Inspection on 29/11/06 for Holy Cross Priory Nursing Unit

This inspection was carried out on 29th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Holy Cross Priory Nursing Unit 03/11/08

Holy Cross Priory Nursing Unit 11/10/05

Holy Cross Priory Nursing Unit 23/05/05

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 OTS Lead Inspector Melanie Freeman Key Unannounced Inspection 29th November 2006 11:00 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 Holy Cross Nursing Unit DS0000014001.V291446.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. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Holy Cross Nursing Unit Address Cross In Hand Heathfield East Sussex TN21 OTS 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) 01435 863764 01435 863764 The Grace and Compassion Benedictines Soley Kurinhikanathil Mathai Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That only older people requiring nursing care are to be accommodated That no more than twenty one (21) residents are accommodated That service users are aged sixty five (65) years or over on admission Date of last inspection 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 town. 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 residents and admits residents who are either privately funded or funded by Social Services. The home’s fees as from 01 October 2006 are £500 per person per week. Additional costs are charged for chiropody (approx £9) hairdressing (£4.50 upwards), newspapers, magazines and toiletries. The homes literature states that one of its main aims is to provide the highest standard of care for every person living here at the home, their family and carers. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 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 often use 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 was a key inspection that included an unannounced visit to the home and a further visit, which was completed via an appointment to follow up on the procedures followed when dealing with resident’s monies. Following the visits to the home contact was made with resident’s representatives and a visiting health care professional. The inspection visits were facilitated by the registered manager, who received the direct feedback from the inspector at the end of the visits. The inspection began with discussions with the acting manager (Sister Benedicta) of the care home in respect of progress made since the last inspection. A tour of the premises was undertaken and a range of documentation was reviewed including the home’s statement of purpose and service users guide, care plans, duty rotas, medication records, and recruitment files. The care documentation pertaining to three residents was reviewed in depth along with a number of policies and procedures and records relating to health and safety. The inspector was able to eat a midday meal with a group of residents in the communal dining room and to spend time with residents and their visitors, and observing practice in the home. The second visit to the home focussed on the records relating to residents personal allowances held by the home and the accounting system in the home. In addition service users surveys were given to 10 residents or their representatives and 5 staff surveys were left in the home for staff to complete and return. The inspector received 9 service users/representatives surveys no staff surveys were returned, information contained in the returned surveys has been incorporated into this report. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Holy Cross Nursing Unit DS0000014001.V291446.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 Holy Cross Nursing Unit DS0000014001.V291446.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, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from the provision of comprehensive and well-presented documentation, which enables prospective residents to make an informed choice about whether to move into Holy Cross Nursing Unit. All residents are assessed prior to an admission being agreed to by a competent person. Residents are only admitted to the home if their needs can be met. Intermediate care is not provided. EVIDENCE: Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 9 The home has a detailed Statement of Purpose and Service Users’ Guide in place. Both are kept on display within the main reception area of the home for residents and visitors to see, alongside a copy of the most recent inspection report. Both the Statement of Purpose and Service Users’ Guide were found to be detailed and comprehensive covering: the home’s philosophy of care, the facilities provided, complaints procedure, and health and safety aspects. Both these documents have been kept up to date. A review of the admission process confirmed that pre-admission assessments are completed by the registered manager prior to an admission being agreed and ensures that the needs of residents admitted to the home can be met by the staff within the homes environment. Once this assessment is completed a letter is sent to the prospective resident or their representatives to confirm the prospective residents needs and that the home are able to meet these needs. Holy Cross Nursing Unit has several prospective residents on a waiting list although priority is always given to residents from The Priory or other homes within the order. The manager reviews the needs of those on the waiting list every three months over the telephone, and confirmed a full assessment would always be completed prior to admission. A review of the homes documentation and discussion with the manager confirmed that intermediate care is not offered or provided at Hoy Cross Nursing Unit. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care documentation provides a good framework for the provision of care it however needs to be extended to promote a person centred approach to care. Resident’s care needs are met taking into account resident’s dignity with evidence of regular input from health care professionals as necessary. Procedures and practice in the home allow for the safe administration of medicines. EVIDENCE: The care documentation pertaining to two residents were reviewed in depth as part of the inspection process. These on the whole were found to be full and comprehensive and to provide clear guidance to staff on how to meet the care needs of residents however Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 11 they need to be developed further to promote a person centred approach and this should include the exploration of individual psychological and social care needs of residents. Risk assessments are used to inform the care provided and these included an assessment of pressure areas, nutritional needs, the risk of falls and safe moving and handling. During the inspection visit it was observed that staff were supporting a resident to stand by holding her under the arms rather than using a supporting handling belt. This matter was raised with the manager who advised that staff had the necessary equipment and training and would talk to staff again about safe moving practice. I knew it was the best place to be cared for’. ‘I feel secure that any care needs will be met’. ‘A close relative received excellent care here two years ago’. ‘A home from home’. The inspector was pleased to note that the local Doctors visit the home regularly and review the resident’s health care needs and that when residents have specialist care needs appropriate professionals are sourced for their input. An example of this was seen in respect of one resident who needed specialist advice from an Occupational Therapist regarding posture and seating. One of the registered nurses is also working as a link nurse with the local Nurse Consultant on tissue viability. Other visiting health and social care professionals confirmed the standard of care was good and appropriate to meet the needs of the residents living in the home. All residents spoken to were very happy with the care and support provided to them and this view was echoed within the surveys received. Residents comments included ‘I knew it was the best place to be cared for’ ‘I feel secure that any care needs will be met’ ‘A close relative received excellent care here two years ago it’s a home from home’. The medicine procedures and records were found to be clear and mostly accurate, apart from some gaps in the administration record. The deputy manager was aware of these and was following this matter up with the staff responsible. The medicine administration observed was found to be completed in a safe and appropriate manner. All medicines are administered and monitored by the registered nurses working in the home and the storage area was found to provide good facilities for all medicines. During the inspection visit staff were seen to be attending to residents needs in a respectful manner and to have their choices respected. Some staff were Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 12 noted to have a very good rapport with residents happy to spend time individually with them one comforting a resident who was upset. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected 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. This judgement has been made using available evidence including a visit to this service. Links with friends and relatives are encouraged and choices made are respected. Resident’s opportunities for stimulation through leisure and recreational activities are not fully developed in the home to meet individual needs. The food is adequate however the standard of the meals provided needs to be improved to ensure residents receive an appealing and nutritious diet. EVIDENCE: During the inspection it was noted that residents were invited to some entertainment provided in the afternoon and the activity organiser explained that different games and entertainment is provided through the week on the two days that she works in this capacity. Arrangements for Christmas entertainment are progressing and residents spoken to said how much they enjoyed Christmas and the effort made by staff to make it special including a pantomime put on by staff. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 14 A review of the care documentation did however identify that an assessment of resident’s social and psychological needs is not fully explored or transferred into the individual care plans. Most residents and relatives spoken to agreed that the home provided a range of activities and entertainment but it did not appear to meet all individual needs. Comments received included ‘the activities could be improved’ ‘activities are arranged but I prefer to read and watch TV’. Visiting is very much encouraged and visitors seen and spoken to said that they were made to feel very welcome and that the staff were very hospitable and provided beverages. During the inspection visits it was noted that on the whole staff were responsive to residents wishes asking for their views regularly, although some staff were inclined to assume what residents wanted and this is most probably due to the fact that staff know residents very well and although the staff assumptions may be correct the promotion of choice needs to be a principle that is always followed. This matter was raised with the manager to follow up with all staff. The inspector ate a meal with a group of residents and the meal was found to be adequate. Meals are prepared in the main kitchen in the adjoining home and then transported in a heated trolley. Feedback from residents indicated that the food is not always appropriate or enjoyed, comments received included ‘I am vegetarian and variety is limited’ ‘sometimes I feel a bit hungry perhaps larger portions at meal times’ ‘the food you have what you are given and sometimes this is great and sometimes not so good’. The manager confirmed that there is no regular cook currently although recruitment is being progressed along with a provision for the unit for the evening meals and this has affected the quality of the food. Ways of improving the food and its presentation should be investigated. The inspector was concerned to note that all residents having their meal were sitting in wheelchairs and discussion took place with the manager around the importance of appropriate seating and the regular change of residents positioning. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be 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 good. This judgement has been made using available evidence including a visit to this service. Appropriate systems are in place to ensure that all complaints are handled appropriately and that residents are safeguarded from harm. EVIDENCE: The home has a detailed complaints procedure, and although there had not been any formal complaints recently, residents and relatives spoken to confirmed that they would speak to the registered nurses on duty, if they had any issues and that these would be addressed by them or the manager as necessary. Complaint reports are readily available for any complaint to be recorded and how the confidentiality of these records are to be maintained was discussed with the manager. The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training. The manager had a good understanding of possible adult protection issues and there are systems in place to ensure all staff are able to refer any matter directly to a senior person in the home. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Holy Cross Nursing Unit provides residents with a warm, comfortable and homely place to live. EVIDENCE: Holy Cross Nursing Unit is a purpose built home that was built specifically to care for residents with nursing needs. The home is on one level and therefore all areas in the home have good access to most residents. The home provides an attractive lounge and separate dining room along with a chapel, outside space includes a sensory garden and extensive grounds. The home is well maintained and redecoration is completed on a rolling programme. The dining room has benefited from some new furniture, equipment and fixtures. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 17 Although most areas of the home have vinyl flooring and can give an institutional feel the individual rooms are personalised and can provide a homely environment with residents having many of their own possessions around them. All rooms are currently used for single use and the manager confirmed that the two registered shared rooms would only be used if a couple wanted to share. All laundry is completed in the adjoining care home where the facilities are suitable. Holy Cross Nursing Unit DS0000014001.V291446.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 good. This judgement has been made using available evidence including a visit to this service. Staffing numbers and skill mix provides a competent staff team that can meet residents health and personal care needs. The homes recruitment procedures followed were found to be robust. EVIDENCE: At the time of this inspection 19 residents were living in Holy Cross Nursing Unit. Staffing arrangements were found to be appropriate to meet the care needs of these residents and extra sisters come to the home from the Priory at high activity times, for example to help residents with their feeding. A staff rota was available for inspection and confirmed that a registered nurse is working in the home at all times with the registered manager often providing the second registered nurse. Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 19 Residents spoken to said that staff were available to look after them, and all feedback received about the staff was very positive, comments included, ’nursing staff are extremely good and always around when needed’ ‘everyone is very kind and helpful and I would not want to be any where else’ ‘staff are very good listeners’ ‘the great thing about the nursing unit is its Christian atmosphere and the fact that it is friendly and informal’ ‘the staff are always very caring’. The recruitment files pertaining to the three most recently employed carer staff were reviewed as part of the inspection process and identified that the recruitment practice was completed in a robust manner and included an application form, referencing and both Protection of Vulnerable Adults and Criminal Records Bureau checks. Staff training is an important part of the home and the manager confirmed within the pre inspection questionnaire that 33 of care staff have completed a National Vocational Qualification in care at level 2 or equivalent. Records seen confirmed that staff have received training covering a wide range of subjects. It was noted that the staff had received palliative care from a specialist nurse and a pharmacist was providing medicines training to a group of registered nurses on the day of the inspection visit to the home. Holy Cross Nursing Unit DS0000014001.V291446.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, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and ensures the best interests of residents are protected. Quality assurance measures allow for residents and representatives views to be taken in to account and responded to. Systems are in place to ensure resident’s monies are safe and health and safety issues are well managed. EVIDENCE: Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 21 Since the last inspection the home manager has been registered and has completed her Registered Manger Award and National Vocational Qualification in management at level 4 and is awaiting her certificates. She is a registered nurse and has shown high motivation and a commitment to working within the specialist care area of caring for older people. She has demonstrated since the last inspection that she has been able to respond positively to the requirements made at the last inspection and during the inspection visits she was seen to have a good relationship with residents and their relatives and a good working relationship with staff. Residents/representatives and visitors questionnaires are completed on an annual basis these are audited by the manager with the results being made available within the service users guide. Discussions took place with the manager on how this quality measure could be further improved and the manager confirmed that she was already planning to include staff views in the next report. The home holds a small amount of money on behalf of each resident and this is used to pay for personal items, chiropody and hairdressing. This money is supplied by the resident’s representative or via Social services as the personal allowance. These small accounts are held by the administrator and she records the amount spent in the homes shop and retains receipts for any services or external purchases. When she is given money or returns money she does not routinely supply a receipt and this was discussed during the inspector’s second visit to the home. A clear procedure was not in place to safe guard the money and the staff dealing with it and this was discussed with the administrator. An accountant deals with the fees and the inspector was advised by him that his accounts are audited by an external auditor every year. Certificates relating to Health and Safety in the home were reviewed and found to be full and extensive. Environmental and fire risk assessments are completed although the environmental risk assessments need to be further developed to fully assess the outside areas of possible risk. Holy Cross Nursing Unit DS0000014001.V291446.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16(2) Requirement Timescale for action 01/03/07 2. OP15 3. OP35 That the home provides the necessary facilities to promote residents opportunity for activities and recreation. 16(2) That the home provides adequate quantities, suitable, wholesome and nutritious food that meets the needs of each individual living in the home. 17(2)Sch4 That the systems for dealing (9)(a)(b) with resident’s monies is reviewed and improved to include the use of receipts and a procedure that reflects the practice in the home. 01/01/07 01/01/07 Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 24 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. Refer to Standard OP7 OP8 OP11 Good Practice Recommendations That the care documentation is improved to include a person centred approach to care. That the use of wheelchairs is reviewed to ensure resident’s mobility is promoted and appropriate seating is provided at all times. It is recommended that the home consider devising an information leaflet that can be provided to residents / relatives in order to help support them in planning for and dealing with death, dying and bereavement. It is recommended that 50 of care staff be trained to NVQ level 2 in care by December 2005. 4. OP28 Holy Cross Nursing Unit DS0000014001.V291446.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection East Sussex Area Office 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 DS0000014001.V291446.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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