Inspection on 21/05/07 for Ashbourne House Nursing Home

This inspection was carried out on 21st May 2007.

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

Other inspections for this house

Ashbourne House Nursing Home 12/05/10

Ashbourne House Nursing Home 25/01/10

Ashbourne House Nursing Home 29/10/09

Ashbourne House Nursing Home 01/05/08

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashbourne House Nursing Home 376-378 Rochdale Road Middleton Manchester Lancashire M24 2QQ Lead Inspector Sue Jennings Unannounced Inspection 21st May 2007 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 Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 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 Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashbourne House Nursing Home Address 376-378 Rochdale Road Middleton Manchester Lancashire M24 2QQ 0161 643 2060 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) Silverdale Care Homes Ltd Deborah Strong Care Home 29 Category(ies) of Dementia - over 65 years of age (16), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (13), Physical disability (1) Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 29 service users to include: *Up to 13 service users in the category of OP (Old age not falling within any other category); *Up to 16 service users in the category of DE (E) (Dementia over 65 years of age); *Up to 2 service users in the category of MD (E) Mental Disorder over 65 years of age); *Up to 1 service user in the category of PD (Physical disability). This is the first inspection under the new ownership. Date of last inspection Brief Description of the Service: Ashbourne House Nursing Home is a converted and extended home located a short distance from the centre of Middleton, owned by Silverdale Care Homes Limited. The home is registered to care for up to 29 people with personal care needs, nursing needs and those with dementia. Accommodation is provided over two floors, the majority of it on the ground floor. Part of the first floor of the building is not available to residents because of structural defects that are being repaired but repairs have not yet been completed. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by the Commission for Social Care Inspection in relation to this home prior to the site visit. The visit was unannounced and took place over the course of five hours on Monday, 21st May 2007. During the course of the site visit time was spent talking to the manager and the responsible individual, four of the residents and two visitors to find out their views of the home. A pharmacist inspector also visited the home to look at how the medication was managed. A number of the Commission for Social Care Inspection’s survey forms were sent to the home but had not been distributed to relatives at the time of the site visit. Time was spent examining records, documents and the resident and staff files. A tour of the building was also conducted. Neither the home nor the Commission for Social Care Inspection had received any complaints in relation to this home. What the service does well: In the areas of the building being used by residents, the decoration, furniture and facilities are of a good standard. The atmosphere in the home was warm and welcoming. The standard of cleanliness throughout the home was good. Residents are able to attend religious services in the community or a minister of their chosen faith can visit them in the home if preferred. Family and friends are encouraged to visit regularly. Medication was stored appropriately. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 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 Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are admitted to the home after a full assessment of needs has been undertaken, however there was no current written information available to residents about the home for them to make an informed decision about admission. EVIDENCE: There was a Statement of Purpose provided at the time of registration. This document should set out the aims and objectives of the home, and include a service user guide so that prospective residents are given enough information to make a decision about moving in. However, it was not available in the home at the time of the site visit. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 9 A sample of residents’ files were examined and contained a social work assessment of need and a copy of the home’s own pre-admission assessment. The manager visited prospective residents before admission, either in their home or in hospital, to carry out these assessments. This is done to make sure the home can meet their care needs. Following admission there is a six-week assessment period during which time the home develops a care plan. This plan is used to inform care staff what they must to do for the resident in order to meet their care needs. There was evidence on the residents’ files that a contract or statement of terms and conditions of residence was provided. This gave basic information on what people who live in the home can expect to receive for the fee they pay. The home did not provide intermediate care. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Overall personal care needs of the residents were being met at the home, however care plans did not contain sufficient detail to clearly identify residents’ needs or the action required to meet needs. EVIDENCE: Each resident was registered with a General Practitioner (GP) and was able to see their GP in the privacy of their own room. There was evidence that residents were referred to other specialised services according to residents’ assessed needs, for example, District Nurses, Dentist, Dietician and Chiropodists. Some residents had received input from the psychiatric services following appropriate assessments and referrals made by the General Practitioner. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 11 A sample of five care plans was examined and found to contain information about next of kin and General Practitioner (GP). This information meant that, when required, staff could access medical treatment for residents and keep relatives informed of any GP visits. Care plans were not person-centred and there was no evidence to show that residents or their representatives were routinely involved in the care planning process. Some of the care plans were a standard pre-printed sheet and did not provide individual detail of the resident’s needs or what action staff had to take to meet those needs. Basic risk assessments are completed. Where there were risk assessments in place, the action needed to reduce the risks was not regularly reflected in the care plan or in the daily records. Some of the instructions are open to individual interpretation. Where a resident is at risk of developing pressure areas, the care plan instructed staff to change the resident’s position “as frequently as necessary”. This lack of clear direction has the potential to place residents at risk of harm. There was no medication policy available at the time of the site visit on 21st May 2007. On the site visit conducted by the Pharmacist Inspector on 30th May 2007, a policy was available, however this was out of date and did not meet with current legislation. There must be a clear medication policy for staff to refer to; this is to minimise the risk of error and to provide staff with guidance. The medication was stored in a lockable metal drugs trolley that was kept in a locked treatment room. A lockable refrigerator was provided for the storage of those prescribed medicines requiring cold storage, however the fridge thermometer did not appear to be showing the correct temperatures and it is recommended that a new thermometer be obtained so that residents’ medication can be stored at the correct temperatures. Controlled medication was stored in a locked cabinet secured to the wall in the treatment room. Each individual Medication Administration Record (MARs) contained a picture of the resident to reduce the risks of mistakes with medication. The records were signed and up to date, with few gaps in recording. Some of the records provided enough information to show that residents were being given their medicines as prescribed, however some medication records needed to be improved to make sure that there is evidence that all medicines are accounted for and that they contain accurate information so that residents are given medicines safely. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 12 Only the qualified nursing staff were responsible for administering medication. By looking at the medicines in the home and the records kept, it could be seen that some medicines were administered properly. However, on the day of the inspection, it was seen that some medicines were not given properly. A resident who had been recently admitted did not have a supply of three prescribed medicines, including emergency treatment for diabetes and some strong analgesics. The resident had also been given the wrong dose of medicine prescribed for diabetes. It was also seen that refused medicine was stored poorly. On the day of the pharmacist inspector’s visit, the manager had left some medicines in an open pot in the door of the trolley. Other refused medicines had been pushed back into the blister packs. This is very poor practice and increases a risk of harm to residents. A bottle of insulin, which was in the fridge, was out of date and unlabelled. Residents may be at risk from being administered the wrong medicines and medicines which are out of date. Medicines which are no longer needed were not being disposed of in a legal manner. The manager must arrange for the proper disposal of medicines. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents were able to exercise choice and control over their lives and meals served at the home offered a varied diet for residents. EVIDENCE: Daily living activities in the home appeared to be flexible and varied. This was confirmed when talking to residents and though observations during the site visit. The home had employed an activity organiser who was developing an activity programme. There were examples of residents’ artwork on the main corridor. Ministers from various local churches visited the home on a regular basis and some residents went to church and this was evidenced in a discussion with one resident. During the site visit two members of staff were overheard shouting at each other whilst residents were around. This was poor practice and could be quite distressing for residents. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 14 Residents were able to bring their own possessions into the home and this was evidenced during the site visit. Meals were at set times and there was a choice of menu, however, choice was given informally and not documented. One resident said “I will eat anything it is always lovely”. Residents were observed enjoying their meals in the conservatory because the dining room was being refurbished. The mealtimes were relaxed and unhurried, and staff provided appropriate assistance to those residents with higher dependency needs. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. In the main, the home’s policies and procedures safeguard residents from harm. EVIDENCE: All staff spoken to were aware of the procedure to be taken in the event of an allegation of abuse being made. There was a copy of the Rochdale Adult Protection Policy and Procedures in the office. However, the home’s own Adult Protection policy gave conflicting information. A requirement has been made that an Adult Protection policy and procedure be put in place to guide the staff; this must be in accordance with the local authority’s Adult Protection policy and procedures. It was also recommended that a flow chart outlining the action to be taken in the event of an allegation being made when the manager is off be displayed to inform senior staff of the process. This will make sure that staff follow the correct procedure and that residents are confident that their concerns will be acted upon. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 16 The home had a complaints procedure that was usually displayed on the ground floor notice board. This had been removed whilst the area was redecorated. A record was kept of all complaints made and included details of the investigation and any action taken. A sample of staff files examined showed that Criminal Record Bureau and POVA checks had been obtained before any new staff started work, so as to ensure that the staff were suitable to work with vulnerable people. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The possibility of residents accessing areas that were being refurbished posed a potential risk to their health and safety. EVIDENCE: There was ongoing refurbishment of the ground and first floors of the building and all residents were temporarily accommodated on the EMI unit until the work was completed. Safety gates were fitted to the staircases to deter residents from climbing the stairs. However, on the day of the site visit, these gates were not secured and the lift was still accessible to residents. Both of these posed a potential risk of accidents to residents accessing the first floor. There were no risk assessments in place with regard to the areas undergoing building work. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 18 There were also concerns about residents accessing the lounge on the ground floor corridor, which was in the process of being decorated. Furniture in this area was in the centre of the room creating potential trip hazards for residents. This area is not in use and should be secured whilst remedial work is being carried out. In order to fully protect residents from harm, risk assessments should be carried out throughout the building. Residents also have access to the main kitchen from this corridor. The floor covering is uneven and the gas cooker does not have a safety ‘cut off’ tap. Both of which could pose potential hazards if residents were to access the kitchen, trip or turn on the gas taps. One resident was seen walking up and down this area throughout the site visit. The home was clean and free from unpleasant odours. Hand washing facilities are in place in each resident’s bedroom, toilets, bathrooms, sluices, laundry and clinical areas. A contract was in place for the professional removal of clinical waste and infection control procedures are adhered to minimising the risk of infection for residents. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The numbers and skill mix of staff were sufficient to meet the needs of the residents accommodated. However, the home’s recruitment policies and procedures did not fully protect the safety and wellbeing of the residents. EVIDENCE: A sample of staff files was examined during the site visit. The staff files had limited information about training and supervision relating to their role as carers. Some files did not contain a contract of employment or two written references. Some references were taken from work colleagues and not from line managers. On some files, where referees were listed on the application form, references had been taken from other sources with no explanation why. There was little evidence that thorough recruitment checks had been carried out to make sure people were suitable to work with vulnerable residents. There was little evidence of staff training on file. In fact, only one of the four staff files examined contained any details of training. A training matrix has been developed and was provided at the time of the site visit. There have been some issues about staff not attending training that has been arranged. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 20 There was no evidence that the staff received regular supervisions. The home was devising a tool to be used for this purpose. All staff must receive regular supervisions to further assist them in supporting the residents appropriately. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home had systems and procedures in place which safeguards and protects residents’ financial interests. EVIDENCE: The manager in the home is new to the service, although she is an experienced nurs. The manager has made an application for a police check to the Commission and once the disclosure has been received an application will be made to the CSCI. The home did not have a quality assurance system in place although some feedback on the service was gathered in staff meetings and consultation with residents and relatives. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 22 Staff spoken to said that a supervision rota had been developed but that supervision had not started. The home did not act as appointee for any residents. Residents’ relatives helped with managing finances. Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 23 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 2 Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 12(1)(a) 13(4)(c) 13(2)(4) (c) 13(2)(4) (c) 13(2)(4) (c) Requirement Risk assessments in care plans must clearly identify the risk and give sufficient detail to staff to ensure risks are minimised. There must be an up to date medication policy to give guidance to staff. All medication must be administered as prescribed to make sure the residents’ health is not at risk. All medicines kept in the home must be within the expiry dates to make sure the medication is effective and residents’ health is not put at risk. All medication must be disposed of legally. All records regarding medication should be accurate and they should ensure that all medication can be accounted for at all times. An environmental risk assessment must be carried out on the current building works to ensure that residents remain safe. Timescale for action 30/06/07 2 3 OP9 OP9 30/06/07 30/05/07 4 OP9 30/05/07 5 6 OP9 OP9 13(2)(4) (c) 13(2)(4) (c) 30/05/07 30/05/07 7 OP25 13(4)(a) (b)(c) 30/06/07 Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 25 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. 8 Standard OP29 Regulation 18 Requirement Staff files must be reviewed to include all information as required under schedule 2 of the Care Home Regulations 2001 for the home to be sure it has obtained all the right information in recruiting suitable staff. Timescale for action 31/07/07 Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 26 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 OP1 Good Practice Recommendations There should be an up to date Statement of Purpose and Function available to residents and prospective residents visiting the home, so that they can read what the home has to offer them. The adult protection policy should be reviewed in accordance with the local authority’s adult protection policy and procedure. The cooker and extractor fan and other equipment in the kitchen should be deep cleaned. There should be an effective quality assurance monitoring system in place. Staff should receive supervision and an annual appraisal. All policies and procedures should be reviewed and, where necessary, updated. An electrical safety certificate should be obtained to demonstrate that the wiring in the building is sound. The floor covering in the kitchen is a trip hazard and should be replaced. The broken smoke detector should be repaired. 2 3 4 5 6 7 8 9 OP18 OP26 OP33 OP36 OP38 OP38 OP38 OP38 Ashbourne House Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Greater Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Nursing Home DS0000068938.V342663.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!