Inspection on 23/05/05 for Holy Cross Priory Nursing Unit

This inspection was carried out on 23rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Holy Cross Priory Nursing Unit 03/11/08

Holy Cross Priory Nursing Unit 29/11/06

Holy Cross Priory Nursing Unit 11/10/05

Holy Cross Priory Nursing Unit 29/09/04

Holy Cross Priory Nursing Unit 28/04/04

Holy Cross Priory Nursing Unit 30/09/03

Holy Cross Priory Nursing Unit 01/07/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Holy Cross Nursing Unit Cross in Hand Heathfield East Sussex TN21 0TS Lead Inspector Niki Palmer Unannounced 23 May 2005 09:00 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 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. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Holy Cross Nursing Unit Address Cross In Hand Heathfield East Sussex TN21 0TS 01435 763764 01435 867843 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Sister Antonia Keehan Sister Benedicta (Acting Manager) Care Home (CRH) 21 Category(ies) of Old age, not falling within any other category registration, with number (OP) 21 of places Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only service users requiring nursing care are to be accommodated. 2. Service users should be aged sixty five (65) years or over on admission. 3. That no more than twenty one (21) service users are to be accommodated. Date of last inspection 29 September 2004 Brief Description of the Service: Holy Cross Priory Nursing Unit is a purpose built extension to The Priory residential care home. It is owned by the Grace and Compassion Benedictine Society (Charitable Trust) and run by the Benedictine Sisters of our Lady Grace and Compassion, which is a Catholic order. It is situated in Cross-in-Hand, approximately three miles from Heathfield village. The unit is attached by a corridor to The priory and is staffed and run as a completely separate home apart from the shared laundry and main kitchen. The residents enjoy a lounge and separate dining area, they can also use the facilities of The Priory if they wish. On site is a hairdressing room as well as a chapel. There are extensive attractive gardens that are accessible to residents and used when the weather permits. The Holy Cross Nursing Unit is registered to provide general nursing care for 21 service users and admits residents who are either privately funded or funded by social services. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Holy Cross Nursing Unit will be referred to as ‘residents’. This unannounced inspection took place on a Monday between 09.00am and 2.30pm. The inspection began with discussions with the acting up manager (Sister Margaret) in the absence of the acting manager (Sister Benedicta) of the care home in respect of progress made since the last inspection, followed by the examination of six care records. In order to gather evidence on how the home is performing, individual discussions took place with six residents, whilst others commented on their care during lunchtime, the inspector having been invited to join them for a meal. In addition, two nursing staff, two carers and one visiting relative were spoken with during the visit. Eighteen residents were accommodated at the time of the inspection. A detailed inspection of the premises and its facilities took place. What the service does well: What has improved since the last inspection? All new prospective residents are provided with a variety of information to help them in their decision of where to live. More choice is now offered regarding the furnishing of bedrooms. The environment is more homely and many aspects of the home safer. New nursing and care staff have been recruited to meet the needs of residents in a robust manner, which safeguards residents. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 6 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. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 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 standard(s) 1, 3 and 6. All residents and relatives are provided with sufficient information and opportunities to help them judge if the home is appropriate for them. The preadmission assessment needs to demonstrate that the home can meet individual needs. EVIDENCE: The home’s Statement of Purpose was updated in December 2004 in response to a requirement made in the last report. It now includes details of the age range and gender of the residents the home can accommodate; the range of needs that the home intends to meet; the home’s admission criteria; arrangements for dealing with complaints and a statement of the physical environment. A copy of this was displayed in the reception area. In addition, the home has also updated its resident [service user] guide. One of the resident’s spoken with said that she was aware of the home’s written information and had copies of both documents in her bedroom. One of the relatives confirmed that his grandmother lived at Holy Cross for a number of years. The staff’s “commitment and kindness” and “good experience” of the home supported his decision to move his mother in to Holy Cross some years later. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 9 When a room becomes available at Holy Cross, priority is always given to people within The Priory. In this situation, information is handed over to nursing staff as part of the assessment process. If an existing resident within the service does not require a place then the acting manager contacts those on the waiting list. Three pre-admission assessments were seen, one of which was for a person who had been on the waiting list since 2001. In this case the assessment identified that she had no nursing needs at that time. Although the acting manager said that the individual had been reviewed in May 2005, there was no written evidence that this had happened. The other two assessments seen were found to contain information covering all areas of daily living such as personal care, well-being and mobility, but did not provide any further information regarding how the home could meet individual needs such as continence and reducing the risk of falls. In addition, it was confirmed by the acting up manager and another registered nurse on duty that they had recently both undertaken separate preassessments prior to admission. It was a requirement from a monitoring visit carried out on 06th December 2004 that all assessments should be carried out by the acting manager to ensure that she is fully aware of prospective residents. Intermediate care is not offered. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 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 standard(s) 7 and 10. The current care planning systems in place do not ensure that the health care needs of residents are identified, met and risks reduced. These shortfalls have the potential to place residents at risk. EVIDENCE: It was confirmed by a registered nurse that the home currently uses a ‘named nurse system’. This means that each resident has an identified person who is responsible for admitting them, devising their plan of care and ensuring that it is regularly updated. Four individual plans of care were seen during the inspection. Where care needs had been identified the plans did not set out in detail the action which needs to be taken by care staff. For example, where three of the residents had a history of falls, a risk assessment had been carried out, but did not provide any evidence of the preventative measures to be taken in accordance with recent clinical guidelines produced by the National Institute of Clinical Excellence for the prevention of falls. All falls are recorded in a separate book outlining the day, time and place of fall, a description of what happened and what action was taken. There was no evidence that risk assessments or care plans were reviewed in order to minimise further risks of falling. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 11 Three of the residents spoken with and one relative confirmed that they are kept informed of their care needs and have their plans of care shared with them on a regular basis. Throughout the inspection, all staffed were found to treat residents with care, respect and dignity. Good practice was observed when staff entered residents’ rooms. All residents confirmed that they are treated with courtesy and politeness and are addressed by their preferred term. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 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 standard(s) 12, 13 and 15. The arrangements in place for daily life and social activities are very good. The variety and temperature of meals needs to be improved. EVIDENCE: A part-time activities coordinator is employed by the home who is responsible for arranging a variety of activities and outings. A day trip to Eastbourne is planned for July 2005. Residents’ likes, dislikes and social preferences are recorded in their care plans. Two residents confirmed that in the daytime they may play a game of cards, musical bingo, reminiscence or gentle exercise. One resident stated that “there’s a lot more going on now than six months ago”. Nursing staff, residents and visitors to the home confirmed that relatives and friends are made to feel welcome at anytime of the day. One relative stated that he is “always made to feel welcome by the staff” and that he always finds the home to be “friendly with a good atmosphere”. All main meals are prepared in the kitchen, which is in Holy Cross Priory. The cook devises a menu on a two-week basis. From the menus seen, there are usually three options are offered, one fish dish and two meat dishes, however it was concerning to note that the two meat dishes were very similar, for example beef stew or beef curry. Vegetables are now being offered and Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 13 recorded. Each resident is given their choice of lunchtime meal in the morning, the options are written on a white board in the dining area. Most of the residents eat their lunch in the dining room, but some choose to eat in their rooms. The lunchtime meal on the day of inspection was found to be tasty and nutritious, but not particularly hot. This has been an ongoing concern for some residents and staff prior to the last inspection. Comments include; “it’s very good but not as hot as it should be”, and “usually good, but sometimes there’s not always a lot, but you can always ask for more”. A requirement has been made in respect of kitchen staff liaising with residents around their choice for the menus and exploring the different options available for keeping the food hot. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 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 standard(s) 18. The home has adequate procedures in place to ensure that residents are protected from harm, neglect and abuse. EVIDENCE: The home has recently revised its Adult Protection Policy (March 2005), however it did not provide any information regarding POVA (Protection of Vulnerable Adults). Staff spoken with appeared to have a good understanding of what constitutes abuse and the actions that they would take in the event of suspecting abuse. One newly appointed member of staff confirmed that she and other nursing staff had recently undertaken training around the protection of vulnerable adults and that she would feel confident in reporting any concerns that she had. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19, 20, 24 and 26 Improvements have been made to the overall environment of the home to ensure the health and safety of residents and staff. EVIDENCE: Since the previous inspection a lock and radiator guard have been fitted to the recently converted bedroom, which is now occupied. Those residents’ whose rooms were overlooked have been given the choice of net curtains and consequently they have been hung in two of the rooms. The kitchenette door is now kept closed when not in use, however it is required that a risk assessment is completed to ensure the safety of residents at all times. The paving area on the rear garden patio has been made level, no longer presenting as a trip hazard to residents and staff. Strip lighting in the living room area has been replaced with a domestic style lampshade and the laundry floor has been covered with suitable flooring that is easy to clean. All of the residents confirmed that they have been given a choice of whether to have linoleum flooring or carpet in each of their bedrooms. To date, only one Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 16 resident has chosen carpeting. All choices are clearly recorded in their care plans and terms and conditions of contract. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. Staffing arrangements and numbers were satisfactory to meet the needs of residents, and recruitment procedures are improved to help ensure the safety of residents. EVIDENCE: On the day of inspection, there were three registered nurses and four carers on duty in addition to the acting manager. It was confirmed by staff and the rotas seen that staffing levels have improved since the last inspection, however it was concerning to note that two of the residents and visitor to the home did not feel that the levels were always adequate. One resident commented “agency staff have been used in the last few weeks, which made it tough on the others”, and another said “staffing could be more, they’re sometimes pushed”. This was discussed with the acting manager who stated that additional staff are employed as necessary, and that the home has worked hard to address it’s staff shortages. A recommendation has been made for the home to review its staffing levels. A total of 14 care staff are employed, six of which have achieved NVQ level 2 or above, this standard is almost met. Three staff recruitment files were checked which found that the home now ensures that two satisfactory references, a police record and POVA check are obtained prior to employment. One newly appointed member of staff said that she was supernumerary for the first three days and that her induction was completed alongside the acting manager and other nursing staff. She felt that her induction to the home was sufficient. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36, 37 and 38. Some progress has been made towards management and administration procedures, this has resulted in health and safety practices being improved to safeguard the well being of residents and staff. EVIDENCE: The current acting manager who was not available on the day of inspection has been in post since November 2004 prior to this she was the deputy manager of the nursing home. She is due to commence her NVQ level 4 in management and is considering applying to the Commission for Social Care to become the registered manager of the home. Through discussion with staff, residents, visitors and examination of the homes documentation, it was clear that the home is currently being managed effectively with a sense of leadership and direction being offered. It was however concerning to note that the acting up manager in her absence had only been in post since April 2005, and had recently qualified as a first level registered nurse in February 2005. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 19 The staffing rotas confirmed that additional time is now set-aside for the acting manager to carry out her management duties. Nursing duties are only carried out in an emergency. Residents’ questionnaires are in place covering seven main areas: choice, meeting needs, promoting normality, protection, environment, staff and management. The quality assurance policy states that the questionnaire will be given out twice a year. The most recent results were analysed in February 2004. Each of the individual questions and answers were broken down into a percentage basis, which did not make the results easy to read or understand. Four staff training and supervision records were seen. Only one provided evidence of recent supervision. Nursing staff who are expected to supervise others said that the only training provided was a video and therefore they did not feel competent in undertaking this role. A business and development plan was drawn up in March 2005. It includes a mission statement, business assumptions, the home’s philosophy of care and a summary of accounts for the previous three years. It was concerning to note that within the business plan, the home gives a list of each of the National Minimum Standards and states that the home has achieved each one. It is recommended that the home remove this section from the plan, as it is the Commission for Social Care Inspection that determines whether or not a standard is considered met. Regulation 26 visits are being undertaken on a regular basis. Since the last inspection a risk assessment for the use of a portable heater in a resident’s bedroom has been completed, and the risks minimised. All hazardous cleaning materials are now stored securely in the kitchenette area away form residents. The rear fire exit route has also been risk assessed to ensure that it provides a safe exit from the home. On the day of the inspection, all staff were noted to have suitable and appropriate footwear in order to carry out their duties safely. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 2 x 2 x x 2 3 3 Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? 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)(a) (2)(a)(b) Requirement That prospective residents who are placed on the waiting list have their needs reviewed on a regular basis. This must be recorded. That the pre-admission assessment document is improved upon to demonstrate how the home can meet individuals assessed needs particularly in areas such as continence and reducing the risk of falls and are only completed by the acting manager [THIS IS OUSTANDING FROM A MONITORING VISIT CARRIED OUT ON 06/12/04]. It is required that all care plans set out in detail the action to be taken by care staff to ensure that all aspects of health, personal and social care needs of residents are met. That care plans meet all clinical guidelines produced by professional bodies concerned with the care of older people and includes a detailed risk assessment reflecting perceived risks to individuals. That residents views are Timescale for action 23/08/05 2. OP3 14(1)(a) (b) 23/08/05 3. OP7 15(1) 12(1) 23/08/05 4. OP7 13(4) 23/08/05 5. OP15 16(2)(i) 23/08/05 Page 22 Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 6. 7. 8. OP19 OP31 OP33 13(4) 8(1) 24(1)(2) (3) 9. 10. 11. OP36 18(1)(2) considered regarding the menus and that the food is served hot. Access to the kitchenete door must be risk assessed as safe. That an application is submitted to the CSCI for a registered manager. Quality Assurance systems must be carried out at regular intervals and be published in an easy to read format which outlines what action is to be taken to improve the service. It is required that all staff undertaking supervision, receive training to undertake this task. 23/08/05 23/07/05 23/08/05 23/08/05 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. 2. 3. 4. 5. 6. Refer to Standard OP7 OP16 OP27 OP28 OP36 OP37 Good Practice Recommendations That personal profiles are put together of each resident including their background and individual histories and stored in their care plans. That the homes adult protection policy and procedure is amended to include details regarding POVA. That the home review its staffing levels according to the assessed needs of residents. That a minimum of 50 of care staff have obtained NVQ level 2 in care or its equivalent by December 2005. Care staff should receive formal supervision at least six times a year. The list of the National Minimum Standards within the business plan should be removed. Residents and visitors should be given a copy of the homes most recent inspection report for details of the homes progress. Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Holy Cross Nursing Unit H59-H10 S14001 Holy Cross Nursing Unit V228036 230505 Stage 4.doc Version 1.30 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. 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