Inspection on 19/07/06 for Ashwood

This inspection was carried out on 19th July 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

Ashwood 21/10/08

Ashwood 15/01/08

Ashwood 23/01/06

Ashwood 02/06/05

Ashwood 28/10/04

Ashwood 02/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ashwood 1 Liverpool Road Ashton-in-Makerfield Wigan Greater Manchester WN4 9LH Lead Inspector Judith Stanley Unannounced Inspection 19th July 2006 08:00 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 Ashwood DS0000005722.V297134.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. Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Address 1 Liverpool Road Ashton-in-Makerfield Wigan Greater Manchester WN4 9LH 01942 722553 01942 720577 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) Mr Serge Pascau Mr Dennis Pugh Mrs Sandra Shepherd Care Home 36 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (36), of places Physical disability (2), Physical disability over 65 years of age (8) Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 36 service users to include: up to 36 service users in the category of OP (Older People) up to 2 service users in the category of PD (Adults with Physical Disabilities) up to 8 service users in the category of PD(E) (Adults with Physical Disabilities over 65 years) up to 1 service user in the category of DE(E) (Adults with Dementia over 65 years) The 2 PD places are only to be used for service users over the age of 60. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 23rd January 2006 2. Date of last inspection Brief Description of the Service: Ashwood is a private residential care home registered for up to 36 adults of either sex who are elderly. It is situated in the centre of Ashton-in- Makerfield close to all local amenities including shops and bus routes. Currently all bedrooms have single occupancy. The Home is registered for 36 so there is a possibility some rooms could be used as doubles. The manager advised that there are currently no plans to have shared rooms. Only one room offers an en suite facility, however, all rooms have a hand basin and there are toilets and bathrooms on both floors. The premises are well maintained both inside and outside. Car parking is available to the rear of the Home. Level access to the Home is provided and a passenger lift ensures access is available to both floors. The current scale of fee ranges from £306.94 to £372.00. Additional charges are made for toiletries, magazines, transport, papers and hairdressing. Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a 7½ - hour period on one day and was an unannounced key inspection and included a site visit. The homes manager was available to assist with the inspection. The first part of the day was spent looking at some of the records the home keeps on residents (care plans), staff files and selection of health and safety certificates. The rest of the time was spent talking with residents, staff and visitors calling at the home. A tour of the premises was also made. Prior to the inspection, comment cards were offered to residents, relatives, GPs, Care Managers and District Nurses. Eight service users have returned comment cards, one states, “ the staff are very friendly, you can always have a laugh and a joke. Parties which they often arrange are very good with plenty of entertainment”. Another resident states, “ the medical care is excellent. All the relevant information was provide before moving in to the home”. Another resident was satisfied with the pre admission assessment visit and states that it was very informative and whatever is needed is done. Positive comments from Healthcare Professionals include, “ I feel the team at Ashwood provide excellent care for our patients, they communicate responsibly and accurately and action management plans promptly” (GP). A social worker responded stating, “ Having secured many respite and permanent places with Ashwood, comments and feedback have always been positive. The staff team share a genuine commitment”. What the service does well: What has improved since the last inspection? Since the last inspection some bedrooms have been decorated and also the downstairs lounge. The lighting in the downstairs lounge has been changed to give more light and dimmer switches fitted to enhance resident’s moods for the evening period and for watching TV. Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 6 The shower room has been refurbished to improve residents bathing facilities. A wider range of indoor activities needs to be planned and made available to suit residents capabilities and should be suitably recorded to demonstrate what activities have taken place on a daily basis and to ensure these are stimulating and fulfilling. 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. Ashwood DS0000005722.V297134.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 Ashwood DS0000005722.V297134.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): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The service user guide and the statement of purpose provide satisfactory information to help residents make a decision about moving in to the home. The home has a satisfactory pre admission assessment procedure to ensure that the home can meet the assessed needs of the service user. EVIDENCE: The service user guide and the statement of purpose are available for prospective service users and their relatives to help them make a choice about coming to live at the home. The guide is detailed and offers information about the staff and their qualifications and the services and facilities the home provides. Three care plans were inspected and were seen to contain pre admission assessments. Assessments are completed by the homes manager or by the Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 9 deputy manager at the most convenient place for the prospective resident either at their home or in hospital. A full assessment is carried out to ensure that the home and staff can meet the needs of the residents. Assessments cover physical condition, continence, sight, hearing and speech, communication, pattern of sleep, mental condition, temperament, social relationships, cooperation, self care, feeding, dressing, toileting, bathing, nutrition, risk assessments in relation to falls, smoking and moving and handling. The assessment helps provide staff with the details they need to assist them in providing the right care for the residents and forms the basis of the care plan. Ashwood DS0000005722.V297134.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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans were detailed and reflected the care needed. The health needs of the residents are well met with evidence of good multidisciplinary working taking place on a regular basis. In the main, the system for the administration and recording of medication are good, however a error in medication was noted, which could be detrimental to the residents well being. Personal support is offered in such a way as to promote residents’ privacy, dignity and independence. EVIDENCE: Three care plans were made available for inspection and on examination all aspects of resident’s health, personal and social care needs are planned for. Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 11 One care plan had not been updated monthly as required, another resident has only just moved in to the home in July so had not needed a review, the third had been reviewed. Discussion with the manager and from hearing her speaking with residents and relatives it was evident that both are involved in care planning and reviewing, however, the care plan must be agreed and signed by the resident whenever capable and/or a representative, if available. There was clear evidence of access to community services such as residents GP, eye testing, District Nurse support, chiropody, advice and ongoing treatment and access to aids and adaptations that maintains the quality of life for residents. Appropriate risk assessments, which seek to protect resident’s health and safety, were also recorded in respect of resident’s risk of falls, skin tact and risk of pressure areas, mobility, nutrition, smoking and other relevant areas. A social profile was seen in care plans, this provided staff with information about the residents they are caring for and included family history, where resident’s had worked, where they went on holiday and interests and hobbies. This information can be used in helping staff initiate topics of conversation. Systems are in place for the storage and administration of medication. Three residents MAR sheets (drugs sheets) were checked against the medication given out on the morning of the inspection. An error was found on the MAR sheet with one resident’s medication, in relation to a discrepancy in the number of the same tablets she should have been given. The manager was asked to address this issue. Staff have a good awareness of how protect residents dignity, privacy and independence. Staff were seen knocking of bedrooms and toilet doors and waiting for a response before entering. They were seen to deal with individual residents in a supportive manner, for example doing things with them and not for them. Ashwood DS0000005722.V297134.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 & 15 Quality in this outcome area is good. This judgement was made using available evidence including a visit the service. The home provides a wide range of activities that takes account of individual expectations and preferences, and provides good opportunities for social inclusion. Residents maintain good links with family and friends and the local community. Residents are able to exercise as much personal freedom and choice as possible. The meals in this home are good offering choice and variety for residents. EVIDENCE: The home has a yearly plan of activities displayed, for example a trip out to Blackpool, entertainers coming into the home and significant dates are celebrated. However from reading the activity file, it does not offer an insight in to what residents are doing on a daily basis in the home. The activities book indicates residents are watching TV, reading papers, listening to music, talking with residents or going out for a walk. These activities need to be expanded Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 13 upon by taking in to account what residents would like to do. This could include for example, gentle exercise, bingo, dominoes, arts and crafts and a reminiscence group. Residents spoken with said they had enjoyed a recent trip out to Blackpool, another said she was asked if she would like to go but said she refused, she would rather stay at the home. Visitors were seen arriving at the home and 2 regular visitors from the church had come in to the home to offer communion to those residents who wished to receive it. They described the home as,’ a lovely home’. The visitors said that the staff always made them welcome, that the staff are very good and they have no concerns about any care practices they had seen. Residents confirmed they got up when they wanted to and went to bed when they were ready and that they made the decision about what clothes to wear that day. On inspection of resident’s bedrooms, they were found to be warm and comfortable, clean and tidy and most residents had personalised their rooms with possessions brought from home. The homes menus had been submitted prior to inspection and when examined indicated that the home offered a well-balanced and nutritious diet. There was a varied selection of foods offered and choices and alternatives were readily available. A wide range of breakfast dishes were available, including a full English breakfast served at weekend. Lunch is the main meal of the day and on the day of the inspection residents enjoyed roast pork, roast and creamed potatoes, carrots, cauliflower and gravy, followed by vanilla sponge and custard, a lighter choice was spaghetti bolognaise. A lighter afternoon tea is served and the choices offered were pea and ham soup with bread and butter or assorted sandwiches or both, followed by Vienetta dessert. The menu states that diabetic or vegetarian and specialised diets are catered for and a range of lighter dessert for example fresh fruit and yoghurts are available. Most residents were seen to dine in the main dining room; some had wanted to dine in the privacy of their own rooms. The dining tables were nicely set with matching crockery and cutlery and condiments and fruit juice on the tables. The Inspector spoke with residents during lunch and they said how the food was always good, and that there was plenty of it. The Inspector noted that suitable portions were served on full sized dinner plates. The chef serves lunches from the trolley in the dining room, this allows him to see what people are eating and if they are enjoying the food served. Staff were seen to assist those residents who needed help in a discreet and sensitive manner. Ashwood DS0000005722.V297134.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 & 18 Quality in this outcome area is good. This judgement was made using available evidence including a visit to the service. Residents and their supporters can be assured their complaints and concerns will be listened to and appropriate action taken. The home has an adult protection policy ensuring that residents are protected from abuse in any of its forms. EVIDENCE: There have been no complaints made to the management of the home since the last inspection and no complaints have been forwarded to the CSCI. Staff are clear about their obligation in protecting residents from abuse. Upto date policies and procedures are available at the home and staff confirmed they had received training in the Protection of Vulnerable Adults. Ashwood DS0000005722.V297134.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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The standard of the environment is good providing residents with a comfortable, homely and pleasant place to live. Infection control procedures are in place, making this a clean environment for residents. EVIDENCE: From a tour of the premises, it was evident that some refurbishment had taken place. The downstairs lounge had been decorated and the lighting changed. The lounge looked brighter and residents spoken with were happy with the overall effect. The lights have been fitted with dimmer facilities to suit the resident’s moods for the evening periods and for watching TV. The Inspector was shown the bedrooms that have recently been decorated; these were seen to be tastefully decorated and comfortable. The main lounge/dining area on the first floor is the where most people meet and sit together; this area was Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 16 comfortable and well lit. The outside patio area is limited, however there is room and suitable seating for residents to sit outside. Systems were in place to control the spread of infection. Staff were seen wearing protective gloves and aprons for different tasks. The laundry is sited away from food preparation and food storage areas and does not intrude on the residents. The laundress was spoken with and confirmed all equipment was in working order. Residents were seen to be clean and nicely groomed with their clothes nicely washed and ironed. On inspection of the toilet facilities it was noted that cloth towels were being used. This was discussed with the manager who said it was resident’s preferences to use cloth towels. The manager is reminded about the risk of cross infection when using cloth towels, it would be good practice to have paper towels in the toilets. Ashwood DS0000005722.V297134.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 & 30 Quality in this outcome area is good. This judgement was made using available evidence including a visit to the service. Staffing levels at the home and the skill mix of staff are appropriate to the assessed needs of the residents. The standard of recruitment and selection practices were good ensuring the safety and protection of residents living at the home. EVIDENCE: On the day of the inspection there was an adequate number of staff on duty. Staff rotas were available for inspection. Staff turnover at the home is low, this helps provide reliable and consistent care for the residents by staff they know and are familiar with. One resident spoken with said, “the staff are great, they are friendly and they look after us really well”. Staff training is ongoing with 97 of staff having achieved NVQ level 2. From information provided prior to the inspection, staff have undertaken several training courses including, Moving and Handling, Basic Food Hygiene, NVQ level 2 & 3 Technical Certificate, Infection Control, First Aid updates and medication training. The deputy manager has recently completed the Registered Managers Award. Further training is planned (no dates submitted) this is to include Diabetes Awareness, Level 4 in Care for allocated senior staff Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 18 and mandatory training. Twenty staff now hold a current first aid certificate ensuring that there is always a first aider on each shift. Two staff files were looked at. Both files contained a written application form, two written references, Criminal Records Bureau checks, job descriptions other forms of identification had been produced, an induction programme was on file and copies of training certificates. Throughout the inspection it was evident that staff were trained and competent to do their jobs. Ashwood DS0000005722.V297134.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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well managed resulting in consistent and reliable service for the people living at the home. Quality assurance systems are in place to ensure the home is run in the best interests of the residents. The home has a satisfactory accounting system in place to safeguard resident’s finances. Procedures and practices within the home promote and protect the health, safety and welfare of people living at working at the home. Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager has the necessary skills and knowledge to manage the home. It was evident from observation and from listening to the manager speaking with residents that she knows the residents well and there was a respectful and friendly rapport between the manager and the residents. Systems are in place for auditing and monitoring the quality of the service. This is done through residents meetings of which the last one was held on 6th June 2006 where residents mainly discussed the menus and the proposed changes to the lighter options available. The residents had described the food as ‘marvellous’. Another topic for discussion was the planned trip out to Blackpool. Minutes of the last staff meeting held on 22nd June 2006 were recorded and available for inspection. At intervals during the year a satisfaction questionnaire is offered to residents and relatives to obtain their views on the care and services provided. An annual audit is completed and the areas covered from September 2005 looked management and staff, staff training, staff supervision and development, residents care plan, health and social care, meal, financial issues, complaints and several other issues. The owner of the home visits on a regular basis and completes a monthly written report on his findings. These reports were available for inspection. The home holds personal allowances for some residents. These were seen to be securely stored and in individual wallets. Three residents finances were checked, for one resident the family deals with all the residents finances, for the two other residents money was checked against the balance sheets and no discrepancies were noted. Information obtained prior to the inspection indicated that maintenance checks had been carried out for the gas, electric, lift, fire equipment and alarms, the manager could produce certificates to verify that this information was correct. Accidents, injuries and illness were suitably reported and recorded and the CSCI informed as required. During the course of the inspection safe working practices were observed with in the home. Ashwood DS0000005722.V297134.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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 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 Ashwood DS0000005722.V297134.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. 1 Standard OP9 Regulation 13 Requirement There was an error in one resident’s medication. All medication must be accounted for and appropriately recorded. Activities need to offer more variety and choice and need to be recorded in the activity book in more detail to demonstrate how residents spend their leisure time. Timescale for action 31/08/06 2 OP12 16 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP26 Good Practice Recommendations The manager is reminded of the risk of cross infection when using cloth towels in the toilet facilities. Paper towels should also be available. Ashwood DS0000005722.V297134.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Ashwood DS0000005722.V297134.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. 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