Inspection on 23/05/06 for Cherry Tree Lodge Care Home

This inspection was carried out on 23rd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Tree Lodge Care Home 30/07/07

Cherry Tree Lodge Care Home 03/09/04

Cherry Tree Lodge Care Home 17/05/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Cherry Tree Lodge Care Home 34-36 Holme Road West Bridgford Nottingham NG2 5AA Lead Inspector Steve Keeling Key Unannounced Inspection 23rd May 2006 09:45 Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 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 Tree Lodge Care Home DS0000008650.V295160.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 Adults 18-65. 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 Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Tree Lodge Care Home Address 34-36 Holme Road West Bridgford Nottingham NG2 5AA 0115 914 3499 0115 9143499 mgbcareservices@aol.com 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) MGB Care Services Limited Vacant Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd May 2006 Brief Description of the Service: Cherry Tree Lodge provides a service to twelve people with a learning disability. The home is situated in two semi-detached three-storey period houses combined into one, located in a residential suburb of Nottingham. Cherry Tree Lodge is within walking distance of local shops, transport links and other amenities within the city. There is a good-sized enclosed garden to the rear of the property. Residents are accommodated in bedrooms on the ground and first floor. There is an internal staircase, and an external metal fire escape; there is no passenger lift within the property, so any person living at Cherry Tree Lodge who has restricted mobility would have difficulty accessing the upper floors of the care home. The fees at the home currently range from £335 - £850. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 4 hour period and involved one inspector. The main method of inspection was case note tracking, this is a method of selecting residents within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the records of the service users to ascertain if the residents identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two residents notes were case tracked. Also as part of the case tracking process, a staff member was informally interviewed to further evidence the quality of care afforded to the residents. It was evident that the staff on duty at the time of the inspection were very committed to providing a high standard of care for all the residents. The staff within the home was very helpful and cooperative thus ensuring that the inspection process progressed in a professional and efficient manner. The report indicates comments from the residents to glean further information as to the quality of care afforded to the service users but unfortunately no visitors were at the home at the time of the inspection to further discuss the care provision within the home. What the service does well: Residents spoken with stated that the staff at the home are very caring attentive to their needs and always respect individual choice. The home is clean, odour free, safe and well managed. Residents stated that the food provided within the home is very good and a choice is always provided. Residents are encouraged to participate in varied social activities both within the home environment and within the broader community. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 6 It is evident that documentation within the home is maintained to a high standard and is secured effectively to maintain the residents confidentiality. 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. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Prospective residents are effectively assessed prior to occupancy at Cherry Tree Lodge and individual needs and aspirations are identified. EVIDENCE: Two residents files were examined on the day of the inspection and each contained an Extended Community Care Assessment. The home utilises the Activities of Daily Living tool (ADL) to assess the resident’s needs. The assessments within the two case tracked notes were detailed in identifying the specific needs of the case tracked residents so as to maintain the residents optimum independence and health within the home. The documentation appertaining to the pre admittance assessment, is clear, concise and well presented. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents have individualised care plans within their personal file. Residents are consulted about all aspects of life at the home and are encouraged in making decisions independently. Residents are encouraged to take risks and achieve optimum independence. EVIDENCE: Two resident’s files were examined on the day of the inspection. It was evident that the newly devised evaluation and care-planning format is designed to be individualistic in meeting the needs of the residents. The new format is very well organised, concise and included pictorial representations to aid the communication process for the residents and aid resident’s participation in the care planning process. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 10 The resident’s needs are evaluated monthly to ensure the any changes are identified and addressed effectively and all personal documentation is stored securely to ensure the resident’s confidentiality is maintained. It was evident that the staff at the home have created an environment that is empowering for the residents which maintains their safety and autonomy. The inspector witnessed several interactions between residents and staff at the home and it was evident that the staff at the home respect the resident’s wishes and offer guidance rather than instructions for the residents. A discussions with a resident established that the aforementioned ethos within the home is the norm rather than the exception and it was established that an effective consultation process is promoted within the home, which includes monthly residents meetings. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16, 17, Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Resident’s benefit from the provision of a varied and stimulating social activities programme. Resident’s are encouraged to interact within the local community. Resident’s can maintain appropriate relationships within family and friends. Resident’s rights and responsibilities are respected at the home Resident’s are offered a healthy diet and enjoy their meals within a pleasing environment.. EVIDENCE: Residents at the home are encouraged to participate in a varied and stimulating social activities programme within the home and within the local community. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 12 Residents have free access in and out of the building, and on the day of the inspection one case tracked resident was looking forward to a trip to the local shops, with supervision from a member of staff, to purchase food supplies for the home. A minibus is also available for resident to access day trips to local areas of interest. Residents are encouraged to identify preferred social activities at the residents meetings and it was evident that the residents at the home were particularly looking forward to planned trips to the coast. A staff member confirmed that the social activities at the home had improved over the past months and a significant amount of money had been made available to purchase board games, paints and other materials to enhance the social activities within the home. A case tracked resident was particularly proud of a painting she had created at the home and it was established that the painting was to be framed and hung in the home. Staff at the home confirmed that no restrictions are in place in relation to visiting times at the home, although relatives are encouraged to call before visiting the home as residents are often on trips or at day centres within the local community. At the time of the inspection no relatives or friends were visiting the home although a case tracked resident confirmed the open access policy at the home and she confirmed that friends could visit whenever they want to. Residents are consulted at the residents meeting to identify a preferred choice of meals and snacks. A case tracked resident stated that the food at the home is “lovely and I can have whatever I want”. The resident’s dining room has been redecorated to a high standard and provides a dining area that is both safe and aesthetically pleasing. Records relating to food temperatures were seen and found to be in order and a new food probe has been purchased to ensure accuracy in relation to food temperature monitoring. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents receive personal support and staff respect the residents preferences and wishes. Resident’s physical and emotional needs are met. The policies and procedure at the home in relation to the receipt, administration and disposal of medicines had not been followed effectively. EVIDENCE: Residents spoken with stated that they were satisfied with the level of personal support and care they received at the home. Resident’s preferences in relation to personal care are identified and documented within the care planning process so as to inform staff and respect the resident’s wishes. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 14 A case tracked resident who preferred to stay in bed until mid morning stated that the staff at the home respected and accommodated her wishes at all times. In an attempt to respect the resident’s physical and emotional needs, resident meetings are performed on a monthly basis at the home. The meetings are intended to identify issues relating to the care provided to the residents at the home so that any issues of concern that the residents might have can be discussed and addressed effectively. The residents meetings also provide a forum to discuss plans for the development of the home, which included the recent refurbishment, so as to include residents in this process and respect their preferences and wishes. Cherry Tree Lodge continues to use the Boots (The Chemists) Monitored Dosage System (MDS). The case tracked residents records relating to administration of medicines were checked. It was evident that one resident had gaps within the Medication Administration Record (MAR) with no explanation as to why the resident had not received the medication. The team leader confirmed that the resident had not been in the home as she was shopping within the local community. MAR charts should not have gaps present, if medication cannot be administered an explanation must be documented and the registered person is required to evidence what actions will be taken to ensure staff adhere to this requirement. At the time of the inspection no resident’s were responsible for the selfadministration of medicines. The team leader stated that should a resident wish to be independent in the administration of medicines the manager would perform a risk assessment, if the resident was deemed as being safe, the resident would be supported to be independent in relation to selfadministration of medication. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents feel confident that concerns and complaints will be listened to and acted upon at the home. Residents are protected from abuse, neglect and self harm. EVIDENCE: The complaints procedure is given to residents or their representatives on admission, the complaints procedure is also on display in the foyer of the home. Since the last inspection the Commission for Social Care Inspection has not received any complaints in relation to the service provision at the home and it was established that the manager at the home is not investigating any complaints. A case tracked resident stated that she felt confident in the staffs ability to address any concerns or complaints she might have and she knew who to talk to if she was unhappy. At the last inspection it was identified that some staff members had not received adult abuse training. It was evident that this shortfall has been address as additional training events had taken place on 7th November and 1st December for all staff, either as a refresher or as an introduction to abuse issues. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 16 Staff spoken with on the day of the inspection were aware of issues relating to the protection of the vulnerable adult and were able to identify the appropriate actions which would be required from them if the suspected abuse was occurring in the home. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home provides a safe, comfortable and homely environment. One the whole the home is clean and hygienic although the kitchen area would benefit from an upgrade. EVIDENCE: The case tracked residents bedroom were seen on the day of the inspection and were found to be well-personalised safe and clean. Residents have audio and visual equipment in their rooms together with books, posters and family pictures. Residents stated they liked their rooms very much, and said that they had everything that they needed. The case tracked bedrooms did not have ensuite facilities but the bathrooms utilised by the residents are adequate in meeting the resident’s needs. The ongoing refurbishment plans are to create a new bath and shower room on the ground floor and it was evident that the work is progressing well. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 18 The home has a high standard of cleanliness and all areas smelt fresh. The foyer of the home has been re-carpeted and the resent improvements to the dining room have now created an aesthetically pleasing and safe dining area. Although some disruption was evident, caused by the re-decoration programme the management and staff at the home have ensured that the inconvenience to the residents has been minimised. The inspection process allowed for a brief examination of the kitchen area and it was evident that the kitchen was somewhat shoddy and in need of an upgrade. The team leader informed the inspector that the refurbishment programme included the kitchen area but could not specify when the upgrade was to take place. The registered person is required to evidence when the planned up-grade will be carried out. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staff at the home are appropriately trained and competent. The recruitment practices at the home are effective in protecting residents from potential abuse. Shortfalls were identified in relation to staff supervision. EVIDENCE: The home operates a three-shift system and it was evident that two members of staff were on duty over the 24 hour period. The team leader confirmed that additional staff would be utilised when residents were on day trips. Individual staff training records were examined, and were found to cover all mandatory areas of training, the staff files are well organised and secured effectively to maintain confidentiality. A staff member was asked about staff training and it was established that the staff member had attended a variety of training events both mandatory and Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 20 supplementary. The member of staff stated that there was a greater emphasis on training since the current manager has been in post and that staff at the home feel supported and valued as a result. The recruitment policies and procedures were examined at the previous inspection and found to be effective in promoting residents safety. The staffing structure in the home is unchanged and as such Standard 34 was not fully addressed at this inspection. Information gleaned from previous inspections indicated that regular formal staff supervision are performed within the home for all staff. On the day of the inspection a staff member was asked to confirm that effective supervision continues at the home and it was established that the staff member had not received regular one to one supervision sessions from the manager of the home, although he felt supported and valued by the manager at the home. It is a requirement that all staff at the home receive formal supervision sessions Bi- monthly to identify shortfalls in practise and allow staff the opportunity to speak about professional and other related issues with the manager. Currently this management element is not being performed effectively. The registered person is required to demonstrate that all staff employed at the home are provided with appropriate supervision. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is well run and benefits from an effective management structure. The views and aspirations of the residents are integral to the development of the home. The health and safety of the residents are promoted and protected at the home. EVIDENCE: Although the manager of the home was not available on the day of the inspection it was evident through staff comments and examination of documentation within the home that an effective management structure is in place. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 22 Staff spoke very highly of the manager’s abilities in relation to the provision of an environment that promotes residents independence whilst ensuring safety for residents and staff alike. In promoting a quality assurance process the manager makes certain residents are consulted via the residents meetings as mentioned earlier, together with a resident’s questionnaires, usually circulated in November of each year. Residents and staff confirmed that the on-going refurbishment and upgrades, which were initiated by the manager, is greatly improving the homes environment for residents and staff alike. It was also evident that the manager has enhanced the social activities within the home and the continued use of the additional equipment and the mini bus is promoting independence and social interactions for the residents at the home. In determining that the residents are safe within the homes environment a range of Health and Safety records were seen, relating to Fire Safety, Gas Safety Certificate, Control of Substances Hazardous to Health (COSHH) and all were found to be well organised and satisfactory. It is evident that all documentation within the home is very well organised, identifies and addresses the needs of the residents and is securely stored to promote confidentiality within the home. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X X 3 x Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 2 3 Refer to Standard YA20 YA30 YA36 Good Practice Recommendations The registered person should ensure that all medication omissions will be recorded appropriately on the Medication Administration Records The registered person should ensure the kitchen area will be up-graded and fit for purpose. The registered person should ensure that all staff within the home will receive appropriate structured supervision at least six time per year. Cherry Tree Lodge Care Home DS0000008650.V295160.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Cherry Tree Lodge Care Home DS0000008650.V295160.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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