Care Home: Ash-Croft House Care Home

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What the care home does well An assessment of service users` care needs is carried out before they move into the home. Staff who administer medication are trained so they are aware of their responsibilities and know how to work safely. Staff ensure service users are treated with respect and their right to privacy is upheld. During the visit staff spoke to service users in a polite and friendly manner and service users appeared comfortable in their company. One service user said `The staff are very good when they help me with my personal care`. Another service user said `The staff are gorgeous and can`t do enough for you`. Service users` friends and family can visit at any time so they can maintain personal relationships and continue to be part of family life. Most of the service users said they enjoy the food and always have plenty to eat and drink. They all said they have a choice of meal. One service user said `The food is fine, it`s the same as you get at home`. Another service user said `The food is excellent and there is always plenty to eat. We always have a choice`. Another service user said `The food is not bad but sometimes a bit bland. Sometimes the desserts are like children`s food`. A complaint procedure is available to service users and their relatives so they know what to do if they are unhappy with the standard of care they receive. The service users spoken to during the visit said they were happy with the support and care they receive and had no complaints to make. Care staff have completed training on how to safeguard adults from abuse. The service users said the staff are kind and friendly and they have never been spoken to or treated badly. One service user said `The staff are good, I have no problems`. Another service user said `The staff are never abusive`. There is training to the National Vocational Qualification standards which is a recognised qualification for staff involved in the care profession. Staff are provided with regular ongoing training to support them in their role and keep them up to date with new ways of working. The recruitment and selection procedures ensure suitably qualified and competent staff are employed. Newly appointed staff now receive induction training to ensure they are clear on their responsibilities and know what is expected of them. The staff spoken to during the visit said they enjoy their work and feel well supported in their role. Health and safety in the building has improved since the last visit. Staff have completed more training and regular audits are carried out. What has improved since the last inspection? Since the last inspection improvements have been made to the care plans and the promotion of health and safety. Staff are now provided with more in depth induction training when they begin working at the home and the ongoing training programme has improved. What the care home could do better: A broader range of social activities need to be provided to prevent service users from becoming board. The condition of the building needs to be improved to provide service users with a more pleasant and comfortable place to live. Improvement should be made to the quality assurance systems to ensure the ongoing improvement of the service. CARE HOMES FOR OLDER PEOPLE Ash-Croft House Care Home 10-12 Elson Road Formby Merseyside L37 2EG Lead Inspector Inger Moynihan Key Unannounced Inspection 18th August 2009 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 Ash-Croft House Care Home DS0000064981.V374762.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. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ash-Croft House Care Home Address 10-12 Elson Road Formby Merseyside L37 2EG 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) 01704 874448 01704 879260 ashcroft@cedarscaregroup.co.uk Cedars Care Group Limited Mrs Diane Furnivall Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 31 Date of last inspection 12th June 2008 Brief Description of the Service: Ashcroft House is a care home registered to provide nursing care for thirty one older persons. The home is situated in Formby and is privately owned. The owner has other homes in the Southport area and these are collectively known as Cedars Care Group. The area around the home is mainly residential and there are local areas of interest such as the squirrel reserve. There are local shops near to Ashcroft House and a main train and bus route within easy walking distance. The accommodation is converted from two previous houses. There are two main lounges - a quieter lounge and a lounge that also provides dining space. There are twenty five single rooms and three double rooms, two rooms have ensuite facilities. Five of the bedrooms are situated up a small number of staged steps called a link corridor. There is no ramp or a stair lift to access them. There are four bathrooms and three shower rooms with aids to assist residents who are less independent. Residents have the use of a call bell with an alarm when they require assistance. There are gardens to the front and the rear of the premises. A large car park area is located at the front. Ashcroft House is a non-smoking building. The weekly fee ranges from £560.00 - £580.00 for the accommodation. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 5 Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. Information about the home was obtained through discussion with the deputy manager and members of the staff team. Policies, procedures and supporting documentation were also looked at along with a selection of service users case files. We also obtained information from the Annual Quality Assurance Assessment (AQAA). The AQAA if a self assessment document that is filled in once a year by all providers. It is one of the ways that we get information from providers about how they are meeting outcomes for people using the service. A part of the inspection process includes sending surveys to service users and staff in order to obtain their views on the standard of the service provided. No surveys were returned to us. What the service does well: An assessment of service users’ care needs is carried out before they move into the home. Staff who administer medication are trained so they are aware of their responsibilities and know how to work safely. Staff ensure service users are treated with respect and their right to privacy is upheld. During the visit staff spoke to service users in a polite and friendly manner and service users appeared comfortable in their company. One service user said ‘The staff are very good when they help me with my personal care. Another service user said ‘The staff are gorgeous and cant do enough for you’. Service users’ friends and family can visit at any time so they can maintain personal relationships and continue to be part of family life. Most of the service users said they enjoy the food and always have plenty to eat and drink. They all said they have a choice of meal. One service user said ‘The food is fine, it’s the same as you get at home’. Another service user said ‘The food is excellent and there is always plenty to eat. We always have a choice’. Another service user said ‘The food is not bad but sometimes a bit bland. Sometimes the desserts are like children’s food’. A complaint procedure is available to service users and their relatives so they know what to do if they are unhappy with the standard of care they receive. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 7 The service users spoken to during the visit said they were happy with the support and care they receive and had no complaints to make. Care staff have completed training on how to safeguard adults from abuse. The service users said the staff are kind and friendly and they have never been spoken to or treated badly. One service user said ‘The staff are good, I have no problems’. Another service user said ‘The staff are never abusive’. There is training to the National Vocational Qualification standards which is a recognised qualification for staff involved in the care profession. Staff are provided with regular ongoing training to support them in their role and keep them up to date with new ways of working. The recruitment and selection procedures ensure suitably qualified and competent staff are employed. Newly appointed staff now receive induction training to ensure they are clear on their responsibilities and know what is expected of them. The staff spoken to during the visit said they enjoy their work and feel well supported in their role. Health and safety in the building has improved since the last visit. Staff have completed more training and regular audits are carried out. 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. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 8 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. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 9 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 Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ care needs are assessed before a service is offered so they know they will receive the care and support they need. EVIDENCE: An assessment of service users’ care needs is carried out before they move into the home. Service users, their family and any relevant health care professional can contribute to the assessment to ensure the staff have the information they need on how to provide the right level of care. Issues relating to equality and diversity such as service users’ disability, gender, age and religion are addressed to ensure their holistic care needs are met. Intermediate care is not provided at Ash Croft House. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ care needs are identified which means staff have instruction on how to provide the appropriate level of care. EVIDENCE: A plan of the care given to each service user is in place and provides staff with information on how to look after the service users in line with their individual care needs. Service users’ general welfare is monitored daily and staff will seek advice from different health care professionals as required. Systems are in place for the administration of service users’ medication. Appropriate facilities are provided for the safe storage of medication and supporting policies and procedures are available to staff should they need more information or clarification on a specific issue. Staff who administer medication are trained in this area of care so they are aware of their responsibilities and know how to work safely. Service users spoken to during the visit said they always received their medication on time. The medication administration record sheets were accurately maintained. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 12 The staff spoken to demonstrated an understanding of how to ensure service users are treated with respect and their right to privacy is upheld. During the visit staff spoke to service users in a polite and friendly manner and service users appeared comfortable in their company. One service user said ‘The staff are very good when they help me with my personal care. Another service user said ‘The staff are gorgeous and cant do enough for you’. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily routines are flexible, although the lack of social activity means service users are not provided with a stimulating environment and may become bored. EVIDENCE: Social activities are provided and birthdays are always celebrated along with seasonal celebrations. Service users gave mixed comments about the activities. One service user said ‘The activities are abysmal. When they do take place I don’t join in and the staff respect this’. Another service user said ‘There are exercises each Wednesday and occasional singers but nothing else’. To ensure service users have an opportunity to meet with the other people living at the home and to prevent them from becoming bored, a broader range of activities should be provided which reflect service users’ interests. Service users’ friends and family can visit at any time so they can maintain personal relationships and continue to be part of family life. The service users said the home’s routines are flexible which means they can make decisions for themselves and go about their day as they wish. Service users can bring their Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 14 personal belongings into the home so they can make their room more homely and comfortable. Service users’ dietary requirements are assessed when they first move into the home so the staff can provide meals they enjoy. A four week menu is in place and diets based around service users’ medical needs are catered for. Staff are available to help service users with their meals if needed and service users can eat in their own room if they wish. Plenty of drinks and snacks are provided throughout the day. A copy of the menu should be displayed in service users’ rooms so they can decide what to eat. All but one service users said they enjoy the food. They all confirmed there is always plenty to eat and drink and a choice of meal is provided. One service user said ‘The food is fine, it’s the same as you get at home’. Another service user said ‘The food is excellent and there is always plenty to eat. We always have a choice’. Another service user said ‘The food is not bad but sometimes a bit bland. Sometimes the desserts are like children’s food’. Service users cannot have their meals together as there are insufficient dining room tables. Consequently some have to eat in the lounge using smaller side tables. This situation is not ideal and the manager should review this to ensure service users have opportunity to eat at the dining room table. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaint procedure ensures complaints are taken seriously and acted upon. The safeguarding procedures ensure service users are properly protected from abuse and harm. EVIDENCE: A complaint procedure is available to service users and their relatives so they know what to do if they are unhappy with the standard of care they receive. The manager has received one complaint since last inspection in 2008. This complaint has been investigated and concluded. The service users spoken to during the visit said they were happy with the support and care they receive and had no complaints to make. Care staff have completed training on how to safeguard adults from abuse. During discussion they gave a basic understanding of the different types of abuse that can occur and what they should do if they know or suspect abuse is taking place. A whistle blowing procedure is in place so that staff can raise concerns anonymously. No allegations of abuse have been made at the home. The service users said the staff are kind and friendly and they have never been spoken to or treated badly. One service user said ‘The staff are good, I have no problems’. Another service user said ‘The staff are never abusive’. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area adequate. This judgement has been made using available evidence including a visit to this service. The condition of the building does not provide a pleasant and comfortable place to live. EVIDENCE: The maintenance of the home remains an ongoing concern and the recommendations issued at previous inspections have not been met. The bathrooms, toilets and some en suites need redecorating. Some lighting was dingy, baths and sinks were stained and the general maintenance was not to an acceptable standard. Lino was stained and water piping and tile grouting was blackened. One bathroom was being used as a store room. The bedrooms were of a mixed standard. Some were quite pleasant and service users had personalised their rooms with their own belongings. Other rooms needed redecorating. In some bedrooms the furniture was damaged and carpets were stained. Radiators and doors were scratched and dirty and Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 17 ceilings needed painting. There was a damp patch on the ceiling in one room and another smelt of urine. Maintenance staff complete jobs each week and while staff acknowledged that improvements have been made in this area, jobs still build up and the maintenance staff could do with more hours to complete their work. There is a large garden at the back of the home with a seating area which service users can use when the weather is good. The garden was not well maintained and it was reported that no improvements have been made to this area since the last inspection. The general maintenance of the garden should be improved so that service users can enjoy spending time there. The staff smoking area was also in the garden. This area was poorly maintained with dirty and damaged furniture. It is not appropriate to have the staff smoking area in the garden as this is for service users’ use. Systems are in place to prevent the spread of infection and there are sufficient laundry facilities for the number of people living at the home. The condition of the laundry needs to be improved to ensure good hygiene standards are maintained. The floor needs to be made permeable and the window and outside door need repairing. Policies and procedures are available to staff so they know how to work safely. These policies are currently being reviewed to ensure they are in line with current good practice. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment and selection procedures ensure suitably qualified and competent staff are employed. EVIDENCE: The deputy manager reported there are sufficient staff employed at the home to support the number of service users living there. There is training to the National Vocational Qualification standards which is a recognised qualification for staff involved in the care profession. Staff are provided with regular ongoing training to support them in their role and keep them up to date with new ways of working. This training covers a range of issues including health and safety, dementia care and equality and diversity. The recruitment and selection procedures ensure suitably qualified and competent staff are employed. Appropriate checks are completed prior to staff being employed. All staff have completed a Criminal Record Bureau (CRB) check. Newly appointed staff now receive induction training which is in line with Skills the Care, which is the recognised training programme for staff involved in the care profession. This means they are clear on their responsibilities and know what is expected of them. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 19 Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management systems ensure the ongoing improvement and effective running of the home. EVIDENCE: The manager, Diane Furnivall, has been working at the home since May 2008 and since this time she has improved the service and addressed most of the requirements and recommendations made at the last visit. The staff spoken to during the visit spoke highly of the manager and said she was very approachable and hard-working. Systems are in place to ensure the ongoing improvement of the service. However improvements need to be made to these systems to ensure all areas Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 21 of the home are improved and service users receive a good standard of care. Service users are spoken to about the care they receive through daily contact with staff and monthly meetings. While service users’ relatives are surveyed for their views of the standard of care provided, service users have not yet been formally consulted this year. Staff do not take responsibility for managing service users’ finances. The staff spoken to during the visit said they enjoy their work and feel well supported in their role. They confirmed the manager or a senior member of staff is always available for advice and support. The manager meets with them regularly to give support and discuss how they are working and they receive an annual appraisal. This support system ensures staff are clear on their responsibilities and gives them an opportunity to develop in their role. Health and safety in the building has improved since the last visit. Staff have completed more training and regular audits are carried out. The AQAA indicated that a range of policies and procedures are available to support staff in their role and ensure they are clear on the responsibilities and know how to work safely. A couple of issues arose during the visit which required attention which were addressed at the time of the visit. Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 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 2 X 3 3 X 2 Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 23 Requirement A programme of renewal of the fabric and decoration of the care home must be produced and implemented with records kept, to ensure that people live in a comfortable and homely environment that is safe and well maintained. Timescale for action 30/10/09 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 OP12 Good Practice Recommendations A structured activities programme should be introduced so that service users have an opportunity to meet with the other people living in the home and prevent them from becoming bored. DS0000064981.V374762.R01.S.doc Version 5.2 Page 24 Ash-Croft House Care Home 2. OP19 The refurbishment of bedrooms and bathrooms should take place and maintenance staff be allocated more hours for the completion of day-to-day jobs. This will provide service users with a more comfortable and homely place to live. The general maintenance of the gardens should be improved so that service users can enjoy sitting there when the weather is good. A Criminal Records Bureau check should be completed every three years for each member of staff to ensure they continue to be suitable to work at the home. Service users should be given satisfaction questionnaires to fill in so they can express their views on the standard of the service they receive. More effective quality assurance systems should be introduced to ensure the ongoing improvement of the service. 3. OP20 4. OP29 5. OP33 6. OP33 Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 25 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.gsi.gov.uk Web: www.cqc.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 Ash-Croft House Care Home DS0000064981.V374762.R01.S.doc Version 5.2 Page 26 - 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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