Inspection on 03/05/06 for Barton Court

This inspection was carried out on 3rd May 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.

Other inspections for this house

Barton Court 22/11/07

Barton Court 29/11/05

Barton Court 17/05/05

Barton Court 07/12/04

Barton Court 09/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Barton Court New Road Minster On Sea Sheppey Kent ME12 3PX Lead Inspector Sue McGrath Key Unannounced Inspection 3rd May 2006 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 Barton Court DS0000023901.V291724.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. Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Barton Court Address New Road Minster On Sea Sheppey Kent ME12 3PX 01795 878003 01795 871296 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) Kent Community Housing Trust Mrs Pamela Margaret Jones Care Home 41 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (16) of places Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. DE(E) is restricted to five (5) residents whose dates of birth are 11.02.1914, 24.08.1912, 29.09.1926, 03.05.1918, 06.11.1921 29th November 2005 Date of last inspection Brief Description of the Service: Barton Court is owned by Kent Community Housing Trust and is one of 10 homes in the Kent area, the company also have 8 homes in Bexley and 4 in Greenwich. The home occupies premises that were originally custom built for the local authority, but were taken over by KCHT some years ago. It provides accommodation for 41 older people, some of who have a diagnosis of dementia, these latter being accommodated in a designated unit. The home is within walking distance of the village of Minster and close to local shops and other amenities. It is near a bus route and is served by GPs from several local practises. There is a warm and friendly atmosphere within the home and visitors are made welcome at any time. The fees charged by this service range from £317 to £438 per week. Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 and took place on the 3rd May 2006 between 10.00 and 16.00. One inspector, Sue McGrath, was in the home and the main focus of the inspection was on the progress of the home in meeting with requirements made at the last inspection, the general environment and the well being of the residents. Under Inspecting for Better Lives this is considered to be a Key Inspection. The Inspector agreed and explained the inspection process with the Assistant Manager as the Registered Manager was not available. During the inspection documentation and records were read, including care plans. A tour of the building was undertaken and many of the residents and some visiting family members/friends were spoken to. Time was also spent talking to staff and members of the management team. Surveys were received from some residents and the pre inspection questionnaire was also completed. The inspector on leaving the home was satisfied that residents were both safe and well cared for. What the service does well: What has improved since the last inspection? Four of the bedrooms have been decorated since the last inspection and all rooms have been equipped with new bedside cabinets and commodes. The dining room has been upgraded to provide a better environment. The hallways are currently being redecorated. Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 6 Staff now benefit from regular supervision. 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. Barton Court DS0000023901.V291724.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 Barton Court DS0000023901.V291724.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): 1-6 Quality in this outcome area is good. The home’s Statement of Purpose and Service User Guide are comprehensive and provide prospective residents and their families with the information they need to make an informed choice about moving into the home. Service users benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. EVIDENCE: The home had a comprehensive Statement of Purpose and a Service User Guide, which was made available to all of the residents. Copies were seen in all Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 9 of the bedrooms. The acting manager was advised to ensure all staffing details were kept up to date. Details seen on residents files confirmed that all had written contracts, this was also confirmed by information gathered from Residents comments cards. As at previous inspections, the management team had completed pre admission assessments but no assessments from funding authorities were held. The Acting Manager confirmed that this information was difficult to obtain. The manager should continue to request and insist on receiving this information prior to starting a new service. Whilst visiting any prospective resident the home would decide whether their needs could be met in the home. Families would be involved where possible and the prospective resident and family would be invited to view the home, where possible. Normally the first four to six weeks would be a trial period. At the end of that time a review would be held and if the residents needs were being met, and they home judged as being suitable for the resident, they would be offered a permanent placement. The home does not offer intermediate care. Barton Court DS0000023901.V291724.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): 7-11 Quality in this outcome area is good. Whilst residents benefited from detailed care plans some areas of the plans need to improve. Health needs are met and service users benefit from having full access to all professional health care services as required. Service users are protected by the home’s policies and procedures for dealing with medicines. Residents are treated with respect and can be assured the home will handle the issue of illness and ageing sensitively. EVIDENCE: Four residents files were reviewed and it was found that they contained care plans and risk assessments. The acting manager explained that new care plans were being developed by the organisation and these were being gradually introduced. Information seen on the current care plans indicated that not all care plans were being regularly reviewed. Discussion took place about how best to record these reviews, as the current paperwork had the facilities to Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 11 review but the reviews were not being recorded as happening. Discussion focussed on how to ensure that regular reviews were carried out and the possibility of introducing a monitoring system into the key workers supervision session. Limited nutritional screening was being carried out and again information was given on various ways to implement this activity. The home does have its own chair scales. Discussion also took place on the best way to record the results of BM tests for the residents with diabetes. All of the residents were registered with a local G.P. and had full access to all medical and health care services as required. Regular eye test were being carried out. Information given on the pre-inspection questionnaire confirmed that three residents had pressure areas. It was identified that two of these arrived from hospital with the broken areas. The District Nurse was fully involved with the care of pressure areas and appropriate mattresses were in place. The home was managing the care appropriately. Medication was being appropriately administered. Several residents were spoken with and confirmed that they were happy with the level of care being provided and they felt their healthcare needs were being met. Several said that staff were always polite and they felt happy and safe at the home. They felt that staff respected their privacy and always knocked on doors before entering their rooms. Some visitors were also spoken with and again a positive response was given over the level of care received by their relatives. The home does have a policy and procedure on death and dying and discussion took place about how best to approach residents and family members on discussing this subject. Some care plans had wishes recorded and other did not. Discussion with the acting manager confirmed that the homes deals very compassionately with residents and families at this difficult time and that it was their intention to enable residents to remain in the home unless there are strong medical reasons to prevent this. Barton Court DS0000023901.V291724.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, 15 Quality in this outcome area is good. Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The residents benefit from the appetising meals and balanced diet offered by the home and those service users requiring specialist diets are well catered for. Residents social and recreational interest and needs are well provided for with a wide range of organised activities. EVIDENCE: Residents said that they had varied activities organised by staff but they missed going out for trips. The Acting Manager confirmed that the home still did not have use of a minibus although she thought one was on order and that it would be shared with nine other homes in the group. Discussion took place with one of the dedicated activities co-ordinators who confirmed that a weekly programme of activities was undertaken. The details of the programme were seen on the notice board. Activities for the residents in Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 13 the dementia unit were included in the daily programme and were well supported by the residents. Visitors confirmed they were always made very welcomed and that visiting times were very flexible with no real constraints. Visitors could meet in the resident’s room, the quiet area or, as mostly happens, in the lounge. On the day of the inspection a church service was taking place and it was confirmed that this was a monthly occurrence. Entertainers come into the home on a regular basis and one resident said it was the highlight of her stay. All of the residents spoken with confirmed that the food was very good and that they had a choice. Menus were seen and these indicated a balanced and wholesome diet was offered. Specialist diets, such as diabetic and soft diets, could be catered for. Liquefied diets were presented in a manner, which was appealing in terms of texture, flavour and appearance in order to maintain appetite and nutrition. The dining area had recently been refurbished and was much improved. It was evident during the inspection that residents were not rushed or hurried during their meals and the atmosphere was relaxed and comfortable. Barton Court DS0000023901.V291724.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): 16,17,18 Quality in this outcome area is good. Residents are protected by a robust complaints system and service users and relatives feel their views are listened to and acted upon. The home has robust adult protection policies and procedures to ensure that residents are protected from abuse EVIDENCE: Comments from relatives showed that they were aware of the complaints procedure but had never needed to use it. Several residents also confirmed they knew how to complain but again most issues were resolved before becoming a formal complaint. The good rapport between staff and residents enabled issues to be dealt with at an early stage. Three complaints had been received and all had been dealt with appropriately. Staff spoken with were familiar with the complaints procedure and were aware of the Whistle Blowing policy but again were happy to talk to senior staff at an early stage of any issues. All of the residents had postal votes if they wished and two preferred to visit the polling station at any election. Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 15 No evidence could be found that staff had received training in Adult Abuse although staff spoken to appeared familiar with the concept. Barton Court DS0000023901.V291724.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): Quality in this outcome area is adequate. Residents mainly benefit from living in a clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. Some areas need some refurbishment. Residents would benefit from more moving and handling equipment. EVIDENCE: The home employs a maintenance person who also monitors all of the Health and Safety checks. The home appears safe and fairly well maintained. The handyman was currently decorating the corridors. The home had 9 toilets, 3 bathrooms and 1 shower, however with the high dependency of the current Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 17 residents most of the toilets were too low. Several were slightly loose at the base and would be improved if new high-level pans were fitted. One area of concern was the high number of residents who required the use of a ‘Stand Aid’ hoist. The home had only one ‘Stand Aid’ hoist and with at least eighteen residents needing to use it on all manoeuvres, an extra hoist is required. The home will be required to purchase a further suitable hoist. The home has several lounges all of which were comfortable and clean. All were equipped with televisions and other electrical items. The main dining room had recently been redecorated and new flooring fitted. This was now more open and pleasant. The vinyl floor tiles in the corridors were showing signs of wear and although staff clearly were trying to maintain a high level of cleanliness, it was becoming increasingly difficult for them. The dementia unit had a very strong odour and the carpet in the lounge area needed to be replaced with appropriate flooring. The worktop in the kitchen/dining room also needed replacing, as the laminate had come away exposing the chipboard underneath. This could cause contamination, as it could not be cleaned sufficiently. All of the rooms had new lockable bedside cabinets and commodes. New ‘digilocks’ had been fitted to all of the upstairs doors. The door to the dementia unit was in the process of being improved. Four of the bedrooms had been decorated since the last inspection. Residents benefited from having a dedicated hairdressing room. Barton Court DS0000023901.V291724.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, 28, 29 and 30 Quality in this outcome area is adequate. The residents benefit from being cared for by sufficient staff who have an understanding of their needs and are committed to a good level of care. Residents could be put at risk from insufficient information held on some staff files. EVIDENCE: The pre-inspection questionnaire indicated that the home had 26 resident with a high dependency and 13 with a medium dependency (total of 39). A total of 795.5 staffing hours were required following the Residential Forum guidelines. The home currently has contracts for 796.5 hours according to the figures given. The home is currently registered for 41 Residents, however will only be using a maximum of 40. If the home admits to 40, it may need to increase staffing levels. The home is advised to monitor the dependency levels on a regular basis to ensure all needs are met. Residents and visitors spoken with complimented staff on how well residents were cared for. Some comments received from residents, via comment cards, highlighted their concerns that at busy times there were insufficient staffs. Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 19 Three staff files were viewed and again did not meet with all of the requirements of Schedule 2 of the Care Home Regulations. One contained only one reference and one other did not have any recorded proof of identity. Training undertaken in previous employment was recorded but no certificates to prove competences or even completion were held. Unless these certificates were made available, the training could not be confirmed and would need to be completed again. A requirement from the last inspection concerned staff files and this will remain in place. The manager is strongly advised to ensure that all staff files comply. A staff training matrix was made available and the acting manager stated that it was connected the companies headquarters for monitoring. This had helped to ensure that training needs were met. Each member of staff had an individual training record. On the matrix supplied to the Commission there was no indication of dates of course, so it was difficult to assess whether the training was current. The home is advised to record dates of when training had taken place. There was no evidence that staff had received Adult Protection training. Fourteen care staff and or Team Leaders had completed NVQ level 2 (40 ). This is below the required level of 50 . Two more staff were currently working towards their qualification (46 ). Barton Court DS0000023901.V291724.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): 31, 33,34,35,36,37,and 38 Quality in this outcome area is good. The residents benefit from having a manager who is supported well by senior staff in providing clear leadership throughout the home and by staff who demonstrate an awareness of their roles and responsibilities. Residents benefit from staff who are appropriately supervised by senior members of staff. Sound financial procedures protect residents. Apart from requiring another hoist, current arrangements were sufficient to protect the health, safety and welfare of residents and staff. Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 21 EVIDENCE: The Registered Manager was currently on sick leave and the Assistant Manager was acting up. It was evident that she was managing well in the absence of the Manager and appeared both confident and competent on the day of the inspection. The home completed effective quality assurance based on seeking the views of the Residents. The Acting Manager was unaware of any development plans for the home. The home appeared to be run in the best interests of the residents. Regulation 26 visits were taking place and the Commission kept informed of the outcomes. Regular residents meetings were taking place with minutes recorded. Staff have meetings, normally every 5-6 months. Appropriate procedures were in place to ensure that resident’s financial interests were safeguarded. Only a small amount of monies were held on their behalf. Two accounts were checked and were found to balance. Staff have now started to have regular supervision as required at the last inspection. All staff that deliver supervision have been appropriately trained. The home maintained competent records and had policies and procedures in place to ensure residents rights and best interest were protected. Policies and procedures were updated in September 2005. On the information made available on the day of the inspection, it was evident that apart for the need of an extra hoist, the residents and staff’s health, safety and welfare was being promoted and protected. Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 2 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 3 18 2 3 3 2 2 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 3 3 3 3 2 Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 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. Standard OP26 Regulation 16(2)(k) Requirement The Registered person shall having regard to the size of the care home and the number and needs of the Service Users keep the home free from offensive odours - this instance refers to the lounge in the dementia unit. This requirement has been carried over from the last report. Action Plan required The Registered person shall not employ a person to work at the care home unless - subject to paragraph (6), he has obtained in respect of that person the information and documents specified in - paragraph 1 - 6 0f Schedule 2. Particularly photographic identification, copy of birth certificate and passport where available. Two references must also be obtained. This requirement has been carried over from the last report. Action Plan required DS0000023901.V291724.R01.S.doc Timescale for action 25/06/06 2. OP29 19(1) (b)(i) 25/06/06 Barton Court Version 5.1 Page 24 3. OP21 23 4 OP18 13(6) 5 OP22 23(2)(n) 6 OP19 23(2)(d) The Registered Person shall having regard to the number and needs of the service users ensure that the toilets are suitable to meet the needs of the service users, in that raised toilets are provided. Action Plan required The Registered Person shall ensure that all staff are trained in Adult Protection procedures. Action Plan required The Registered Person shall having regard to the number and needs of the Residents ensure that suitable adaptations are made, and such support, equipment and facilities as may be required are provided. In that one more suitable hoist is obtained. Action Plan required The Registered Person shall having regard to the number and needs of the Residents ensure that all parts of the care home are kept clean and reasonably decorated in that the work surface in the kitchen in the dementia unit is replaced. Action Plan required 25/06/06 25/06/06 25/06/06 25/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations The Registered person must make every effort to obtain a copy of the care manager assessment, as well as carrying out their own assessment of needs prior to a placement taking place. Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 25 2. OP7 The new risk assessment form shows the risk rating of the risk to be addressed, it may be helpful to include the outcome risk rating following the implemented work practice and strategies to reduce the initial risk rating. The quality of the Residents life could be enhanced if the company could provide the home with transport suitable to the needs of service users. It is recommended that care plans are regularly reviewed and recorded as reviewed. It is recommended that BM testing is better recorded, as discussed. It is recommended that nutritional screening is undertaken as part of the admission process and ongoing care records. It is recommended the homes ensure a minimum of 50 of staff attain NVQ level 2 3. OP13 4 5 6 7 OP7 OP7 OP7 OP28 Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Barton Court DS0000023901.V291724.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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