of clothing confirmed that the laundry system ensured that service users wore their own clothing. Observation throughout the day, however, demonstrated that service users were not always supported in maintaining a satisfactory level cleanliness and grooming. This was discussed with the deputy manager and provider. The meals provided at Ashbourne House are evaluated through a computer programme that should ensure that they are nutritionally balanced. The midday meal on the day of inspection was home made steak pie, potatoes, mixed vegetables and gravy. Dessert was coconut sponge and custard or milk jelly. The cook was observed asking service to make a choice for the teatime meal. The menu provided indicated that meals were varied and culturally sensitive. Service users were very enthusiastic about the meals provided in the home and confirmed that a choice was offered on daily basis. One service user statement included “The food is lovely- the best thing about the place.” Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 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 and 18 Complaints are taken seriously and diligently dealt with in the home. Steps are taken to ensure that service users are protected from abuse, however, the home needs does not always adhere to the Oldham Adult Protection procedure and this can prevent the process of investigation been carried out effectively. EVIDENCE: Examination of the complaints records maintained by the home demonstrated that, complaints were given serious consideration, thoroughly investigated and changes made to resolve any issues. The issue concerned the homes ability to differentiate between a compliant and an allegation of abuse requiring a Protection of Vulnerable Adult (POVA) investigation. The complaints policy fully meets the minimum standards. Service users and relatives who were interviewed stated that they would discuss any concerns with a member of the care staff. The homes adult protection policy and guidelines are detailed and in line with those developed by the local authority however an investigation into an allegation of abuse was not completed in line with these guidelines. Though the incident had been full investigated and dealt with appropriately it is essential that POVA protocol is followed in relation to adult protection. It is important that all staff including the management team attend adult protection training provided by the Local Authority to ensure that they fully understand their role and responsibilities concerning adult protection policies and procedures. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 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, 23 and 26 The private accommodation does not provide a comfortable, welcoming and homely place to be for all service users. Parts of the home are stained and dirty, while a number of bedrooms smell offensive. EVIDENCE: The inspection process included a tour of the communal and private areas. Time was also spent in the communal areas talking to service users and observing their movements. During the tour it was observed that of the exterior of the building and grounds were well maintained. The garden areas were tidy and accessible to service users. A handyman employed by the company carries out maintenance work and arranges the maintenance of equipment and services as necessary. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 17 The majority of bedrooms have en-suite facilities. In addition there are toilets, washbasins and specialist bathing facilities on each floor of the property. All bedrooms were inspected on this occasion and it was noted that a significant number of occupied rooms were starkly furnished, containing only a bed, small chest of drawers and a wardrobe. Discussion with staff and service users indicated that no effort had been made to assist service users in personalising their rooms with pictures, ornaments or other items. These rooms, therefore, did not provide service users with comfortable or welcoming private accommodation. Furthermore many service users had not been provided with any comfortable chairs in their bedroom or bedside lighting Service user records indicated that comfortable seating and other furniture was being provided however these lists were inaccurate. . Two rooms held offensive odours. it was not possible to identify the cause, however this is unacceptable. Service users who were interviewed were satisfied with their rooms; however, there was no evidence that they were aware that they could ask for improvements. These issues were discussed with the provider. The home has deteriorated in respect of cleanliness and therefore is not as comfortable and pleasant to live in as at previous inspections. At a previous inspection the main concern had been a heavily stained carpet in one lounge area, this had not been dealt with and in addition the dining chairs and other items of furniture in the home are also heavily soiled. Fixtures and fittings in the home such as door panels, handles and light switches were also stained and soiled. In addition a number of commodes were bare wood making them difficult to disinfect, these must, therefore, be made safe or replaced. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 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): 27,28,29 and 30 The ability and ratio of staff available in the home do not ensure that services users emotional, physical or social needs are met. The provision of induction training and specialist training needs to be increased and the outcome for service users effectively monitored, thereby improving the quality and effectiveness of care and support provided. The home does not operate a recruitment and selection process that provides full safeguard to service users against abuse. EVIDENCE: The issues concerning staffing were inspected through discussion with staff, observation of staff interaction with services users and examination staff files for three care staff and examination of the duty roster. On the day of this unannounced inspection there were 27 service users living at Ashbourne House. The staffing compliment was one manager; three care assistants, the cook and a one domestic staff. As at a previous inspection, staff seemed hurried and services users were observed waiting for attention. On at least three occasions services users were seen to be distressed, and though comfort and support was offered this was limited and ineffectual in the longterm. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 19 Service users who were interviewed did not particularly comment about a lack of staff as at previous inspections, however, it was evident from the atmosphere in the home and limited casual interaction between staff and service users that the staff roster should be revised or, the way in which staff support service users modified. This issue was discussed with the provider. The provider confirmed that staff have completed training courses including manual handling, dementia care, infection control, National Vocational Qualification (NVQ) in care levels 2, 3 and 4 and a course entitled ‘YesterdayToday-Tomorrow’. The observation of staff practice during the inspection process and, the information available from staff supervisions did not consistently demonstrate the effectiveness of this training. Three staff files were examined and it was noted that, for the most recent recruit, a Criminal Record Bureaux Check (CRB) had been completed however; only one reference was in place. On a positive note it is important to acknowledge that staff records also demonstrated that staff were given the opportunity to discuss their individual concerns and issues on a one to one basis, at intervals according to their needs and an action plan put in place to help with any problems. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 20 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, 35 and 38. The quality and effectiveness of the management in the home is inconsistent and does not provide an environment were good practice is praised and encouraged and poor practice identified and dealt with at every level. The quality assurance system that will enable all involved in the home to comment on the quality of the service is being developed. The finances of services users are safeguarded reducing the risk of financial abuse. Insufficient staff training is provided and so the health, safety and welfare of service users are not adequately safeguarded. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 21 EVIDENCE: The service provided by the home is not adequately monitored, this is evident from the deterioration in certain aspects of the home for example reduction in cleanliness, the lack of furniture in the bedrooms of some service users, the lack of activities, failure to update the medication records with pictures, inability to act on the requirements concerning the deployment of staff in the home and repeated inability to act within the POVA guidelines is cause for concern. These issues were discussed with the registered provider. Individual receipts for all transactions made by service users are now maintained ensuring that all transactions can be verified. Staff have not received updated First Aid training and examination of the record of accidents and cross referencing with the reports concerning the initial treatment, did not demonstrate that service users or staff would always received the most appropriate initial intervention following an accident. A means of analysing the accidents recorded has, however, been established. These concerns were discussed with the provider. Certain aspects of health and safety in the home were been dealt with effectively. Records confirmed that gas and electrical appliances and services were regularly checked and maintained. Fire safety equipment was regularly checked and fire drills completed in accordance with guidance from the Fire Service. Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 22 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 2 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 1 2 x x x 2 x x 1 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 1 x 3 x x 1 Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 23 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. 2. Standard OP1 OP12 Regulation 5 16 (m)(n) Requirement The registered person must ensure that the service user’s guide is accurate. The registered person must consult service users about the programme of activities arranged by or on behalf of the care home, (Previous timescale 01/01/06 not met). The registered person must ensure that the adult protection policy is strictly followed. (Previous timescale 01/01/06 not met). The registered person must consult with environmental health and ensure that they satisfactory standard of hygiene is attained in the home The registered person must review the deployment of staff to ensure that suitable levels are working in the home to meet the health needs of service users. (Previous timescale 01/01/06 not met). Timescale for action 01/06/06 01/06/06 3. OP18 13 (6) 01/04/06 4. OP26 16(j) 01/06/06 5. OP27 18 01/06/06 Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 24 6. OP29 19 7. OP28OP30 OP38 18 The registered person must ensure that all aspects of staff vetting specified in regulation 19 is undertaken. (Previous timescale 01/12/05 not met). The registered person must ensure that persons employed to work at the care home receive training appropriate to the work they are to perform. (Previous timescale 01/01/06 not met). 01/06/06 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Ashbourne House DS0000005486.V271262.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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