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Inspection on 04/07/06 for Barrock Court Nursing Home

Also see our care home review for Barrock Court Nursing Home for more information

This inspection was carried out on 4th July 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Barrock Court is a small friendly home with a pleasant atmosphere and a dedicated staff team. There was good interaction between staff, residents and visitors. Residents enjoyed the meals served at Barrock Court and felt they had sufficient choice. The home was clean and fresh throughout, and residents said the staff were friendly, helpful and kind. The home worked well with outside agencies to ensure residents` specialist needs were met.

What has improved since the last inspection?

The standard of accommodation is continually improving through the ongoing redecoration programme. Improvements had been made to the provision of activities, although this could still be better. The manager had commenced formal staff supervision sessions. The way in which staff were deployed to work around the home had been changed, and this had improved the breakfast time routine.

What the care home could do better:

Following this inspection, five requirements were made for the home, to improve the consistency of residents` care plans, improve the recording of medicines given, increase the variety of activities on offer, raise staff awareness of adult protection and to improve staff training and training records. Three good practice recommendations were made to, improve the quality of pre-admission assessments, display a copy of the complaints procedure and lay tables properly for meals.

CARE HOMES FOR OLDER PEOPLE Barrock Court Nursing Home Barrock Park Low Hesket Carlisle Cumbria CA4 0JS Lead Inspector Jenny Donnelly Unannounced Inspection 4th July 2006 09:45 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 Barrock Court Nursing Home DS0000038773.V295560.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. Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barrock Court Nursing Home Address Barrock Park Low Hesket Carlisle Cumbria CA4 0JS 016974 73765 016974 73865 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) Ancyra Health Limited Mrs Roseanne Fearon Care Home 28 Category(ies) of Past or present alcohol dependence (1), Old registration, with number age, not falling within any other category (28), of places Physical disability (5) Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 28 service users to include: up to 28 service users in the category of OP (Old age, not falling within any other category) up to 5 service users in the category of PD (Physical disability under 65 years of age) 1 named service user in the category of A ( Alcohol dependant past/present) 11th January 2006 Date of last inspection Brief Description of the Service: Barrock Court nursing home was purpose built and is near Low Heskett at the end of a long driveway with fields and trees surrounding it. The home has its own internal courtyard that residents are able to enjoy in warmer weather. The building is on one level, divided into three units. These units accommodate residents of varying levels of dependency and each unit has its own lounge and bathing facilities. At the time of this key inspection, the weekly fees ranged from £468.00 to £591.00 according to the residents dependency. Information for prospective residents and relatives was available in the form of a service users guide. The homes’ latest inspection report was also available in the home. Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which comprised of gathering written information in the form of questionnaires, from residents, visitors and the manager of Barrock Court. I made an unannounced visit to the home on 4 July 2006. During this visit I toured the building, looked at residents’ care records, staff records, maintenance records, and spoke with residents, visitors and staff, in small groups and individually. I observed the general running of the day, including breakfast and lunchtime. The manager was not present at the time of this visit, so a second planned visit was made on 13 July 2006, to access information held by the manager. What the service does well: What has improved since the last inspection? What they could do better: Following this inspection, five requirements were made for the home, to improve the consistency of residents’ care plans, improve the recording of medicines given, increase the variety of activities on offer, raise staff awareness of adult protection and to improve staff training and training records. Three good practice recommendations were made to, improve the quality of pre-admission assessments, display a copy of the complaints procedure and lay tables properly for meals. Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 6 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. Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. The home gathered information about the needs of residents before they came to stay at Barrock Court. The way this information was gathered and recorded could be improved. This would better ensure that the home could meet the assessed needs of every new resident. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: The files of two new residents were inspected to see the quality of the information gathered about their needs, before they were offered a place in the home. In both cases there was good information, in the form of a detailed assessment and record of care needs from their social workers, although it was clear that not all staff had read these. There was also evidence that social workers had conducted a review of the placement after a settling in period. Where a social work assessment was not available, or the resident lived locally, the manager undertook her own assessment of the persons needs. This assessment was recorded on a blank sheet and did not follow any set format. It is recommended that a standard assessment tool be used, to ensure all the Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 9 areas required under the national minimum standards are included in every assessment. The home is not registered to provide dementia care, but a had a number of residents with mild dementia needs. Four staff completed a dementia care training programme last year, which is due to be repeated this year. Should the level of need for dementia care rise, the home should consider moving residents onto a registered dementia care facility, or applying to vary their own registration to include dementia. Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. The quality of residents care plans was inconsistent, with some care plans being much better than others. This could affect the quality of the actual care delivered to residents. The management of residents’ medicines was safe, although improvements could be made in the record keeping. Residents felt they were well treated by staff. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: Barrock Court had a good care planning system in place. A review of several care plans showed that individual nurses did not complete them to a similar standard. This meant the quality of the care planning information was inconsistent, and varied from very good to very poor. The records of two residents with wound care needs were assessed. In one case there was a detailed treatment and dressing plan, and a good record of changes and improvements to the wound. In another case there was no dressing plan at all, although the residents had a pressure sore and leg ulcers that were being attended to frequently. One residents’ care plan was at odds with the Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 11 information supplied their social worker. The consistency of the care plans needs to be improved. The care plans showed that residents had good access to healthcare professionals outside of the home, and professional advice and treatment had been sought were appropriate. The management of medicines was inspected and found to be satisfactory. Medicines were supplied along with administration record charts by the doctors’ surgery. The administration charts were a mixture of printed and handwritten, and the nurse on duty said this was how they were supplied to the home. The handwritten charts had been double signed to check the prescription was copied out correctly. The storage of medicines was tidy, and there were good records of amounts of medicine received into the home. Three administration charts showed several instances where medicines had not been signed as administered, and no reason for omission recorded. It was not possible to know if the residents had been given these medicines or not, and they were not optional items. The home needs to improve this. Residents said they were treated well by staff and that their dignity was upheld. Visitors confirmed that they had only observed staff treating residents well and speaking nicely to them. Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. There were limited opportunities for residents to partake in organised activites or be assisted with quiet occupation. Residents who had friends and family locally were able to go out of the home, but for others this was more difficult. Residents said they enjoyed the meals, and the cook would always do them an alternative to the main dish if they asked. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: The home employed an activities organiser for 15 hours a week over three days, giving one day for each unit of the home. However, some of the activity persons’ time was taken up helping with care duties and meals. During my first visit to the home, the activity person was working in the laundry all day. There was no set programme of activities as such. For an hour before lunch there was time to chat with residents, and for an hour or so after lunch an activity such as dominoes or bingo took place. There was also an occupational therapist who came into the home for 10 hours a week to do passive exercises and look at any behavioural needs of residents. The home did not have any transport so there was little opportunity for residents to go out unless they had relatives to take them. One resident said it would be lovely to visit the seaside and have an ice cream. The manager said there were visiting entertainers occasionally, and as the home is fully staffed, carers do have time to chat with Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 13 residents, look at magazines etc. The home can access a community minibus but it is difficult to book. Although a lot of work had been done to improve activities for residents, people were not really getting full use of the hours dedicated to activities and occupation. Visitors said they were welcome in the home at any time, were offered drinks, and the staff knew them and were friendly. Residents said they enjoyed their meals, and the cook knew what they liked. As the weather was very hot, some residents had lunch outside, under sunshades. The main meal was sausage pie with potatoes and vegetable followed by ginger sponge and custard. There was no alternative on the menu, but residents had been told in advance what the main meal was, so they had opportunity to ask for an alternative. One resident had asked for a ham salad and this was provided. The menu was fairly traditional consisting of casseroles, roasts and pies. This did not seem suitable for the very hot weather, but residents said it was what they liked. There were plenty of jugs of juice around the home, and staff were offering residents frequent top ups. Table setting was discussed with manager, as most place settings had just two spoons and no knife and fork, including the resident who had a salad. The manager said many residents liked to eat with a spoon, and this was safer for those residents being fed by staff. It is recommend that tables are set properly and residents can choose which piece of cutlery to use, and not feel they have to follow what other people do. Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. There was a clear complaints system in place through which people could raise any concerns they had. Residents and visitors were confident that should they have concerns, the manager would sort things out promptly. The home had clear procedures in place of the protection of vulnerable adults, but not all staff had received training in this area, and some did not not know how to respond to an allegation of abuse. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: The home had not received any complaints since the last inspection, and none had been made directly to the inspector. The homes’ complaints procedure was clear, telling people how to complain and giving timescales for an expected response. The complaints procedure is included in the service user guide, a copy of which is given to every resident/family. It is recommended a copy also be put on display in the home, for the benefit of other visitors. Residents and visitors were not really aware of the homes’ complaints procedure, but said if they had any concerns they would speak to the manager, and felt confident the matter would be dealt with swiftly. The home had policies and procedures in place for the protection of vulnerable adults (abuse) advising staff what to do in the event of any accusation being made. These also referred to the local multi-agency guidance for adult protection referrals. There was a training session for staff on adult protection, by an external trainer last year. Not all staff, including the manager, were able to attend this. Some of the staff spoken to say they had not received any Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 15 adult protection training, and were not clear about what to do should any incident or allegation occur. All staff must receive training in adult protection to ensure that any allegation made is properly handled, and that residents are protected. Barrock Court Nursing Home DS0000038773.V295560.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The home was purpose built and as such meets the practical needs of frail older people. Residents lived in a clean and pleasant environment, which was improving through the gradual upgrade of décoration. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: The home is purpose built and all on one level. There is good wheelchair access throughout the home, and external ramps where necessary. The home is divided into three units, with each having its’ own lounge and bathrooms. There were two dining rooms. The third dining room had not been used for a long time and had been converted into an office. There was still plenty of communal space the number of residents accommodated, although the lounge areas were overcrowded with furniture, which the manager cleared periodically. There was a smoking room for joint use between staff and residents. As well as ground to the front of the home, which overlooked the Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 17 surrounding countryside, there was an enclosed courtyard where residents could sit out, although one resident commented, “there isn’t much of a view from here”. All bedrooms had an en-suite toilet and basin. Units 1 and 2 had two bathrooms offering bathing and showering facilities. Unit 3 had a bath only, so anyone wishing to use a shower did so on another unit. There had been some decoration and new carpets provided since the last inspection. Bedroom carpets were being replaced at one each month. Two bedrooms were noted to smell unpleasant. One was due to a leaking ensuite that was booked for repair and would then have new flooring. In the other room, the problem was more difficult to manage, but there was a frequent cleaning and de-odorising programme in place. There were some minor repairs needed, a missing toilet seat and bathroom light that did not work. These had been attended by the second visit. With the exception of the two bedrooms mentioned above, the home was clean and fresh throughout. The laundry was in full operation throughout the day, and domestic staff were going about their duties. Visitors commented that the home was always “nice and clean”. Barrock Court Nursing Home DS0000038773.V295560.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. Residents were suppported by a committed and caring staff team, who were present in sufficient numbers to meet peoples’ needs. The planning, provision and recording of training could be improved to ensure all staff have attended training relevant to their role. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: Staffing levels were as expected, with one nurse and 5 carers on duty. A student nurse, 2 domestics, a handyman, an administrator and a cook and a kitchen assistant supported them. Inspection of staff files showed that there was standard company documentation in use to assist with sound recruitment procedures. Staff had completed application forms, attended for interview, references and criminal records bureau checks had been obtained. Staff files had recently been transferred onto a new format, which meant that some records were not fully up to date in respect of training. The method of recording staff training was not clear, photocopies of some training certificates were held on file whilst others were not. The manager had no easy way of checking which staff had attended what training events, without going through individual files. Fifty one percent of the care staff had an NVQ in care at level 2 or 3, with other care staff working towards achieving this, which is good. Some staff spoken with said they had attended a lot of training whilst others said they had not done much. Some staff had received training in adult Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 19 protection, infection control and safe use of chemicals (COSHH), whilst others had not. Staff spoken with had received fire training and training in the safe moving and handling of residents. All staff had at some point done basic food hygiene training, but this was now out of date for some. The home needs to improve training and training records and ensure that all staff receive appropriate and timely training for their role. Residents and visitors spoke well of the staff group, saying, “they are all nice girls”, “they are very good here”, and “if all places were like this, there would never be any problems”. The atmosphere in the home was pleasant and friendly. Barrock Court Nursing Home DS0000038773.V295560.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. Residents benefited from living in a well managed home, where they were consulted about their veiws and wishes. There were satisfactory arrangements in place to keep the building a safe place to live and work. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: The registered manager has been in post at Barrock Court for two years, and is suitably qualified for the post. The manager receives regular support in her role from the company who own the home. Quality assurance checks were in place and comprised of regular questionnaires to residents as well as the managers’ own audits. The residents’ questionnaires had covered different topics including the environment, the admission procedures and daily life in the home. The responses to these were generally uninformative, or not a true reflection as Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 21 staff had completed them for residents. The manager was considering doing a survey of relatives instead. The managers’ audits covered checks on care plans and medication records. These had last been carried out in April 2006 when shortfalls were found in both areas. The audit tool did not show how these shortfalls were followed up, but the manager said she alerted staff to them, and checked again a week later that the necessary improvements had been made. The home did not hold any money on behalf of residents. There were systems in place to promote and protect the health, safety and welfare of residents and staff. This was demonstrated through the regular fire safety checks, and staff fire and moving and handling training. The manager had submitted a list of last inspection dates to the inspector for the services within the home, such as water temperatures and electrical testing. Barrock Court Nursing Home DS0000038773.V295560.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 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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. 2. 3. Standard OP7 OP9 OP12 Regulation 15(2) 13(2) 16(2)m Requirement Every resident must have a plan of care that details all his or her current care needs. All medicines must be signed as administered, or a code for non administration entered. Service users must have more varied access to activities and occupation. (This was to have been met by 29/02/06) All staff must be familiar with the homes’ policies and procedures on adult protection. The home must ensure that all staff receive appropriate and timely training. Timescale for action 01/09/06 01/09/06 01/10/06 4. 5. OP18 13(6) 18(1)c 01/10/06 01/10/06 OP30 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 OP3 Good Practice Recommendations It is recommended that the home conduct pre-admission DS0000038773.V295560.R01.S.doc Version 5.2 Page 24 Barrock Court Nursing Home 2. 3. OP15 OP16 assessments using a standard assessment tool to ensure all assessments conform to a set standard. It is recommended that tables be laid with a full set of cutlery at meal times. There should be a copy of the homes’ complaints procedure on display. Barrock Court Nursing Home DS0000038773.V295560.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Barrock Court Nursing Home DS0000038773.V295560.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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