Inspection on 07/10/05 for Ashcroft Nursing Home

This inspection was carried out on 7th October 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashcroft Nursing Home 21/08/07

Ashcroft Nursing Home 30/08/06

Ashcroft Nursing Home 24/05/05

Ashcroft Nursing Home 14/02/05

Ashcroft Nursing Home 09/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Ashcroft Nursing Home 18 Lee Road Hady Chesterfield Derbyshire S41 0BT Lead Inspector Jenny Thornton Unannounced Inspection 7th October 2005 11am 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 DS0000002038.V256145.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. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ashcroft Nursing Home Address 18 Lee Road Hady Chesterfield Derbyshire S41 0BT 01246 204956 01246 555524 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) Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) Mrs Lynda Hodgkinson Care Home 42 Category(ies) of Dementia (22), Old age, not falling within any registration, with number other category (20) of places Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 Brief Description of the Service: Ashcroft care home provides nursing and personal care for up to 42 people aged 65 years and over, 22 with dementia and 20 not falling within any other category. The home is purpose built and is located on the outskirts of Chesterfield close to a main bus route. The home comprises of two units on two floors. Lea View unit is located on the first floor and is for persons with dementia, Willow View unit is on the ground floor and is for older people. Stairs and a passenger lift access the floors. Each unit has it’s own staff group. The kitchen and laundry facilities are shared. Residents have access to a garden. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was un-announced and took place over four and a half hours. The Inspector spoke to eight residents, seven relatives, eight members of staff and the manager. Several residents had difficulties in expressing themselves in words and were unable to contribute directly to the inspection, but they were observed throughout the visit as to how well their needs were being met by staff. The Inspector examined various records. The home has made progress towards meeting the requirements and recommendations from the last inspection report. What the service does well: What has improved since the last inspection? A ‘stand aid’ mobile hoist had been provided for residents. A good number of the bedrooms have been redecorated and new furniture and bedding has been provided. Improvements have been made to the administration of resident’s medicines. The registered manager has returned to work and has re-established stability in the home. Additional staff have been recruited and the staffing levels and skill has increased to meet residents needs. Staff have attended various training and further care staff have achieved an approved qualification. Ashcroft Nursing Home DS0000002038.V256145.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. Ashcroft Nursing Home DS0000002038.V256145.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 Ashcroft Nursing Home DS0000002038.V256145.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): The assessment of resident’s needs did not show that individual’s needs were fully assessed and planned for. EVIDENCE: Three residents care plans were examined as part of the case tracking process, which is used to help determine how the home meets individuals’ needs. Lea View unit- Two care plans contained limited information relating to residents medical and mental health needs, and did not include a record of all medicines the resident was taking at the time of admission. Not all sections of the assessment form had been completed, and a full assessment had not been completed for one resident who had been transferred from another home. Assessments did not include all essential information about individual’s needs, preferences and abilities, on which to plan their care. Care plans did not show that residents or relatives, where able, were involved in completing their assessment. Willow View unit- One care plan examined contained a fairly detailed assessment, although this lacked detail and supporting information about individuals needs, preferences and abilities, on which to plan their care. The Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 9 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 and 9 Arrangements are in place to ensure that residents’ health and personal care needs are met, although care plans need to further detail how residents needs are being met Arrangements are in place for the safekeeping and handling of medicines, which safeguard residents’ welfare, although certain procedures required strengthening. EVIDENCE: Two out of three care plans examined did not detail all resident’s needs and how they were being met. A care plan was not in place relating to prevention of further falls, for a resident who had sustained a fracture following a recent fall. Staff said that the assessment and care plans are completed with involvement of resident’s or relatives where possible, but this was not clear from reading the care plans. Staff generally completed a monthly statement relating to residents care plans. However, not all reviews reported on the effectiveness or appropriateness of the care and treatment being delivered. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 10 Discussions with relatives and staff maintained that resident’s health and personal care needs were met. Although care plans did not detail how personal care and health needs were being met. Arrangements are in place to enable residents to be seen by an optician, dentist and chiropodist on a regular basis. Discussions with relatives and records showed that qualified staff promptly contacted resident’s GPs where required. Residents able to express their views said that their privacy and dignity is respected; this was observed during the inspection. Relatives shared this view. Good systems were in place relating to the administration and management of medicines in the home to safeguard residents welfare. Records relating to ordering, receipt and disposal of medicines were kept to ensure that medicines are appropriately handled. Medication administration records had been duly signed. Medicines that had been handwritten onto resident’s medication administration records had been signed by the member of staff completing the record, and checked and counter signed by a second member of staff, although the administration sheet did not record the quantity of medicines received. Medicines for both units were kept in the treatment room on Willow View unit, which contained satisfactory storage facilities. However residents prescribed creams and ointments were kept in a box in the office on Lea View unit to enable staff to readily access and apply these. The office did not provide secure facilities for keeping the medicines, in that the door did not contain an approved lock. The controlled drugs cupboard on Willow unit was relatively small, and was used to store controlled drugs for both units. The controlled drugs cupboard was full at the time of the inspection, although staff said that the size of the cupboard was adequate for the current needs of the two units. Following recent changes in legislation relating to the disposal of medicines, the manager said that the Company was setting up a new contract with a licensed company to dispose of the home’s medicines. In discussions with qualified staff it was highlighted that until a new contract was set up they had been advised by their community pharmacist to dispose of medicines by a nonapproved method. The manager was unaware of this arrangement and agreed to immediately review this practice, and put in place an approved contract for disposing of medicines. Records were in place to record the daily temperature of the medicines fridge, to ensure it remained within the required temperature. However daily checks of the fridge temperature were not maintained, and staff did not record the maximum and minimum temperature. The fridge also required defrosting. The manager requested that qualified staff address this issue. The sharps containers were not dated and signed to show how long the containers had been in use. The sharps box for Lea View unit was virtually full; the manager sealed the box and replaced it when brought to her attention. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14 and 15 Importance is given to ensuring that residents maintain personal choice and control over their lives, where possible. Relatives are made to feel welcome and are involved in their relatives care. The home provides a good variety and choice of foods, which residents enjoy. EVIDENCE: Residents and relatives said that some social activities took place. The activities persons had recently left and a new person was due to take up post on 24 October, with a view to establishing a varied activities programme for residents. The manager reported that the Company had increased the activities person’s hours from 20 to 30 hours a week to further meet residents social interests and needs. Observations and discussions with staff and relatives showed that residents are helped to exercise choice and control over their lives, where possible. Residents said that daily routines were flexible; some residents preferred to spend time in their room during the day. Residents, relatives and staff confirmed that contact with family and friends is supported. Relatives said that they can visit at any time and are made to feel welcome in the home. Two relatives spent most of their day in the home and were fully involved in Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 12 caring for their relative. Relatives said that they had formed good relationships with staff and the manager. The menus provided a choice and variety of meals. Two relatives had a meal at the home each day with their family member. Relatives and residents spoken with said that the meals included home cooked foods, which they generally enjoyed and that there dietary needs and preferences were accommodated, where possible. A new cook had been appointed and was due to take up post. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 13 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 The home has a satisfactory complaints system and relatives and residents were confident that their views are listened to and acted upon by the manager. EVIDENCE: The manager confirmed that a summary of the complaints procedure including the address and the phone number of the Commission for Social Care Inspection is included in the service users guide, which residents and relatives receive a copy of on admission. The complaints procedure currently displayed in the home did not include the address and the telephone number of the Commission for Social Care Inspection, but stated that this was available from the home or by phoning the company’ s office. Residents and relatives said that they found the manager and staff approachable and felt that concerns are listened to and acted upon. Relatives stated that they had had cause to complain about several issues in the registered manager’s absence. However, residents and relatives were confident that the registered manager was addressing various concerns that had arisen in her absence. The Commission recently received a written complaint about odours on Lea View unit and residents wellbeing. The complaint was investigated during this inspection and was upheld in regards to odours on the unit. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Further improvements have been made to provide a safe and comfortable environment for residents to live in, although further measures need to be taken to minimise odours in the home. EVIDENCE: Residents and relatives considered that the environment is comfortable and homely and is maintained to a good standard throughout; this was apparent on the inspection. Arrangements were in place to ensure that the home is well maintained. Since the last inspection a good number of the bedrooms have been redecorated and refurbished to a good standard, although this was not in the form of a written refurbishment plan. New furniture, bedding and floor covering had been provided. The majority of bedrooms contained personal belongings and reflected individual’s preferences. A phased programme had yet to be put in place to fit further lockable storage areas and locks to bedroom doors. This requirement remains outstanding from the inspection report dated October 2004. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 15 The manager said that information had been obtained in regards to installing a suitable loop system in the lounge area to assist residents with poor hearing. No date had been set for installing this. This requirement remains outstanding from the inspection report dated October 2004. Lea View unit- a number of the light bulbs in the lounge and dining area required replacing. When brought to staff’s attention the administrator took immediate action to replace the bulbs. Daily domestic cover was provided on the two units, one domestic covered both units at the weekend. The manager had put a case of need for additional domestic hours and the Company had approved this. At the time of the inspection the home was clean although offensive odours were present in the lounge, corridors and certain bedrooms on Lea View unit. An immediate requirement sheet was left on inspection to address this issue. A requirement was made on the last inspection report dated May 2005 to keep the home free from odours. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): After a period of instability the staffing levels and skill mix had increased to meet the needs of residents. Continued efforts need to be made to ensure that all staff have received appropriate training for the work they carry out. EVIDENCE: The home has some very committed staff that have worked at the home for several years. Relatives and staff said that the home had experienced a number of staff changes over recent months resulting in limited staffing cover. Regular staff had worked extra shifts to help cover the shortfalls. Additional qualified nurses and care staff had been recruited and further staff were due to take up post. The home currently had a good skill mix of qualified staff to meet residents’ needs. Relatives and staff were assured that the manager had addressed the staffing shortfalls, and confirmed that the manager had recently increased the staffing levels on days to meet resident’s needs. Relatives and staff considered that sufficient staff were now provided to meet residents needs. Staff spoken with said that they had attended various training since the last inspection including areas identified on the previous report such as pressure area care, care planning, and protection of vulnerable adults. As previously stated the manager had recently returned to work after been absent for a year, and had identified that not all staff had attended all mandatory and Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 17 essential training and had set up various training for staff over the coming months. The manager planned to update the training records and identify key areas of training for staff for the year in the form of a training plan. The home has exceeded the 50 target of care staff having achieved NVQ Level 2 or equivalent. The manager confirmed that 11 out of 18 care staff have achieved N.V.Q Level 2 or above qualification to ensure they are trained and competent to do their job, and that further staff were undertaking the training. A new member of staff that had been in post for six weeks said that she had received a good level of support from staff, but had yet to complete the home’s induction programme. A senior member of staff on the adjoining unit had been assigned to complete the carer’s induction programme, which was not appropriate in that the staff did not work together. The manager agreed to address this issue. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 18 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, 32 and 33 The home is run in an open and positive way, which staff and residents benefit from, and the return of the registered manager has re-established clear leadership throughout the home. EVIDENCE: Due to personal circumstances the registered manager had been off work for the last year. Several relief managers have covered her position, which relatives and staff said had affected the stability and running of the home. The registered manager had recently returned to work and had put a clear plan in place to improve the care and services at the home, which staff and relatives were aware of. The registered manager has considerable experience and skills and runs the home in an open and positive way. Staff felt valued by the manager. Staff said that the atmosphere at the home is very friendly, and that staff work together as a team. This was apparent on the inspection. Staff, residents and relatives felt that the home was well run, and found the manager approachable and said that she involved them in decisions about the home. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 19 The manager has a good understanding of the areas on which the home needs to further improve, and had set out a clear plan and priorities to achieve this. Procedures are in place for monitoring the care and services provided at the home. Residents and relatives consider that the home is run around their needs and that their views are sought and acted upon. Resident/relative meetings continue to be held. Discussions with staff and observations on inspection supported that safe working practices were followed. The mobile hoist on Lea View unit had recently been taken out of use, as it required repairing. The manager said that the hoist was due to be repaired. Both units shared the new stand aid hoist, which created some inconvenience in terms of having to transfer the hoist between the two floors. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X X Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Timescale for action A full assessment of residents 31/12/05 needs, preferences and abilities must be completed on admission. (Previous timescale of 30 June 2005 not met) Care plans must set out in detail 31/12/05 the action that needs to be taken by staff to ensure that all aspects of residents needs are met, and demonstrate residents/relatives involvement. All medication administration 30/11/05 records that are handwritten must record the quantity of medicines received. All medicines kept on Lea View 30/11/05 unit including creams and ointments must be stored securely. Arrangements must be put in 30/11/05 place to ensure that medicines are disposed of by a licensed company/person. Arrangements must be put in 31/12/05 place to further meet residents social and religoius needs and preferences. Care plans must show how residents needs are being met. (Previous timescale DS0000002038.V256145.R01.S.doc Version 5.0 Page 22 Requirement 2 OP7 15 3 OP9 13 4 OP9 13 5 OP9 13 6 OP12 16 Ashcroft Nursing Home 7 OP24 12 8 OP22 23 9 OP26 16 10 11 OP30 OP30 18 18 of 30 June 2005 not met) A phased programme must be carried out to fit suitable locks to all bedroom doors. (previous timescale of 30 April not met) Suitable facilities and equipment must be provided for residents needs - in this instance a loop system. (previous timescale of 30 April 2004 not met) The home must be kept free from offensive odours. (previous timescale of 24 April 2005 not met) All staff must receive training apporpriate to the work they are to perform. All new staff must complete the home’s induction programme within six weeks of appointment to their post. 30/04/06 31/12/05 30/11/05 30/04/06 31/12/05 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 OP7 OP9 OP9 OP9 Good Practice Recommendations Monthly reviews of residents care plans should report on the effectiveness or appropriateness of the care and treatment being delivered. The manager should continue to monitor that the controlled drugs cupboard provides sufficient space to store all controlled drugs. The maximum and minimum temperature of the medicines fridge should be monitored daily and recorded, and the fridge should be regulary defrosted and cleaned. Sharp’s boxes should be signed and dated when first used to monitor how long they have been in use. All sharps boxes should be regularly replaced and changed when three quarters full, to minimise the risk of needle stick injury. The complaints procedure displayed in the home should DS0000002038.V256145.R01.S.doc Version 5.0 Page 23 5 OP16 Ashcroft Nursing Home 6 7 8 9 10 OP19 OP24 OP30 OP30 OP38 include the address and the telephone number of the Commission for Social Care Inspection. An annual redecoration and refurbishment plan should be put in place for the home. A phased programme should be carried out to provide a lockable storage facility for all residents. All staff should have an individual training and development plan, which clearly shows what training they have attended. The manager should form an annual training and development plan for staff. A stand aid hoist should be provided for each unit as funding permits. Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Ashcroft Nursing Home DS0000002038.V256145.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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