Inspection on 06/12/06 for Birchwood Nursing Home

This inspection was carried out on 6th December 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Birchwood Nursing Home 26/01/06

Birchwood Nursing Home 26/10/05

Birchwood Nursing Home 20/12/04

Birchwood Nursing Home 16/07/04

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

CARE HOME ADULTS 18-65 Birchwood Nursing Home Lees New Road Oldham Lancashire OL4 5PL Lead Inspector Sandra Buckley Unannounced Inspection 6th December 2006 9.30am Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 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 Birchwood Nursing Home DS0000025456.V322008.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 Adults 18-65. 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. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birchwood Nursing Home Address Lees New Road Oldham Lancashire OL4 5PL 0161 621 2750 0161 621 2779 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) Turning Point Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 16 (MD) No service user under the age of 18 years to be admitted to the establishment. 26th January 2006 Date of last inspection Brief Description of the Service: Birchwood is a large, detached building situated approximately four miles from Oldham town centre. The home is registered to provide nursing care for up to 16 service users with past and present mental health problems, aged 18 years and over. The property is owned and managed by the charity Turning Point, in conjunction with the local NHS Trust. Their aim is to provide care and accommodation to service users who no longer require care within a hospital setting but still require support and observation. The service offers a step down approach and enables service users to learn or re-learn life skills, enabling them to achieve independence within the community. Accommodation is in 16 single rooms, all of which have en-suite and shower facility. Two of the rooms have been adapted to form bed-sits, with a cooker and a fridge to promote independent living. Each room has a telephone, which receives incoming calls. There is a large lounge/dining room and a small library/sitting room. A kitchenette is provided for service users to make refreshments situated in the occupational therapy/computer room. The home provides a designated smoking area for service users. In addition to the en-suite facilities, there is one bathroom suitable for service users who may have a disability, and a domestic type bathroom; three communal toilets are situated in other areas of the building. The home has appropriate aids and adaptations to promote the independence of their service users. The home’s fees are £750.10, service users are required to pay for their personal hairdressing and newspapers also some trips and entertainment in the community. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection which included an unannounced visit to the service took place on the 6 December 2006. On this inspection the home was without a registered manager due to the retirement of the post holder. A clinical nurse manger had only been in post for six weeks and was being supported in daily routines of the home by nursing staff and another manager within Turning Point’s organisation. During the inspection three residents were interviewed in private, as were three members of staff. Discussions also took place with a group of residents and the clinical nurse manager. The inspector undertook a tour of the building selecting rooms at random for inspection and looking at a selection of service users files, as well as other documentation, including duty rotas, medication records. Eight questionnaires were left for completion by the service users. None had been returned at the time of writing this report. What the service does well: Service users are given a phased introduction into the home, ranging from daily visits, weekend stays and a trial six-week period providing service users with an informed choice. One service user said “I liked it here right away and would like to stay”. Rehabilitation back into the community is often a slow process however staff remained aware of the service users goals. Since the last inspection two service users had successfully moved into “independent living” after spending time in the rehabilitation flats within the home. This makes way for other service users to have the same opportunity. Service users comments included “ I have regular one to ones with my key worker”, “ I keep in contact with my family” and “Staff are very good to me”. Service users have a good standard of single accommodation with ensuite/shower-room and a telephone intercom system. There has been a recent change in the homes smoking policy, service users confirmed they had been consulted and agreed with the policy change. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment process and recording in place does not fully gather all relevant information which may mean that some service users whose needs cannot be fully met are admitted to the home. Service users are encouraged to visit the home prior to admission in order to provide them with an informed choice. EVIDENCE: Three service users assessments were looked at in depth. These were found to contain insufficient detail of the service users needs. The signature of the person and date of the assessment were not always completed. Several more case files were examined which found assessments and care planning in different formats. The assessment process needs to be more in depth when conducted by the home. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 9 Service users are offered a gradual introduction into the home, they discussed coming to the home for a visit moving to a weekend stay, if successful a stay of six weeks is proposed after which a review is held in order to see if the home is meeting the service users needs. One service user said “ I like it here right away and would like to stay”. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved in the decision-making processes in the home leaving them feeling in control, and promoting their choice and independence within the home. EVIDENCE: As mentioned earlier, the assessments in place contained insufficient detail, which means that the care plans drawn from such assessments were also lacking in detail. The ones seen did not accurately reflect the needs of the service users. Risk assessments were in place. An overall view of the files inspected was that recording systems need to be more uniform and streamlined in order not to miss service users individual needs. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 11 Interviews with staff and service users demonstrated that service users needs were being met, despite the lack of adequate recording. The home provides two independent living flats. At the time of this inspection the service users who were living in these on the last inspection had successfully moved on. This allowed another service user the opportunity to experience independent living with staff support which has gradually reduced as the service user progresses. This was a positive feature of the home on this inspection. Each service users is allocated a named nurse and a support worker. There was documented evidence that regular meetings take place with support staff. Community meetings also take place to discuss ongoing developments in the home. One service user said, “I have a new key worker and we have been discussing me moving into the flat, not sure about doing my own coking though, but they will help me”. Another said “ I have regular meetings with my key worker”. The home completes a living skills assessment in line with a risk assessment, which includes budgeting and understanding the value of money. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The employment of occupational therapists will increase the social and therapeutic activities for service users and so aid service users in their recovery. Service users have opportunities to maintain links with their families and the wider community. The improvements to menu planning, choice and the dining experience provided a congenial atmosphere for service users. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 13 EVIDENCE: Birchwood have a wide age range varying from young low dependency to older people with high dependency needs. The inspector spoke to several service users about their lifestyle in the home. Some of the comments received were, “ My key worker introduced me to a day centre but I did not like it and we are now looking for something different.” Others talked about a recent Blackpool trip, which they enjoyed and the forthcoming Christmas activities. One-service user said “I see my sister and family regularly” and another said “I go home for weekends sometimes”. At the time of this inspection a full time occupational therapist and part time assistant had been employed with the view of extending the social, educational aspects and therapeutic aspects of service users. The clinical nurse manager stated these staff would have the responsibility of maintaining social and educational care files for service users with consultation with the service user their named nursed and support worker. At the time of inspection Birchwood had introduced a “smoking policy” that did not allow service users to smoke in their rooms, only in the designated smoking areas. Interviews with service users provided evidence that they had been consulted during the change of policy with most understanding the need for additional fire safety. Service users said they had freedom of movement, one said “ I don’t have to ask to go out I have my own key”. Another said “Staff are very good to me” and I can go to bed and get up when I want,” and “I am not interested in going out much”. Recommendations were made on the last inspection regarding the dining experience for service users, which did not provide a homely atmosphere or social interaction. On this inspection it was found that big improvements had been made to menus, consultation with service users and table setting. The inspector dined with service users and found there were several choices of meals, which reflected on the menu. Lunchtime menu consisted of homemade soup and prawn risotto with an alternative of jacket potato and chilli. Oneservice users said, “ Staff come round and ask us the night before what we want the next day and the food is really good now”. Another said meals are really good here”. One area of change was the time for the main meal of the day, which has changed from lunchtime to evening. Service users said they preferred this option because they were not always hungry after a late breakfast. The home offers a small kitchenette area off the main lounge for service users to make drinks or a snack if they wish. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 14 A notice board situated near the main lounge gave information on the forthcoming Christmas activities and how to access Turning Point’s caravan for holiday breaks. . Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Efficient communication systems and staff routines were in place ensuring service users needs were met. EVIDENCE: The home had made improvements in staff routines in relation to service users personal care needs .The inspector noted that service users looked well cared. Service users discussed the support they received from their key worker and named nurse saying, “I have regular one to one with my key worker”, another said, “Staff help us to clean our room and remind us to bring down our washing”. Most of the service users at the home can manage their personal care with only prompts being given from staff. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 16 There was evidence on service user files that they have access to professional health care. Most service users attended their own doctor’s practice for a flu injection. Those who require medication given in injection form visit a local health care clinic. Dates were recorded when the service users next appointment was and if they need to be accompanied. Specialist mental health care needs were also recorded e.g. psychiatrist and community psychiatric nurses. A new system of medication had just been introduced in blister pack form. The clinical nurse manager was able to demonstrate how the ordering and returning of medication was monitored. Examination of medication records found these were correct and signed for at the point of administration. Only qualified staff administers medication. At the time of this inspection no service users were self-medicating. The monitoring of service users health care and personal care needs is done through regular handovers at change of shift when all staff are present. Interviews with service users in the smoking room found they had been informed of groups to help them to give up smoking. One service user had been informed of the use of herbal cigarettes, which they felt was helping them to give up smoking. In one instance a specialist bed had been purchased to provide the service user with more comfort and enable staff to deliver personal care in safety. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were confident they could raise concerns with staff and they would be listened to. Staff training ensures service users are protected from abuse. EVIDENCE: Staff training in the protection of vulnerable adults is mandatory within Turning Point’s organisation and at Birchwood. Service users are provided with information on how to make a complaint on their admission to the home. No complaints had been received since the last inspection, however should this occur a record is maintained at the home with a copy being sent to Turning Point’s head office for analysis. Service users confirmed they would feel comfortable in bringing any complaints to staff’s attention and were confident they would be listened to. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a good standard of accommodation, which had been personalised to suit their needs. The environment was clean, tidy and without odour providing comfort for service users. EVIDENCE: The inspector looked at all communal areas, a selection of service user bedrooms and the rehabilitation flats. Bedrooms were personalised to the service users own taste with hi-fi systems also tea making facilities if a risk assessment indicates it is safe to do so. Each bedroom has an ensuite shower room providing the service user with additional privacy and comfort. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 19 An in house telephone system is in place, which allows service users to receive incoming calls and speak to other service users in the privacy of their own rooms. The telephone system also extends to communal area were it was observed one service user contacting another to inform them that lunch was ready. A number of rooms had been decorated and provided with new furniture. A rehabilitation flat had also been decorated ready for the next service user. The inspector noted that some bedroom carpets had cigarette burns and needed replacement. The clinical nurse manger said the smoking policy had been revised in conjunction with the service users to ensure this did not occur again when the carpets were replaced. The home was clean, tidy and without odour. The inspector noted that staff had tried to reduce the institutional look of the home by the provision of pictures in corridors and improvements in the dining area. The clinical nurse manager said the home were in discussions with the owners of the property regarding redecoration. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment procedures were in place ensuring that all staff are suitably checked out before they commence work which protects service users. The arrangements in place for staff induction, supervision and training ensured that a skilled and supervised workforce was in place to support service users in their lives. EVIDENCE: The home maintains a record of dates of job applications and evidence of criminal record bureau (police) checks. Turning Point provides a mandatory induction for permanent staff that includes managing challenging behaviour and the protection of vulnerable adults. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 21 The clinical nurse manager reported this was being reviewed to bring it in line with recent changes at the Skills For Care counsel. On commencing staff are provided with an induction, which is farily basic and does not particularly contain sufficient detail to ensure staff awareness of the service users privacy and dignity rights. It is acknowledged that a more in depth induction is provided by the organisation. However, on past inspections it has been identified that the time lapse has been considerable with some staff waiting up to a year for induction. In discussions with the clinical nurse manger and a member of the organisation who was providing part time management cover they stated the organisation now aims to complete a full induction within six weeks. At interview newly appointed staff confirmed they had been given detailed job descriptions clarifying their roles and responsibilities. On commencement of duty they are required to shadow experienced staff until deemed competent. The home operates their own bank staff, which are used on a regular basis. . Due to staff changes in the home, they have fallen short on this inspection of 50 of staff holding NVQ’s, however new staff had been enrolled to undertake training. There was evidence that staff supervision had taken place. At interview staff demonstrated a good knowledge of residents needs and goals. It was evident that good communication took place through regular handovers, key worker and staff meetings. Residents interviewed gave examples of how their key worker supports them saying, “staff are very good and support met to hospital appointments”. During interviews staff gave examples of the training they had undertaken, this included health and safety, moving and handling, first aid, protection of vulnerable adults and managing challenging behaviour. The inspector asked questions regarding the care needs of residents with staff providing good information on the goals of service users and their emotional needs. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management structure in the home provides a good support system for service users and staff through effective communication systems. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 23 EVIDENCE: At present there is no registered manger in post. A regional manger advised the inspector that a new manager had been appointed. No application has yet been made to Commission for this person to be registered. A registered mental health nurse had been appointed clinical nurse manger, however they had only been in post for six weeks. They were supported on a part time basis by a manager from another home in the organisation that was contactable by phone at any time. In addition to this nursing staff in the home provided support on the day-to-day operations. Some improvements had been made in staff communication and routines, which had been to the benefit of service users and raising staff awareness. There was evidence that equipment in the home was regularly serviced and that staff had received health and safety training. Service users were involved in a recent policy review regarding smoking within the building promoting ownership of the decisions made. Although positive outcomes for service users were maintained on this occasion a review of the homes assessment procedures and recording systems especially in relation to care planning needs to take place to ensure outcomes remain positive. Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 2 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 25 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 YA2 Regulation 14 Requirement Timescale for action 28/02/07 2 YA6 15 The registered person must not provide accommodation to a service user at the care home unless they have a suitable assessment by someone suitably qualified or trained. (more detail needs to be included on the assessment form). The registered person must 28/02/07 ensure a detailed care plan that is individualised to the service users is completed in line with the service user’s assessed needs (the care plan must link to the assessed needs). 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 YA35 Good Practice Recommendations The registered person should ensure that the number of staff who hold NVQ is increased to 50 . Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Birchwood Nursing Home DS0000025456.V322008.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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