Inspection on 22/05/07 for Ashcroft Nursing Home

This inspection was carried out on 22nd May 2007.

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

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

Other inspections for this house

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashcroft Nursing Home Church Street Cleckheaton West Yorkshire BD19 3RN Lead Inspector Stephen French Key Unannounced Inspection 22nd May 2007 08:30 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 Ashcroft Nursing Home DS0000069574.V333731.R02.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. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashcroft Nursing Home Address Church Street Cleckheaton West Yorkshire BD19 3RN 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) 01782 341771 0208 5188683 Continuum Healthcare Limited Vacant Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category Code OP. The maximum number of service users who can be accommodated is 42. 09/08/06 2. Date of last inspection Brief Description of the Service: Ashcroft nursing home is a privately owned and provides both personal and nursing care for up to forty two older people. It is a detatched property located in the centre of Cleckheaton, close to shops, community facilities and public transport. The accomodation is over three floors which are accessed by two passenger lifts. There is a large lounge, a smaller quiet lounge, a smokers lounge and a dining room. The home offers a majority of single rooms some with en-suite facilities. The home’s manager informed the Commission on the 22/5/07 that the current scale of charges at the home is £350.00 - £426.00 per week. Information about the home and the Commission for Social care Inspection is made available to people within the home’s Service User Guide, copies of which are given to prospective and current people and can be obtained, on request, from the home. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit carried out on the 22nd May 2007. The inspector arrived at the home at 08.30 am and left 15:00pm. During this visit the inspector spoke to some of the people living in the home, some of the staff and the home’s management. The inspector read care records, audited a sample of medication, reviewed staff recruitment and training records and carried out a brief tour of the building. Prior to the visit 10 questionnaires were sent to the home to obtain the peoples views about living at the home. Eight questionnaires were returned, and these included comments such as “ No activities since the activities organiser has left”, ”Meals are of a poor standard”, “More social activities would be nice”, “I feel the home has deteriorated especially the food” Some people in the home are very frail and would not be able to complete a questionnaire. Relative surveys were also sent out and eleven were returned, comments included, ”Staff give the care and attention needed”, No communication with relatives, standards have slipped”, “No social activities” “Dining room and lounges in need of redecorating”, “There seems to have been a lot of cut backs since the new owner took over” “ The home needs redecorating, since the new owner took over nothing seems to have been done, staff moral low” and “Looks after my relative well and keeps me informed, the home is clean bathrooms need updating. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the provider and information completed by the manager. The previous manager has left the home and the new acting manager has only been in post for three weeks. This was the first time that she has been involved with an inspection and the Inspector would like to thank her for her assistance during this visit. People spoken to were generally very happy with the care that was provided by the home and they all commented on how nice the staff were and that they felt their health and personal needs were being met. It was evident through discussion that people are not happy with lack of social activities and some said that the standards of meals and decoration were not very good. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home must provide suitable social activities in which people can join in if they wish, at the moment people are bored and do not receive sufficient stimulation in order to enhance their social well being. To give a better picture of how people have spent their day the daily entries in the care files should indicate their social and psychological well-being. People should be asked about their preferences in choices for meals and discussions should take place between the management and the people who Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 7 live in the home and a new menu should be produced. This will improve the quality of life for people living in the home and ensure they receive a well balanced diet. To improve the environment in which people live the registered provider should undertake a redecoration programme, which includes replacing some of the furniture and providing a new stair carpet. 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. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 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 Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 People who are considering living at the home have the information they require and their needs are assessed to ensure the home can meet those needs. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The Acting manager provided a copy of the updated Statement of Purpose and Service User Guide. The Statement of purpose needs slight amendment to include details of the managers qualifications and experience to ensure that people who wish to move into the home have the information they need in order to make a choice. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 10 The acting manager said that the funding authority always provide a copy of the persons core assessment and care plan prior to admission to the home. These were seen for those care plans examined. She went on to describe the process she undertakes when a new person wishes to be admitted to the home. Following receipt of an assessment from the local authority she and the clinical nurse visits prospective admissions either in their own home or in hospital and completes a pre admission assessment. This assessment determines the level of care the person will require and a decision is then made to decide if the home can meet the person’s health care needs. Pre admission assessments were seen for a person who had recently been admitted to the home confirming that the home is following their admission policies and procedures. One person spoken to said that the previous manager had visited him at home prior to him moving in. Five questionnaires received from people who live in the home said that they had received information about the home before they moved in. The home does not offer Intermediate care. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The health care needs of the people living at the home are being met and medication is administered safely. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The manager said that each person has a care plan, which informs the staff of the actions they are to take to ensure that the persons health, personal and social care needs are met. As part of this visit five peoples care files were examined. These contained information, which had been obtained from the pre admission assessment and from discussions with the person and their relatives. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 12 Risk assessments were completed for such things as nutrition, moving and handling and skin integrity. These risk assessments alert the staff to the possibility of the person requiring further support or medical intervention in order to prevent further deterioration in their condition. Where an assessment had identified a risk a detailed care plan was in place. Risk assessment and care plans seen were reviewed monthly to ensure the care that was being given was meeting the health care needs of the person. Staff make a daily entry in each persons care file outlining the care provided that day. On examination of these records it was found that the persons social and psychological well-being was rarely mentioned and staff had focused on tasks they had performed. These entries do not give a holistic view of how the person has spent their day and there was discussion on how this could be improved. From examining care plans it was seen that the healthcare needs of the people living at the home are met through the home’s own practices and with the assistance of other healthcare professionals such as district nurses, GP’s and members of the mental health care team. There was evidence in the care files that changes to the care plans had been discussed with the person or their relatives. Two people spoken to said that they were aware of their care plans and that staff had discussed changes with them. Qualified nursing staff are responsible for the administration of medication. Should a person wish to self medicate then a risk assessment would be completed and staff would support the person in taking their medication. Medication seen on the day of inspection was stored correctly. Policies and procedures are in place to ensure the ordering, storage, administration and disposal of medication is done safely. The stock balances of four peoples medication was examined, and balances tallied with the medication administration records held by the home, confirming that people receive their prescribed medication safely and on time. Ashcroft Nursing Home DS0000069574.V333731.R02.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): 12,13,14,15 The social activities and the variety of meals within the home need to be reviewed to ensure they match the expectations of the people living there. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The acting manager said that at the moment the home does not have a social activities organiser the previous person left three weeks ago and she is currently trying to recruit a new person. On the day of the visit there were no activities taking place and people were spending their time sitting in one of the lounges or in their own room. Three people spoken to said that there had been no activities since the activities organiser had left. Five comment cards received also expressed concern that there were very little activities taking place recently. This was discussed with the acting manager who said she was aware that this needs to be addressed and she said that from next week one of the care staff would be allocated two Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 14 hours per day to arrange social activities until the post can be filled. In the last three weeks there has been one occasion were outside entertainers have visited the home and another occasion when the people who live in the home received a visit from a donkey sanctuary. The acting manager said that visitors are welcome to visit the home at any time of the day and evening, and people spoken to confirmed this. People said that they were able to choose what they did during the day and this included what time they rise and retire and where they sat during the day. The home has a four-week menu, which has two choices of main meal for lunch. Meals can be taken in either the dining room or in the person’s own room if they wish. Four comment cards received and two people spoken to said that the meals were not very good. One comment card said that the breakfast was good but that the rest of the meals were very bland other people spoken to said that the meals were nice. One the day of the visit the lunch consisted of liver and bacon with carrots, broccoli and potatoes and this was sampled by the inspector and was very nice. The manager said that she was aware that some people were not happy with the quality and variety of food on offer and that she is meeting with the cook and people who live in the home to discuss how this can better meet their needs. Ashcroft Nursing Home DS0000069574.V333731.R02.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): 16,18 People are safeguarded and are confident that complaints are listened to and investigated People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The home has a complaints policy, which was seen displayed in the reception area of the home. People are given a copy of this policy when they are admitted to the home. People spoken to and comment cards received confirmed that people were aware of the homes complaints policy. As theacting manager has only been employed at the home for three weeks she said that she was aware of the actions she would take should she receive a complaint. She was able to describe in detail the process she would undertake when dealing with any complaints. She said that she would inform the complainant of the outcome of any investigation undertaken. The acting manager is not a qualified nurse therefore she said that should a complaint be made about any aspect of the health care that a person receives she would seek the advise of the clinical lead nurse and investigate the complaint together. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 16 The acting manager said that staff receive training in safeguarding as part of their induction training as well as periodically to ensure they are aware of their responsibilities in reporting incidents should these arise. Staff training records and three staff spoken to confirmed that this training has taken place and it was noted that a further training day had been arranged for 29/5/07. Ashcroft Nursing Home DS0000069574.V333731.R02.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): 19,21,23,24,25,26 People live in a safe comfortable environment, which would be further improved if the provider carried out redecoration and replacement of some of the furniture. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: As part of this visit a tour of the building was conducted, this included a number of people’s bedrooms, communal lounges, dining room and bathrooms and toilets. People’s bedrooms see were personalised with their own belongings such as ornaments, pictures and small pieces of furniture. Bedroom doors are lockable Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 18 and people are given the option to hold the key if they wish. It was seen that a number of bedrooms were in need of redecoration and some of the bedroom furniture was looking tired and worn. The reception area was in need of redecoration and the stair carpet leading up to the first floor was seen to be threadbare in places. There are two lounge areas where people can sit and watch television or listen to music; both of these areas are in need of redecoration to improve the environment in which people live. There are a number of bathrooms and toilets in close proximity to bedrooms and communal areas. The bathrooms contain specialist baths to enable people with mobility problems bath safely. It was noted that some of the bathrooms were also in need of redecorating and one bathroom that had recently been used as a storage room had been put back to its original use. The manager said that she was aware that there were areas of the home which were in need of updating and she said that refurbishment of the home had been discussed with the provider. Five comment cards received from relatives stated that the home was in need of redecoration. Two people who live in the home said that they were happy with the décor. Ashcroft Nursing Home DS0000069574.V333731.R02.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): 27,28,29,30 People are cared for by a competent, trained staff team in sufficient numbers to meet the needs of the people living in the home People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The staff duty rota was examined for the month of April 2007 and staffing for 42 people consisted of AM; 1 qualified nurse and five care staff. PM; 1 Qualified nurse and four care staff Night time; 1 qualified nurse and two care staff. All of the people spoken to said that there were adequate staff available to attend to their needs. One relative comment card received thought that there did not appear to be enough staff on duty. A sample of five staff recruitment records were examined and these were found to hold the correct information and evidence that checks had been made to ensure the staff were not exempt from working with vulnerable people. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 20 The acting manager said that new staff complete an induction programme to ensure they have the information and skills to be able to care for the people living in the home. Induction records examined for recently employed staff confirmed that induction training was taking place. Staff spoken to during this visit informed the inspector that their skills and knowledge are updated regularly by attending various training courses such as health and safety, moving and handling and by completing a National Vocational Qualification. Ashcroft Nursing Home DS0000069574.V333731.R02.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): 31,33,35,36,38 The home is well managed and the views of the people are sought and any shortfalls are addressed. Systems are in place to protect the health and safety of the people and staff People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The acting manager of the home has only been in post for three weeks. She has worked in the caring profession for over nineteen years and showed an awareness of the needs of the people currently living in the home. A qualified Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 22 nurse who deals with the clinical management of the home supports her in her role. The acting manager said that she was aware that she needs to complete quality-monitoring tools to ensure the needs and expectations of the people living in the home are being met. Completed audits, which had been done prior to her being employed, were seen for such things as care planning medication and the environment. Following an audit she said an action plan would be drawn up and any short falls would be addressed. This is to ensure that people’s expectations of the home and the care they receive are met. People who live in the home are able to keep small amounts of personal monies within the homes safe. This enables them to be able to purchase small items such as sweets, newspapers and pay for hairdressing. Receipts are issues for each transaction and people can check their balance whenever they wish. Three amounts of people’s monies were checked against the records held by the home and the balances tallied. The acting manager said that staff receive at least six supervisory sessions per year with a senior member of staff. During these sessions they are able to discuss, amongst other things, training issues and the aims and objectives of the home. Supervision records examined during the visit confirmed that these have taken place at regular intervals. The acting manager said that she would be responsible for the supervision of housekeeping staff and the clinical nurse would supervise all care staff, Accidents to service users and staff are recorded. Contracts are in place for such things as waste disposal, servicing of hoists and electrical equipment. Ashcroft Nursing Home DS0000069574.V333731.R02.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 3 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x 3 x 3 2 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP12 Regulation 16 (2)n Requirement The registered provider must arrange and provide the people who live at the home with suitable recreational activities in which they can join in if they wish. Timescale for action 31/08/07 Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP1 OP7 OP15 OP19 Good Practice Recommendations The statement of purpose should be updated to include the new managers qualifications and experience. The daily entries in the care files should say how the person’s social and psychological well-being is being met. People who live in the home should be consulted about the choice of food on offer. The communal areas should be redecorated and consideration should be made in replacing some of the furniture. The damaged caused by a water leak on the upstairs landing should be addressed. 5. OP24 A new stair carpet should be laid. The bedrooms identified should be redecorated. Consideration should be given in replacing some of the bedroom furniture. 6 7 OP25 OP31 The vanity unity in the room identified should be repaired. Consideration should be given to redecorate bathrooms The person managing the home should complete the registration process with the commission for social care inspection. Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Ashcroft Nursing Home DS0000069574.V333731.R02.S.doc Version 5.2 Page 27 - 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. 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