Care Home: Goyt Valley House

What the care home does well Goyt Valley House provides a comfortable, homely, and relaxed environment for service users. Service users and relatives spoken with made positive comments about the home and the staff and said they were provided with good care. The home was found to be reasonably maintained although a major refurbishment is planned to rewire the home, replace the life and bathroms and carry out other general improvements. The inspector was told by service users that the food was very good and they were given choice. The manager is experienced and appropriately qualified. Service users described the home as `well run` and said that the managers and staff worked very hard. Staff spoken to were experienced and committed. There is a strong individual service user focus and a well established `key worker` system which was described as very successful by both staff and service users. The home takes part in Derbyshire County Council`s system of quality assurance and information provided by this exercise has been made available to service users and is being used as part of an improvement plan. The home have worked hard to improve the variety and availability of activities, including outings. The home follow Derbyshire County Council`s recruitment and selection procedures. There is a corporate complaints procedure, although minor concerns are dealt with on an informal basis. What has improved since the last inspection? Several requirements at the last inspection related to care planning documentation. On this occasion four service users were case tracked. Their care plans had monthly summaries that had been completed by both night staff and day staff, which provided useful and accessible information on whether significant changes or problems had occurred. This met one of the requirements made at the last inspection. However, work still needs to be carried out on other requirements as detailed below. The major building works being carried out to replace the roof have now successfully been completed. There is now a full management team in post. What the care home could do better: A number of requirements remain outstanding from the last inspection in relation to care plans. Some assessments appeared not to contain significant information relating to a service user`s circumstances. On the day of inspection there were several instances where some care planning documentation was not sufficiently clear to indicate whether the service user was appropriately placed in a residential home. Service users daily routines were not specified in sufficient detail (although service users indicated that they were in practice offered choice about their daily routines). Although the care planning documentation had a consistent format the personal service plan was very brief and did not provide sufficient detail on how individual needs should be met by staff. The inspector was informed that the home is covering most shifts on the staffing rota, but there is currently a problem with recruitment, some staff who have been recruited cannot start because they are waiting for their CRB checks, and recently there have been difficulties due to holidays and sickness. On the day of inspection a number of shifts needed to be covered at short notice. This is very time consuming for managers and having a larger number of relief staff or considering staff commencing training after a POVA First check might contribute to the alleviation of this problem. Extensive refurbishment is planned including rewiring and a new lift. While in the longer term this will contribute to the quality of life of service users by improving their environment, in the short term this work will have considerable impact on service user`s daily lives and will need to be carefully planned to maximise safety and minimise inconvenience. It is anticipated that the CSCI will be informed of the home`s plans to manage this work, which it is understood may take over a year to complete. CARE HOMES FOR OLDER PEOPLE Goyt Valley House Jubilee Street New Mills High Peak Derbyshire SK22 4PA Lead Inspector Denise Bate Unannounced Inspection 22nd August 2006 09:30 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 Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Goyt Valley House Address Jubilee Street New Mills High Peak Derbyshire SK22 4PA 01663 508212 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) www.derbyshire.gov.uk Derbyshire County Council Margaret Clayton Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2006 Brief Description of the Service: Goyt Valley House is a care home providing personal care and accommodation for up to 30 older people. It is owned by Derbyshire County Council. The home is situated in the village of New Mills, near Glossop. It is close to local amenities, such as shops and public houses.The homes bedrooms are single, none of which have en-suite facilities. The home provides a variety of sitting rooms, and one large dining room. Fees are £364 per week for permanent service users, with a range of prices for short term care service users. Additional charges are made for hairdressing, chiropody, newspapers and toiletries. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over seven hours. During the inspection six service users, two relatives, and four staff members were spoken with. The manager and a deputy manager were present during the inspection and provided assistance and information. Written information was provided by the manager prior to the day of inspection. Nine surveys were received prior to the inspection providing feedback on the services provided. An assessment was made of the progress by the registered persons to address the requirements made at previous inspections. A number of records were examined, including risk assessments and care plans, staff files, and medication records. Four service users were case tracked. A tour of the building took place. What the service does well: What has improved since the last inspection? Several requirements at the last inspection related to care planning documentation. On this occasion four service users were case tracked. Their care plans had monthly summaries that had been completed by both night staff and day staff, which provided useful and accessible information on whether significant changes or problems had occurred. This met one of the Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 6 requirements made at the last inspection. However, work still needs to be carried out on other requirements as detailed below. The major building works being carried out to replace the roof have now successfully been completed. There is now a full management team in post. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 8 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 Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Assessments are done by care managers or other professionals based in the community. Some assessment information was not in sufficient detail to ensure the care provided by the home could meet service users’ needs appropriately. EVIDENCE: Assessments are carried out in the community by social workers and care managers and copies were seen on the care planning documentation of case tracked service users. Potential new service users are invited to spend a day at the home with their relatives but no formal record of these visits was seen. Information on one case tracked service user had arrived on the day of admission and did not appear to contain full medical information impacting on the quality of care that could be provided within the home, and on the Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 10 information that could be passed on to other professionals in the event of an emergency. The home does not provide intermediate care so standard 6 does not apply. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 11 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, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans relating to personal and social care needs of service users are sometimes not completed in sufficient detail to direct and inform staff on how individual needs should be met. Service users are encouraged and supported to be independent and to exercise choice and are treated with dignity and respect. This contributes to the enhancement of service users’ everyday lives. EVIDENCE: Work has been done to create a consistent format for care planning documentation as required at the last inspection. Some service users had signed documentation indicating that care plans had been discussed with them. All case tracked service users had personal service plans, daily logs, assessment forms for nutrition and tissue viability, risk assessments, monthly summaries, and monitoring forms e.g. heath professional visits, etc. The Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 12 personal development plans were very brief and did not reflect the individual needs and preferences of service users in detail nor provide comprehensive guidance to staff on how needs were to be met, e.g. daily routines. However, in practice the staff and managers at the home are very ‘service user’ orientated, the key worker system works successfully, and service users and relatives spoke very highly of the quality of care they receive; ‘ staff do everything they can to make us comfortable’, ‘ I enjoy living here’. However, the high quality of care provided is not reflected in the quality of the personal service plans. The assessment documentation of one service user, and the review information of another service user were discussed in detail with the manager. The assessment information had only arrived with the service user on the day of admission and therefore there had not been sufficient time for the home to assess whether his needs could be met appropriately. In addition some medical information that could have been helpful to the home in caring from him did not appear in the most up to date assessments carried out by a professionals in the community. Review information, also written by a professional in the community, on another service user was inaccurate or not clear, e.g. it referred to the ‘nurse’ in the ‘nursing home’, nor was it clear in the review or care planning documentation whether or why the service user’s care was best provided for in a care home providing only residential care. CSCI and the home will be discussing these matters further outside the inspection process. As mentioned previously, the shortcomings in the care planning documentation do not reflect the high quality of care actually provided by the staff. Staff were observed carrying out caring tasks sensitively and safely. They used every opportunity to communicate with service users. Service users spoke very positively about staff and said they were treated with dignity and respect. The administration of medication was inspected and records of case tracked service users found to be satisfactory. The inspector was informed that the home had recently appointed a new pharmacy and that arrangements were working well. The home has a separate medication room with the medicines trollies, fridge and controlled medication cupboard. Derbyshire County Council have recently introduced a new medicines code for their residential homes and staff plan to study this document to ensure that their practices comply. Arrangements for controlled drugs are satisfactory. Storage arrangements are appropriate, and the controlled drugs book was looked at and checked against the medicine held in the cabinet and found to be correct. The home make a note when medication is opened, e.g. on eye drops, and these were seen to be within date. The inspector was informed that all staff administering medication had appropriate training. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are provided that suit the expressed preferences of service users. Regular outside contacts are encouraged and supported. This assists in contributing to a pleasant atmosphere and the overall high level of satisfaction for service users. Dietary needs of service users are catered for with a balanced and varied selection of food available that meets service users’ tastes and choices. EVIDENCE: The home have worked to improve activities since the quality assurance questionnaires feedback identified activities as an area for improvement. Regular activities include craft, quizzes, outings, in house entertainment, bingo and religious services. The service users indicated that they would like to resume music and movement. Details of forthcoming events and other information useful to service users and relatives/friends are displayed in the main entrance area. One service user commented ‘ we have good days out’. Festivities like Christmas and Easter are celebrated and enjoyed by both Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 14 service users and staff, the home ‘is very good over Christmas and Easter’. There is a file detailing activities that have taken place and records of who has taken part. The home has contacts with local community groups. It was confirmed by service users and relatives that visitors to the home are welcomed. Most service users have contact with relatives and friends and some go out on a regular basis. Most service users lived locally and reflect the cultural background of the local area. Service users and relatives spoken to were complimentary about the standard of catering, and the choice of menus that are available. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place which promote the Safeguarding Adults from abuse. A clear and accessible complaints procedure is in place ensuring service users can be confident that any issues raised would be acted on effectively and promptly. EVIDENCE: There is a corporate complaints procedure in place, although most relatives and service users prefer to raise issues on a more informal basis. The manager is viewed by service users and relatives as approachable and responsive. There have been no formal complaints recorded. The home have started to keep a record of minor informal complaints, and an example was given. Derbyshire County Council has clear procedures for dealing with the safety of service users and safeguarding them from harm. Staff spoken to showed an awareness of safeguarding adults issues and would pass any concerns on to their line manager. Training in safeguarding adults has been provided for staff. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally reasonably maintained and provides service users with an attractive and homely place to live. The planned refurbishment will benefit service users by enhancing their environment. EVIDENCE: The building provides service users with a comfortable and homely place to live. There are a range of lounges, some of which also have dining areas. There is an attractive garden and veranda where service users can sit in good weather. The welcoming atmosphere was remarked on by service users in the pre inspection questionnaires and on the day of inspection. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 17 While the general appearance of the home is satisfactory, there are matters relating to the building that Derbyshire County is addressing through a comprehensive refurbishment plan which includes rewiring, a new lift, new bathrooms, and redecoration. The assessment of the environment as ‘good’ reflects commitment to the refurbishment to ensure that all matters relating to the safety of the home are kept in good order. The home have already had a new roof. This significant investment should improve service users lives in the long term by providing a safe and attractive environment. In the short term there will inevitably be considerable disruption for both service users and staff. The manager informed the inspector that a schedule will be drawn up in the near future to plan the work and this will include details of how the work will be carried out safely. At the time of inspection it was understood that the work would be carried out with the service users remaining at the home although there would not be full occupancy. It is anticipated that the home will give details to the CSCI on how plans will be made to minimise disruption to service users, and in particular how the individual needs will be safeguarded of some service users who have dementia or other conditions. Formal risk assessments will need to be carried out to comply with health and safety requirements, as they were when the roof was replaced. It is also anticipated that service users will have an input in to how they would like the communal areas and their individual bedrooms to be decorated. Some toilets and bathrooms were seen and found to be satisfactory. Service users gave the inspector permission to see their bedrooms, which were comfortable and have been personalised. All parts of the home seen on the day of inspection were clean and tidy, and this was also commented on by service users. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A trained and competent workforce are in place which generally meet the dependency needs of service users currently accommodated within the home. Service users benefit from being supported by a trained and competent staff team. EVIDENCE: At the time of inspection there were some staff vacancies and frequent adjustments to staff rotas were required due to staff sickness or holidays. The inspector was informed that there were very few shifts that were not eventually covered and it was anticipated that the situation would get easier within a few days as staff returned from holiday. Some staff had been appointed but the home were waiting for Criminal Record Bureau checks to be returned before staff could commence their induction. There was some frustration caused by the delay in these disclosures being returned. The provider’s human resource department do not undertake Povafirst checks, which could be used to ensure that staff members are not on the Pova register in order to enable the potential staff members to commence supervised induction at the home. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 19 The service users and their relatives spoken with stated that there was adequate numbers of staff in order to meet their support needs, and stated that the staff ‘do everything they can to help’. Staff felt that although they were busy, all staff were prepared to be flexible by changing shifts, etc. to ensure that service users needs were met at all times. Derbyshire County Council has made a commitment to staff training and 50 of staff are trained to NVQ2 or above. There is an ongoing programme of mandatory training. Three staff files were seen and two had evidence of CRB checks, copies of contracts and references. One staff file did not have a copy of the application form and references, but these had been seen by the manager at the time of interview. Copies of these documents are held centrally but the manager will ensure that copies are sent to the home for the member of staff concerned. Derbyshire County Council has a thorough and detailed recruitment and selection procedure. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is suitably qualified and experienced and staff demonstrate an awareness of their roles and responsibilities, thus ensuring the home is run in the best interests of service users. EVIDENCE: The manager is experienced and suitably qualified to run the home. Service users and relatives spoke positively about the manager, and felt confident that any matters raised with her would be dealt with. There is now a full management team and members are each taking responsibility for a particular aspect of the day to day running of the home. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 21 The inspector was informed that the home is visited regularly by a representative of the registered person and copies of Regulation 26 visits were available, indicating that day to day matters are looked into, and action take where appropriate. There had been a quality assurance exercise which indicated that the majority of elements of the service provided at the Goyt Valley House had been rated as good or excellent, e.g. staff trustworthiness and willingness to maintain independence, cleanliness and comfort; and there had been an improvement in satisfaction year on year. The results of the survey had been made available to service users. Areas for improvement had been clearly identified and included activities and trips out, which the home have subsequently worked to improve. Regular meetings are held with the service users and the minutes were made available to the inspector. The inspector was informed that at present service users’ finances are kept in the safe and manual records kept which appears to work satisfactorily. Staff confirmed that they have regular supervision. Information on maintenance and health and safety records was provided by the manager in the pre-inspection questionnaire and indicates that matters relating to health and safety are satisfactory. The fire officer visited in July 2006, but his report has not yet been made available. At the last inspection in February 2006 the roof was being replaced, and risk assessments had been put in place in relation to the disruption caused by the building work. It is anticipated that a similar process will be planned for the forthcoming refurbishment. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP14 Regulation 12 (2) (3) (4) 15 Requirement Timescale for action 30/12/06 2 OP7 Service users care plans must contain evidence of their preferred daily routines. (original timescale 30/06/06) The service users’ care plans 30/12/06 must be based on the home’s assessment as well as that of the placing professionals. (original timescale 30/06/06) 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 2 Refer to Standard OP3 OP3 Good Practice Recommendations A full medical history should be provided for all prospective service users to ensure that their needs can be met appropriately. The home should not admit service users outside their category of registration, and should consider applying for a variation should they wish to do so. DS0000035811.V307943.R01.S.doc Version 5.2 Page 24 Goyt Valley House 3 OP7 4 5 6 7 OP27 OP38 OP38 OP38 Care planning documentation should clearly indicate how service user’s nursing needs are to be met and evidence provided that the plans have been agreed between all professionals involved in providing and monitoring care, and that the family agree and fully understand that the home is providing residential care only. Consideration should be given to recruiting more relief staff to ease pressure on current staff when shifts cannot be filled due to sickness or holidays. Plans for the refurbishment should take account of service users’ individual needs. Detailed plans for the refurbishment should be forwarded to the CSCI. A regulation 37 report should be sent to report the incident involving a service user discussed on the day of inspection. Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Goyt Valley House DS0000035811.V307943.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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