Inspection on 05/09/06 for Ashley Manor Nursing and Residential Care Home

This inspection was carried out on 5th September 2006.

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

Ashley Manor Nursing and... 31/01/06

Ashley Manor Nursing and... 19/07/05

Ashley Manor Nursing and... 23/09/04

Ashley Manor Nursing and... 03/03/04

Ashley Manor Nursing and... 14/01/04

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The Cotswold Home

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Newbeech House

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

CARE HOMES FOR OLDER PEOPLE Ashley Manor Nursing and Residential Care Home Winchester Road Shedfield Hampshire SO32 2JF Lead Inspector Pat Griffiths Unannounced Inspection 5th September 2006 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 Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.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. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashley Manor Nursing and Residential Care Home Winchester Road Shedfield Hampshire SO32 2JF Address 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) 01329 833810 01329 835137 info@ashleymanorhome.co.uk Mrs Theresa Andrews Mrs Rosamund Jane Heath Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability over 65 years of age of places (45) Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31/01/2006 Brief Description of the Service: Ashley Manor is a registered care home providing nursing care and accommodation for 45 service users of both sexes in the older people category. Accommodation is provided on three floors, which are accessed by stairs and passenger lift. The home has large well-maintained gardens and parking is available in the grounds. The accommodation comprises of thirty-five single and five shared bedrooms. Twenty-five of the single rooms have en suite facilities provided. The home is privately owned and situated on the outskirts of Southampton, close to the village of Wickham. The manager said that the current fees are £590 - £670 per week, with extra charges for hairdressing, chiropody, papers and toiletries. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This fieldwork visit was unannounced and took place on 5th September 2006, starting at 10am and finishing at 4pm. All key standards were examined and the visit included looking at areas of the home such as bedrooms, communal/shared areas and the home’s kitchen and laundry as well as the garden. Documents and records were examined and staff working practices were observed where this was possible without being intrusive. Residents, visitors and staff were spoken to in order to obtain their views of the service that the home provides. Visitors that spoke to the inspector were very positive about the care their relatives received, commenting that the home looked much nicer now that the building works and decoration were finished. The home’s deputy manager was present throughout the visit, the registered manager was present after lunch, and both were available to provide assistance and information when required. Other information included in this report is obtained from sources such as a pre-inspection questionnaire, completed by the manager, and information that the commission has received since the last visit made to the home in January 2006, such as notices received about incidents that have occurred in the home. What the service does well: What has improved since the last inspection? The internal decoration of the home is complete and the residents are settled into their rooms, enjoying the new features in the garden and the extra space of the conservatory. The owners have now registered as signatories with the CRB (Criminal Records Bureau) and the manager and owners carry out all necessary checks for new staff in the home. The recruitment procedure has been expanded to include a written summary of all recruitment interviews and ensures that informed decisions are made regarding the suitability of all applicants. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 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. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.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 Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Arrangements for assessing prospective residents ensures that their individual needs can be met in the home. Standard 6 does not apply to this service EVIDENCE: The inspector was advised that pre-admission assessments are done by the manager or deputy, who go to visit the potential residents. The manager said that occasionally residents visit the home before admission, but usually it is family or friends that visit and then advise the potential resident. The manager said that health information is obtained from the GP and care manager as well as meeting and assessing any potential resident. The pre-admission assessment is completed before a place is offered in the home and is used as the basis for the care plan. The inspector saw several pre-admission assessment records and it was noted that the comprehensive assessments provided the relevant information needed regarding the residents personal, health and social needs. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 9 The manger said that the home does not provide intermediate care, but does offer respite care if a bedroom is available. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Arrangements for care planning and risk assessment ensure that the residents assessed and changing needs are met. The residents’ health care needs are met by visiting healthcare professionals. The homes medication policy and staff training ensures that staff and residents are protected. Arrangements ensure the residents privacy and dignity is upheld EVIDENCE: The inspector looked at three individual care plans for the residents and saw that they provide information on how the assessed needs of the resident should be met. This included moving and handling information such as the need for a hoist or wheelchair and dietary information such as the need for a pureed diet. Specialist care needs, such as regular blood tests for diabetics, were noted and appropriate records kept. The plans are individual and personal, noting that one resident prefers a cup and saucer for hot drinks and a beaker for cold drinks. Information was also provided about which names the residents prefer to use, which are sometimes very different to their given Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 11 names. Information such as what time residents prefer to get up and go to bed is also included. The home has a medication policy in place; observation of a medicine round by the inspector and discussions with trained staff indicate that the policy is followed. None of the residents are responsible for their own medication. The manager showed the inspector the new system the home has for disposing of unused or unwanted medicines. Staff were seen supporting residents in a dignified and respectful manner, such as when providing assistance at mealtimes or moving around the home. Assistance was seen to be given at the resident’s own pace and in an unhurried fashion. Staff were seen to knock at bedroom doors and wait for a response before entering. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home ensures that there are a variety of activities available for the residents and an open visiting policy. Residents are encouraged to exercise control over their lives. Arrangements ensure contact is maintained with family and friends and a wholesome and balanced diet is available. EVIDENCE: Residents that spoke to the inspector said that they could choose to spend their time in several parts of the home, such as the sitting room, conservatory or their bedrooms. Several were seen reading their newspapers in their bedroom in the morning and then entertaining their visitors in the garden in the afternoon. The inspector met one of the nurses in the home who has a special interest in the residents activities and spends four hours each week organising and providing activities. These activities include one-to-one sessions for manicures and a monthly party. The parties are themed and topical, so there has been a tropical beach party and a 4th July party and there are plans for a Halloween event. There are photographic displays of the events hanging in the sitting Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 13 room and the residents were keen to tell the inspector about the entertaining dance routines that the staff do at these parties. The home also has a craft activities organiser and there are visiting musicians. The current calendar of activities is pinned up on the notice board and includes details of the church services that are held in the home on the second Tuesday of each month. The manager said that the home has an open visiting policy and residents can entertain their guests in their bedroom, the garden or one of the sitting rooms in the home. Residents are encouraged to exercise control over their lives, such as deciding when to get up, what clothes to wear or where to have their meals. The cook told the inspector that the menu is based on the likes and dislikes of the residents and that choices are available at every meal. Residents commented that they liked the food and knew they could ask for something different if they didn’t like the choices available. Snacks are available on request, such as biscuits, fruit or sandwiches. Meal times were seen to be leisurely and help was given in an unhurried manner when needed. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home has a complaints procedure in place, enabling residents, relatives and staff to make complaints should they wish. Staff training in Adult Protection promotes the safety of the residents. EVIDENCE: The home has a complaints and whistle-blowing policy in place, details of which are available for staff, residents and their visitors. The manager said that they have an up to date copy of the local authority adult protection policy and it is available for staff to read. Visitors that spoke with the inspector felt happy that they could take any complaints to the manager and that it would be dealt with properly. The manager told the inspector that the complaints procedure is being reviewed and amended to include more details, such as the timescales for responses to complaints. Staff that spoke with the inspector indicated that they understood the prevention of abuse and adult protection policies, and commented that it had also been a section of their NVQ (National Vocational Qualification) training. The manager said that the home was trying to provide annual updates in adult protection training. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to this service. Arrangements ensure the home is safe, well maintained, clean, and hygienic. Arrangements for maintaining the home ensure that residents stay in a safe environment EVIDENCE: The inspector was able to tour the home and see some of the bedrooms, kitchen, laundry and communal areas. The extension to the home, which has provided 25 extra en-suite bedrooms, a hairdresser’s room and a conservatory, is now in use. All bedrooms in the home have been decorated and carpets have been replaced or ‘deep cleaned’. The bedrooms seen by the inspector looked homely and had been personalised by the residents and their families. The residents commented that they were glad that they could bring some of their ‘bit and pieces’ with them, which included photographs of their families and pictures that they had embroidered many years ago. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 16 The gardens are being landscaped, and there are raised beds and paved areas to allow wheelchair access to more areas of the garden, the new lawns have been seeded and more paths are planned to allow access to other parts of the large garden. More ramps have been added to all external doors and the new fishpond has been fenced in for the safety of residents and visitors. The new laundry, which has three washing machines and two dryers, continues to do the personal laundry in the home and the bed sheets and towels are sent to an external laundry. There is also a new machine for labelling the residents clothes, which has proved to be a great success. The conservatory is light and airy and has blinds and shades in place to protect the residents from bright sunlight, an alarm has been fitted to the external door to monitor any unsupervised exits into the garden. The cook said that the kitchen staff have had training on the ‘Safer food, better business’ system of record keeping and showed the inspector the folder, which was up-to date with all necessary recordings such as the daily fridge temperatures. The deputy manager said that they are going to make the bathrooms more homely, by fitting curtains and blinds at the windows and putting mirrors and pictures on the walls. On the day of the visit the home was seen to be clean and tidy, with no unpleasant odours. The care staff in the home are supported by laundry staff, cleaners and kitchen staff who work a roster to ensure that these services are provided every day of the week. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The numbers and skill mix of staff ensure that needs of the residents are met. The home has a recruitment policy and procedure, which is now used properly to protect the residents and staff. Arrangements for induction and training ensure that the staff are able to meet the needs of the residents. Arrangements ensure that residents’ needs are met and that they are in safe hands at all times. EVIDENCE: The home employs twelve registered nurses, twenty-seven care assistants and thirteen ancillary staff such as cooks, cleaner and laundry staff. The home also employs a handyman and gardener. Agency staff are occasionally used, usually the same staff, providing continuity of care with staff who know the home and the residents. Seven of the care staff have completed National Vocational Qualifications in care, three others are currently undertaking the course and two more will be starting the course soon. This does not meet the expected target of 50 of the care staff with an NVQ2 or above. The manager said that staff are encouraged to do the training and all attend the mandatory training sessions, but some staff are reluctant to take on more training. The manager said the home now has the new induction training (Skills for Care) in place and will start using it Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 18 when they next take on new care staff. The manager is a registered nurse who also has an NVQ4 in management and the deputy is also a registered nurse who has completed an advanced Management for Care course. The home has a robust recruit policy and following action points raised at the last inspection the home now undertake their own Criminal Records Bureau checks, and the deputy manager said that all are up to date. The deputy also said that they have used the POVAfirst facility when they are short staffed. (Criminal Records Bureau disclosure is a police check and Protection of Vulnerable Adults). The new staff files were seen to contain new written interview record sheets, where the interview is documented in more detail and helps the manager to make informed decisions regarding suitability for employment in the home. New staff do not start work until their CRB disclosure is returned or an acceptable POVAfirst is obtained. The inspector looked at the files of three new members of staff and found that all the relevant checks had been completed, such as obtaining references and CRB disclosures. Other staff files were checked and found to contain the correct information and there was evidence that the nurses have had Nurses and Midwives Council checks on their professional qualifications before starting work in the home. The home has a rolling programme of training and a record is kept to ensure that all staff are up-to-date. The training programme was seen to have sessions planned for annual updates in manual handling and food hygiene as well as training in infection control, abuse awareness and dementia. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Arrangements ensure that the home is well run and in the best interests of the residents. The residents’ financial interests are safeguarded. Arrangements are in place to ensure that the health, safety and welfare of the residents and staff is protected. EVIDENCE: The home is run by a very experienced manager who is a registered nurse and has completed her registered managers award. She is supported by an equally experienced deputy manager. Between them they operate an open-door style of management and staff that spoke to the inspector said that they felt they were able to approach either for information or support. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 20 The home recent completed a service users survey, the twenty-eight questionnaires sent out resulted in twenty-two responses, all of which were very positive. Residents and their relatives are happy with the care provided. Residents and visitors that spoke to the inspector during the visit also indicated that they were happy with the care provided. Ten comment cards from residents were returned to the commission and all the boxes were ticked to indicate satisfaction with the care, support and food provided by the home, there were no adverse comments or complaints. Twelve comment cards were received by commission from relatives or friends of residents in the home and the comments were all very positive ‘Very pleased with the care and friendliness of the staff’ ‘I am very happy with the standards of care in this home’ ‘I have found this a very well run, friendly home. They retain a lot of staff and they have now become part of my mothers extended family.’ ‘Any issues are dealt with promptly’ ‘Ashley Manor is one of the best care homes I have seen’ ‘It is reassuring that my mum is taken care of so well, and its such a burden taken off my father, and my mum is happy – that’s the main thing’ ‘we are thoroughly satisfied with all aspects of the home’ ‘I cannot fault the care, attention and kindness my mother receives. I have even attempted to contact the media in an attempt to recommend that the staff receive an award’ ‘I am please with all the help and attention my sister gets at Ashley Manor, I’ve no complaints at all’ The home looks after small amounts of pocket money for some of the residents. This money is kept in separate, labelled, plastic wallets. Each wallet contains a small account book to record the income and expenditure of each resident and receipts are also kept. The inspector checked the cash and balances on two accounts and both were correct. The completed pre-inspection questionnaire indicated that the service contracts for services such as the boilers, the fire safety equipment and the lift, were are all up-to-date. A fire risk assessment for the home has been completed and the record of the weekly fire alarm tests was also examined and found to be up-to-date. The deputy manager said that there are arrangements in place to ensure that the home is locked and secure at night. During the day the front door is kept closed and access is gained only by ringing the bell. The back door has a keycode for entry and all other external doors are linked to the alarm system. The manager also discussed the planned extension of the kitchen and was able to confirm that the building work will not affect the day-to-day running of the home or the provision of meals. The home owners are also planning to build a small sunroom as an extension to the sitting room, which will provide a quiet room which could be used for listening to music or entertaining visitors. Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 21 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 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 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 X X 3 Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Ashley Manor Nursing and Residential Care Home DS0000047024.V305994.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!