Inspection on 05/07/07 for Cherry Garth - North Yorkshire County Council

This inspection was carried out on 5th July 2007.

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

Cherry Garth - North Yorkshire... 02/07/09

Cherry Garth - North Yorkshire... 12/07/06

Cherry Garth - North Yorkshire... 22/02/06

Cherry Garth - North Yorkshire... 19/05/05

Cherry Garth - North Yorkshire... 09/02/05

Cherry Garth - North Yorkshire... 21/09/04

Cherry Garth - North Yorkshire... 02/03/04

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Larchfield Manor

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Beeches The - North Yorkshire County Council

The Grove Waltham

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Carentan House

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

CARE HOMES FOR OLDER PEOPLE Cherry Garth - North Yorkshire County Council Chapel Street Thirsk YO7 1LX Lead Inspector Pauline O`Rourke Unannounced Inspection 5th July 2007 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 Cherry Garth - North Yorkshire County Council DS0000034497.V343767.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. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Garth - North Yorkshire County Council Address Chapel Street Thirsk YO7 1LX 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) 01845 523189 01845527471 cherry.garth@northyorks.gov.uk www.northyorks.gov.uk North Yorkshire County Council Joan Craft Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (2) of places Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The category for Physical Disability (PD) only applies to the named service users. 12th July 2006. Date of last inspection Brief Description of the Service: Cherry Garth is registered to provide care and accommodation for up to 48 older people, 2 of whom may have a physical disability. The manager is Mrs Joan Craft and North Yorkshire County Council owns it. It is a purpose built property and accommodation is situated on two floors. There are 40 single rooms and 4 shared bedrooms, none of which has an ensuite facility. There are communal bathrooms and toilets provided on each floor. There is a passenger lift. It is situated very close to the centre of Thirsk and local amenities are near enough to walk to. A copy of the service users guide to the home is given to people thinking about living there. It is available in different formats if necessary. A visit is made to the home before a decision is made to move in for a trial period. A copy of the latest Commission for Social Care Inspection report is available for prospective service users and relatives to read. On the 5th July 2007 the weekly fees were up to £368.90 subject to a financial assessment. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment Comment cards returned from people living at Cherry Garth, health and social care professionals and relatives. A visit to the home (carried out) by one inspector that lasted for six and a half hours. During the visit to the home twelve people who live there, four staff and two visitors were spoken with. Care records relating to four people, four staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Cherry Garth for the people living there. The long term future for Cherry Garth is to move towards supported living and people in the home as long with staff are anxious about this change. The duty manager was available to assist throughout the visit and Mrs Craft, the manager was available for feedback at the close. What the service does well: The home provides a service that meets the expectations and needs of people. It enables people to remain part of their local community in which they have spent their lives. They are also able to receive care and support for their health and physical needs. The management team works to ensure the people who live at Cherry Garth can live the lives they want to. There are regular meetings for the people who live in the home and the staff. This allows people to express their wishes. People who live at the home said that the staff were ‘wonderful’ and ‘they will do anything for you’ and ‘they try to spend time with you when they are not busy’. Relatives also said ‘Make residents feel secure and happy. All the staff have a good understanding of the elderly needs and do their best to fulfil them. We cannot praise them too highly for the good work they do” Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 6 The staff who work at the home are thoroughly checked before they start their employment and they receive support and training to ensure they have the skills needed to do their job. The home is clean and well maintained and people can access all areas of the building. There is a nice garden where they can sit and enjoy the fine weather 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. The summary of this inspection report can be made available in other formats on request. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. 6 does not apply. People who use the service experience excellent quality outcomes in this area. People who decide to use this service can be assured their needs will be met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The files for four people who live at Cherry Garth were seen and these all contained comprehensive assessments by care managers prior to admission to the home. A member of the management team of the home visits all prospective service users either at home or in hospital and completes their own assessment prior to arranging admission on a trial basis. This is in addition to the assessment provided by the care manager. A review is held after the person has been in the home for a number of weeks. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 9 Several people spoken with during the visit had recently been admitted to the home and all of them said that the manager had visited them prior to their admission. They could all identify a key worker who helped them settle in. A relative said that they had visited the home prior to their relative coming in and had found the staff helpful and informative. The duty manager confirmed that they visit people before they are admitted to the home and she said that this had enabled them to ensure the balance of needs within the home was appropriate to the availability of the staff Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience excellent quality outcomes in this area. People receive the care and support they need. The staff provide support in a sensitive way that promotes the independence and dignity of the people who live at Cherry Garth. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The four case files each contained a promotion of independence plan that enables staff to care for the person as an individual. The plans are reviewed each month by the key worker and with the person concerned. This review is recorded in the service users file. Three people spoken with said that they discussed their plans with their key worker regularly. On the day of the visit a review was taking place and family, staff, social care professionals and the person who lived in the home were all involved. Staff keep a record of events Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 11 and areas of concern in the file but this is not a daily record and several files seen showed no recording for the period of a month. The case files examined showed that the health care needs of people are met. Everyone is registered with a GP and, access to specialist services when necessary are obtained through the GPs surgery. District nurses visit on a regular basis to provide treatment and advice to staff. There was evidence on the files of service users attending appointments with dentists, opticians, audiologist and chiropodists. There is a monitored dosage system for those service users who require medication. A medication round was observed and the procedure was properly followed. The administration records were found to be accurate and up to date. Medication is logged in and out of Cherry Garth so the quantity of medicines in the home at anyone time can be checked. All staff that handle the medication have received training through a Distance Learning Course in The safe handling of medicines. This training is further supplemented through supervision. Throughout the visit the interactions observed between people who lived in the home and staff was seen to be relaxed and friendly. Staff called people by their chosen names and always knocked on a closed door before entering. Feedback received from relatives said: “Staff are very well trained, kind and thoughtful, they help people in a very dignified manner. Helping them to cope, but also leaving them their independence, helping them through the stress of their age and illness, never taking away from them, independence or dignity”. People in the home said that the ‘staff are wonderful’, ‘They always knock on my door before they come in’ and ‘you can have a bit of fun with them’. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience excellent quality outcomes in this area. People are able to make choices on a daily basis and are supported to do this by the staff. They enjoy a good and varied diet and a social and recreational programme helps them to maintain their interests and hobbies. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People choose their own routine including what time they wish to get up and go to bed, what clothes to wear and what to do during the day. Two people spoken with made a point of going for a walk several times a day in to Thirsk and were seen leaving in the morning for such a walk. Another person was actively seeking groups or events they could attend away from the home. Other people in the home organised their own activities such as domino games and there is access to a cinema lounge where there is a large screen TV and movies available to watch. During the summer there is a bus trip every other week and several people said they had been out for picnics but had stayed on the bus because of the weather. A religious service is provided in the home Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 13 each week on a rota basis by a number of different denominations within Thirsk. Visitors are welcome at anytime and a number of visitors were seen to come and go as they wished. The visitors spoken to stated that they were always welcome and could see their relatives in private in their own room or one of the small lounges if they wished. Some visitors took their relatives out for the day. Feedback received from visitors said: “Any visitors are allowed in to visit at anytime. There are no set visiting times between meals you can stay as long as you like and are always made welcome by staff. This is a good & means that people can visit when they can fit it in and are welcome into a friendly environment”. Several visitors spoken with said that the “staff were always welcoming. They could have a drink with their relatives if they wished and that staff always kept them informed about their relatives”. All of the people in the home spoken with said that the food was exceptional. The meals are planned on a weekly basis and suggestions are gather from people in the home by the catering staff. The regular meetings held by people in the home also inform the menus. The meals are mainly traditional but newer foods are being introduced such as lasagne, and curry. Breakfast was a leisurely meal with people coming down to the dining room when they were ready. Likewise lunch was relaxed and people were assisted discreetly if they needed help. At the lunch meal there was a choice for both the main course and the sweet and people spoken with said ‘the meals are wonderful’ ‘they are always nice’ one person said ‘I have put weight on since I came in here.’ During the visit the cook was trying to prepare for a barbeque but this was dependent on the weather. They use local produce and this allows for a greater flexibility in the provision of meals. Special diets are catered for and advice would be sought from the dietician if staff thought there was a need for this. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. People who live at Cherry Garth and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There is a comprehensive complaints procedure in place, it is advertised on the information board as well as being in the Service User Guide. All of the people spoken with would take any concerns to the manager or their key worker. There have been three complaints received, a record of these were seen and all had been dealt with in a positive way. Issues raised through this process are fed back to staff in a staff meeting. Feedback received from relatives indicated that they knew how to complain if they needed to. An Adult protection protocol is in place and staff were aware of their responsibilities under this procedure. This procedure was recently implemented and followed properly. Staff have received training through National Vocational Qualification and the manager also reinforces the training in the monthly staff meetings. The manager understands the procedures and attends meetings and provides information to external agencies when requested. Staff spoken with understood their responsibilities if they Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 15 suspected any form of abuse or mistreatment of the residents. Staff are thoroughly checked prior to the commencement of their employment to ensure they are suitable to work with vulnerable adults. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use the service experience good quality outcomes in this area. People live in a warm, comfortable and safe environment. They can access all areas of the home, which encourages independence. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Cherry Garth is a two-storey building and has a lift so that people can access all areas. A tour of the building was carried out and it was seen to be well maintained, clean and odour free. The health and safety checks to ensure the safety of the building have been carried out. In recent months the lift has been breaking down on a regular basis, but it has since been serviced and is currently working properly. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 17 People have their own bedrooms and those seen had been personalised by the individual. People spoken with said that although their rooms were small they were adequate for their needs. Several people have a slightly larger room these can be used as double rooms but are currently used as singles. There are a selection of communal areas and people can choose where they want to sit. Feedback received from relatives said: “The building on the whole is very clean and bright& cheerful”. Another relative did comment: “Maybe the actual residents rooms could do with a makeover, redecoration etc”. The manager did say that as rooms become vacant they are redecorated at that point. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience excellent quality outcomes in this area. Staff, that, have been thoroughly vetted prior to the commencement of their employment, support people. They receive regular training and are in sufficient numbers to ensure they can provide the support required by the people in the home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: At the time of the visit there was a team manger, four resource workers, two domestic staff, and three kitchen staff on duty. The staff team meets the needs of the people in residence. Staff spoken with said that there was enough staff on duty to allow for more personal interactions particularly on an afternoon. The people in the home said ‘the staff are wonderful and will do anything for you’, ‘You can choose if you want a female carer instead of a man if you want’ More than 50 of the staff have completed an National Vocational Qualifications level two in care, and several staff spoken with were either completing or had completed the level three in care. Staff also said that they can access training relating to their role and they also keep their health and Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 19 safety training up to date. Staff also have regular team meetings and these are used to discuss issues within the home and to keep training issues up to date. Feedback received from relatives includes; “The staff are very well trained, kind and thoughtful, they help people in a very dignified manner. Helping them to cope, but also leaving them their independence, helping them through the stress of their age and illness, never taking away from them, independence or dignity. Being there night and day to help and support people who would not cope in the community”. And “All the staff have a good understanding of the elderly needs and do their best to fulfil them. We cannot praise them too highly for the good work they do”. Four staff files were seen and these contained all the necessary preemployment checks along with evidence of supervision and appraisals. One newer member of staff said that when she started at Cherry Garth her first week of employment was purely training on the Induction course. She has since had an in-house induction and spent two weeks shadowing another member of staff. She also did some fire training on her first day. Discussions with the manager revealed that the staff problems suffered last year have settled down and the current staffing compliment is up to strength. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience excellent quality outcomes in this area. People live in a home that is well managed and systems are in place to protect their health and safety. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The registered manager has over 25 years experience in the care and management of older persons homes. She has a Registered Managers Award and Level 4 NVQ in the management of care services. She is also an NVQ Assessor. People spoken with during the visit said that the manager and all of the management team are always available if they want to speak to them and Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 21 they have confidence in their ability to change things if they are not right. Staff also said that the manager was fair and operated an open door policy to all. There is a quality Assurance system in place. Each North Yorkshire County Council home has a quality champion and they have to visit other homes and mark them against the standards. The quality champion at Cherry Garth said that they enjoyed visiting other homes as you picked up good practice ideas as well as areas for improvement. A report is produced with timescales for improvements and sent to the home. It is then up to the champion to ensure that the improvements are implemented. Other information used in improving the service provided at Cherry Garth is gathered through meetings with the people who live there and questionnaires that are sent to relatives and visiting professionals. When it is necessary people can leave their personal monies in the office safe. The records and cash held were checked and all tallied. Receipts are kept and someone from North Yorkshire County Council audits the accounts every three months. The health and safety records were checked and all were found to be up to date. Risk assessments for fire, the environment, COSHH and people who live in the home. All accidents and incidents are recorded and when necessary they are reported to the Commission of Social Care Inspection. Whilst the accidents are reviewed on a regular basis it was suggested to the manager that the key workers incorporate these in to the monthly reviews carried out. This might then show any patterns of incidents and allow staff to alter the care plan accordingly. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Staff should keep a daily record of peoples activities. This information can then be used to inform the care planning process and if necessary can be used to monitor general health and wellbeing. Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Cherry Garth - North Yorkshire County Council DS0000034497.V343767.R01.S.doc Version 5.2 Page 25 - 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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