Inspection on 19/12/05 for Barking Hall Nursing Home

This inspection was carried out on 19th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Barking Hall Nursing Home 13/10/08

Barking Hall Nursing Home 19/10/06

Barking Hall Nursing Home 06/03/06

Barking Hall Nursing Home 08/02/05

Barking Hall Nursing Home 25/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Barking Hall Nursing Home Barking Nr. Needham Market Suffolk IP6 8HJ Lead Inspector Helen Fontaine Unannounced Inspection 19th December 2005 10:00 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 Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Barking Hall Nursing Home Address Barking Nr. Needham Market Suffolk IP6 8HJ 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) 01449 720793 01449 722977 Pri-Med Group Ltd. Patricia Ellen Smaldon Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2005 Brief Description of the Service: Barking Hall is registered to provide care with nursing to 26 Older People. It is owned by the Pri-Med Group Ltd, a private company with a number of care homes in Suffolk. The home is situated a short distance away from Needham Market, a small rural town with amenities such as shops, public house, Doctors general practice and Post Office. The home over looks the countryside and adjacent to the local parish Church. The building is set in its own extensive grounds with car parking at the front and a patio area between the original house and the next extension. The accommodation is partly in a converted domestic dwelling and an extension nearly completed right across the back. All the existing rooms are en-suite as are the new rooms, all of which comprise of a shower, toilet and washbasin. The communal spaces are still in the process of being developed, but currently there is an entrance hall, dining room and a lounge. The extension will include a walkway to link the home, enclosed courtyard and a new kitchen. Once the development and refurbishment has been completed, the home will be able to offer care for up to 40 service users. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Barking Hall took place over five hours and was the first statutory inspection visit in the inspection programme for 2005/6. The manager of the home Patricia Smaldon; who is referred to as the matron, assisted the inspector; this term will be used throughout the report. During the inspection two residents were spoken to individually and a number of others during the lunchtime. A member of staff was spoken to, a tour of the building was undertaken and a number of records were looked at. What the service does well: The home is very nicely decorated and beautifully kept; the dining room was particularly nice with its original fireplace. All the rooms were very clean and the difficult issue of keeping the home clean but not clinical has been achieved. The rooms in the new extension were well equipped and the home’s needs for various storage and laundry facilities have been well thought out. The corridors are wide, giving a feeling of space and allowing free passage for all the staff and equipment needed. The staff were observed to be very polite and caring with the residents and during the lunchtime, they managed the balance between giving residents support and not standing over them while they ate their meal. The food was very good; the cook made a positive effort to meet the residents and make sure that everyone got what they wanted. The residents were offered drinks; this included a choice of red or white wine with their meals. All the residents spoken to commented on the good food, one lady said that they would get too fat if they were not careful. The staff are dedicated to the care and support of the residents and everyone spoken to said how well they were cared for. One visitor came to the office to say that their family member had improved beyond all expectations. They wanted it known that the care they received, was the very best their relative could have had. The staff member spoken to commented that they enjoyed working in the home and that the staff work together closely to achieve the best possible support for the residents. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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 Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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): 2,3 and 5 Admissions to the home are well planned but the home is not undertaking full assessments. Families and residents do have an opportunity to visit the home and establish its suitability. EVIDENCE: The home’s contract/statement was looked at and each new resident receives a statement of terms and conditions. The home gives the resident two copies of the terms and conditions and asks for both copies to be signed. The resident or family keeps one copy and the home keeps the other on the resident’s files. The document looked at had the resident’s date of issue, registration number and the document was numbered 1-15 covering; time of stay, one months’ trail period, subject to one months notice, residence in the home does not constitute a tenancy, fees and extra’s, fees paid by Local Authority, what the fees cover. The document also covered the areas of; residents temporarily away from the home and other areas such as queries and complaints. All the documents on residents files looked at had been signed with the room number that the resident was occupying. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 9 The files of three new residents were looked at during the inspection and two of the files evidenced, that the matron had not been out and done an assessment. The two residents in question had both been in hospital and the matron had done the assessment over the phone and with the families. The initial assessment form had a number of areas not completed and the matron said that these would be completed over the initial months trial. One resident’s relative spoken to said that their relative had come from hospital to the home and had a stomach infection; this was not documented on the initial assessment. The home must make sure that a qualified member of staff assesses every proposed resident and it is established that the home can meet their needs. The staff on duty do need adequate information to be able to ensure that the new residents needs are met. Although the new resident was spoken to and their relative felt that they were very well looked after and said that they were very much better than when they moved into the home, the resident themselves were not involved in the assessment process. The home’s initial assessment document was looked at and this was appropriate and in-depth. The initial assessment covered areas of basic information such as full name, date of birth, address, social history and health treatment history. The assessment had a dependency score, date of introductory visit and signature by the home’s staff. Another section covered the nursing dependency, safe environment, able to maintain own safety, with four headings scoring 1-4. Mobility, personal hygiene, elimination, eating and drinking were scored as, 18 as high, 10-18 medium and 0-10 low. This form completed prior to admission to the home would give more than enough information for the home and the staff to assess if the home can meet the needs of the resident. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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, 10 and 11 Service users have a comprehensive care plan and are assisted to access community health services. Service users feel that they are treated in a respectful manner and their privacy is upheld. EVIDENCE: The home’s care plans for each resident were set out in great detail, covering all their needs including their health care needs. The first sheet of the care plan had the resident’s consent form that the resident had read and been part of the development of the plan. The plan had the resident’s personal details and issues about what the residents like to be called. One resident’s file looked at indicated that the resident liked to be called a special name. The plan also covered information around the person to be contact in emergencies, medical details and diagnoses. Other areas covered were observations like, weight, height and blood pressure and when they had their flu jabs. There was a section around arrangements in the even of a residents death, it was documented one resident wanted the family to decide. This section documented issues around resuscitation, who the resident wanted contacted and if they had any special requests around funeral arrangements and which undertaker they wanted contacted. All the residents files looked at were all Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 11 completed in full and the matron said that sometimes it is difficult and upsetting for the residents and their families when they complete this section. As the home is a nursing home the care plan covers all areas of both social and health needs and the plan is colour coded to cover areas of; maintenance of safe environment which was red, communication orange, mobility green, breathing blue, eating and drinking gold, elimination lilac, personal cleansing and dressing white, control of body temperature cream, expressing sexuality salmon, social and spiritual needs pink, rest and sleep light yellow and pain control in terminal residents yellow. Each of the residents plans looked at had different coloured section, depending on their individual needs. Each of the of the coloured sections had been completed and each area also had a risk assessment. In addition to these sections there were the dependency scoring and the authorisation forms for the use of bed sides. On one of the sections the diabetic nurse had been involved, this was documented in large print that was easily seen by staff. There was also a section for documentation and reports from hospitals and consultants. The home also documented right at the front of the care plan the list of review dates; these were seen to be regularly undertaken for the three plans looked at. It was noted that all the previous paperwork was removed, rather than keeping it behind the new one. This kept the care plan used by the staff, up to date and clear. The plan ended with the daily notes and again only the notes applicable for the recent weeks were kept with the plan, keeping the care plan document from getting too big. The care plan clearly exceeded the National Minimum Standard and a great deal of hard work has gone into maintaining this documentation. The matron and the staff were observed treating the residents with great respect. The staff knocked on all doors before entering and during the resident’s lunch, carefully asked what each resident would like. None of the staff were seen talking to each other in the company of any resident and it was observed that staff treated the residents and each other with respect. However this did not detract from the homely atmosphere and good interaction that went on, it was noted that staff and residents could be heard laughing. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service can expect to be encouraged to maintain contact with family and friends, to be able to choose how they spend their time and to receive a balanced diet. EVIDENCE: The home’s care plan documentation covers area of lifestyle, expectations, social, cultural and religious needs. One resident spoken to said that they very much liked chatting to staff and when asked said that the staff did come and talk to them. Residents can choose to have their meals in their room, whilst others liked to have their meals in the dining room. Residents were observed chatting to each other over the meal and were offered either red or white wine with their lunch. The home’s cook was seen earlier in the morning, visiting each of the residents to ask what they would like to eat. All the residents spoken to during the tour of the home and during the lunchtime, all were very clear that they liked the food. The resident spoken to in their room said how much they liked the food despite the fact they were fussy over what they ate. The relative said that their family member was very thin on admission to the home and despite being in the home for a short period they had put on quite a bit of weight. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 13 The matron said that the home tried very hard to arrange activities and entertainment. However some of the residents were very frail and did not want to take part in anything that they arranged. The matron said that the home has a special activity volunteer on a Wednesday afternoon, some of the residents had been to a local school for a concert and dancers had come to the home. The home had recently had a Christmas party and there had been an entertainer. The matron said that some of the residents had been making Christmas decorations, leading up to the home’s party. The residents and relatives meeting minutes looked at, documented that there had been a Trafalgar day celebration. During the inspection there were a number of relatives and friends visiting. One relative came to the matron’s office and wanted the inspector to know how well the home had cared for their family member. The visitor said that their family member could not have got better care anywhere else and had improved beyond all expectation. One resident was leaving the home after a short stay to move to a home nearer their family; the relatives and the resident were heard to thank the matron and the staff for the excellent care they had received. The resident visited in their room with their relative also said how well they had been care for and the relative was equally as appreciative. This family member was more than happy and although the resident was expecting to return to their home when fully recovered, the family member would have been just as happy for them to remain in the home. The matron was clear though that if this resident wished to return home they would support and assist them to do this. The food was observed to be of the highest standard, there were choices and variety. During the midday meal, each resident’s preferences were met and there was still the choice of changing their minds if the meal that was served was not what they wanted. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service can expect that any complaint will be taken seriously and investigated and that they will be protected from abuse. EVIDENCE: The home’s complaints documentation was looked at during the inspection and the last complaint was in 2004. There were however a number of compliments, which out numbered the complaints completely. A number of residents were spoken to at various times during the inspection, all spoke very favourably that all concerns and complaints would be dealt with and listened to. The member of staff spoken to also said that they felt very sure that if they had any concerns it would be listened to. They were equally sure that if any of the residents were unhappy or had a complaint, it would be listened to and dealt with. The homes statement of purpose and terms and conditions documents complaints and is part of the pack given to anyone considering moving into the home. It is headed, part 1 our promise, part 2 how you can help residents/family to say how the home can improve. Part 3 tell us your views and the last sheet gives contacts numbers of the provider company, Commission for Social Care Inspection, the Local Authority and the Ombudsman. The member of staff spoken to also said that they were very sure that any adult abuse would be picked up. Residents spoken to when asked about adult abuse said that they felt very safe, the resident spoken to with their family was very sure that they would be safeguarded. The home’s policy and procedure for adult abuse was looked at and this documented the management of the abuse policy, definition of abuse, types of abuse, prevention of abuse and Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 15 dealing with abuse. The document was divided into sections, urgent, immediate and the risk has passed. This document also had the contact number for the Local Authority for both Suffolk and Norfolk. The home also had a rolling programme of training for Adult Abuse, this is currently in house training but the matron said covers it fully. The matron said that the home is currently arranging training for the staff from the Local Authority training team. The homes certificate for training covers, dealing with abuse, recognising the signs and symptoms abuse/neglect, recognise your contribution in reducing risk of abuse and recognising the actions to take in the event of abuse. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24 and 26 This home provides a clean and well-maintained environment for service users. The communal facilities are of a high standard and service users are able to personalise their own bedroom. EVIDENCE: The home is very well maintained with a homely atmosphere and is very clean and hygienic. The home has achieved the balance between being clean but not clinical, which when running a nursing home is not easy. All the areas were beautifully furnished, with a mixture of the old original house and the new extension. The new extension has large rooms with en-suite and wide corridors that allows everyone to access all areas of the home. In addition to the en-suites, there are additional toilets and bathrooms that give the residents a choice of either a shower or a bath. The residents have good quality furniture in their rooms and have personalised them with photos and ornaments. One resident visited in their room, despite having only been in the home for a short time had photos and ornaments of their own. The rooms allow plenty of space for equipment if it is needed and Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 17 the new extension has been designed to have storage spaces for all equipment that might be needed. The home has a brand new laundry room, this is large and gives the staff ample room to store and access the machines. Bed linen and towels are sent to a laundry, this is collected and delivered straight to the door from the laundry room. In addition to this the home has a number of washing machines and dryers for personal items needing washing. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 People who use this service can expect that the number of staff and the training they receive will allow their needs to be met, however they cannot be assured that the present recruitment checks will be sufficient to protect them. EVIDENCE: The staff on duty at the home consist of 1 qualified nurse on each shift, morning, afternoon and night. There are four carers on in the morning shift, three carers on in the late shift and 2 carers on at night. The matron is not part of the shifts; there is 1 cook and a kitchen assistant and 1 supper cook, three domestics, a handyman Tuesdays and Thursdays and another outside worker on Mondays, Wednesdays and Fridays. The home has access to an additional emergency handyman, who is on call if the home should need to. The home also has an admin assistant, who works three days a week. The homes staff training was looked at, seven staff have National Vocational Qualification level two and three have level one. One of the staff is now trained to National Vocational Qualification advanced level 1 assessor. The matron has the Diploma in management; this results in the home having more than 50 of its staff trained to the appropriate level. Staff files looked at was the newest member of staff and one that had worked at the home for sometime. Each of the files had a picture of the member of staff, the job application and interview form, health form and an interview from signed by the member of staff. The files also contained a new employers receipt form, personal declaration, Criminal Record Bureau check, criminal Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 19 convictions form, two references and Protection of Vulnerable Adults first check. In addition to training already mentioned in the report, the staff files had training records for health and safety, Parkinson’s disease, first aid, care planning, manual handling, communication skills and safe handling. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Residents can expect that their financial interests are safeguarded. EVIDENCE: The residents finances on the whole are dealt with by the relatives, the matron has a small amount of money for some of residents, which is kept in a locked, drawer. The home’s documentation around resident’s money was seen and each transaction had a receipt and was signed by two members of staff. The matron said some residents don’t have any money in the home that the families pay for anything they might need. Other residents look after their own money and the home has no involvement with how much they might have. Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 1 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 4 X 3 3 X 4 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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 OP3 Regulation 14(1) Timescale for action The registered manager must 19/01/06 ensure that all service users admitted into the home have had an assessment that they have been involved with. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Barking Hall Nursing Home DS0000037085.V274273.R01.S.doc Version 5.1 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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