Inspection on 31/05/05 for Cherrytrees

This inspection was carried out on 31st May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cherrytrees 30/01/09

Cherrytrees 23/05/07

Cherrytrees 08/06/06

Cherrytrees 12/12/05

Cherrytrees 25/10/04

Cherrytrees 18/05/04

Cherrytrees 05/12/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Cherrytrees Respite Services Kitelands Road Biggleswade Beds SG18 8NX Lead Inspector Rachel Geary Announced 31 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cherrytrees respite service Address Kitelands Road Biggleswade Beds SG18 8NX 01234 363222 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Bedfordshire County Council Care Home 2 Category(ies) of Learning Disability registration, with number of places Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Period of stay: Respite (max 6 weeks stay) 2. Current respite service users who are over 65 years of age may continue to receive a service from the home, as long as their needs are being met. No new service users over 65 years of age may be admitted to the home without prior consultation with the CSCI. 3. An application for the position of manager with sole responsibility for the respite service must be received by 31/3/04 (this remained outstanding at the time of this inspection). 4. Complete re-provision (subject to CSCI and other relevant authorities approval of the proposed plans) of the respite service by November 2005 Date of last inspection 25th October 2004. Brief Description of the Service: Cherrytrees is a respite service located on the outskirts of Biggleswade, sharing a site with a domiciliary care service. The accommodation and grounds are owned and maintained by Aldwyck Housing Association, with Bedfordshire County Council providing the staffing and care support. The service currently has a condition of registration to reprovide by November 2005 as it does not meet the requirements of the National Minimum Standards for Younger Adults. It is hoped that the service will remain in the local area. The accommodation comprises of a small flat, which is intended to provide respite care for up to 2 adults with learning disabilities at any one time. Stays are limited to a maximum of six weeks. There are two bedrooms, a shared kitchen, a bathroom and living/dining area. The accommodation would not meet the needs of individuals with a physical disability. Community facilities and shops are a short distance from the home, which is also in easy access of local transport routes. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection of Cherrytrees respite service. The inspection took place over one day and lasted for nearly 7 hours. The inspector looked at records, and talked to an HR (human resource) advisor, the resource manager, Martin Hawken, and the acting manager, Ayshea Hutchison. The inspector was also able to talk to two service users, a member of staff and the mother of one service user. This lady said some very good things about the service and spoke highly of the staff and management. Some questionnaires were sent out by the home to service users and 4 were received back by the time of writing. What the service does well: What has improved since the last inspection? The acting manager was able to show that a number of improvements had been made since the last CSCI inspection. Some of the improvements included sorting out requirements from the previous inspection report, and working on ways to make things easier to understand for service users. Important changes have also been made to help service users develop everyday skills during their stay such as shopping, cooking and household tasks. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 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 standard(s) 1 and 5. Some useful documentation is available to help prospective service users to be clear about the service being provided at Cherrytrees. EVIDENCE: The inspector was given copies of the service’s ‘Statement of Purpose’ and ‘Service User Guide’. Both documents contained the majority of required information, however some information was inaccurate or missing. Since the last inspection of this service, the acting manager had developed a service user contract, which met the requirements of this standard. Attempts had also been made to ensure this document was user friendly. The inspector was told that the service was in the process of sending these out and agreeing terms and conditions with respite service users and their families/representatives. The acting manager was in the process of developing a number of user-friendly systems using photos, magnetic boards and picture cards. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 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 standard(s) 6, 8 and 9. The care planning system is generally clear and provides staff with the information they need to meet service users’ needs. Care plans and risk assessments do not yet adequately promote opportunities for service users to develop their independent living skills however. EVIDENCE: Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 10 Service user files had been organised into categories with daily notes also being maintained. Examination of files showed some care plans, which contained some detailed and comprehensive information however; one plan only contained basic information and was not dated. Support needs were not always adequately identified, or had not been broken down into measurable goals aimed at supporting individuals to maximise their independent living skills. In addition plans were not user friendly, and not all were dated or signed by staff, the service users and/or their representatives. The home had adopted a system called ‘planning your stay with us’. A userfriendly chart was being completed with each service user on arrival at the unit, which covered their preferences with regard to leisure activities and working on independent living skills. The plan seen during this inspection however, only recorded activities as they were completed, rather than planning ahead in order to meet the service user’s needs/preferences. A number of generic risk assessments had been completed however; limited individual risk assessments were in place, particularly those required to promote independent living opportunities. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 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 standard(s) 14, 15 and 17. The home had made some good progress in enabling service users to participate and make decisions with regard to meal planning and preparation. EVIDENCE: A member of staff supported both service users to go to a local pub after their tea. The acting manager spoke about introducing systems for maintaining regular communication and feedback from relatives/representatives of service users. These had not yet been fully implemented. The inspector observed a good rapport between the relative of one service user and the staff team. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 12 The home had adopted a user-friendly system introduced within the unit to aid service users to plan menus, prepare shopping lists and to carry out the weekly grocery shopping. Each item of food/drink regularly used within the unit, was recorded on a list, accompanied by a clear photo of the item (particularly useful for individuals who are unable to read). The home was able to meet the specialist dietary needs of service users as required. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 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 standard(s) 18, 19 and 20. Staff provide appropriate and sensitive support to service users although this is constrained by the current medication policy which does not promote flexibility or the separation of the service. EVIDENCE: Due to the nature of the service, the majority of service users’ health needs were being supported by their families/main carers. Information regarding individuals’ medical professionals was being held however, incase of an emergency. The inspector observed staff providing appropriate support in a manner that encouraged service users to maintain their own independence. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 14 The current BCC medication policy requires 2 staff to administer medication. There are not always 2 members of staff on duty within the respite unit however, and the unit is staffed predominantly by agency staff. A risk assessment had been drawn up which identified that medication is to be administered with support from the adjacent BCC supported living service. It was discussed that this was not an appropriate arrangement, and that this blurred the separation of the two services. One care plan did not adequately detail up to date information with regard to the service use’s medication. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 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 standard(s) 22 and 23. Appropriate arrangements for protecting service users are in place. EVIDENCE: The Service User Guide contained detailed information on how to make a complaint. In addition, a user-friendly version had been developed, and was ready to go on display in the entrance hall. A copy of the revised local multi agency protocol (April 2004) regarding the protection of vulnerable adults in Bedfordshire and Luton, was available in the home. Records indicated that this had been discussed at the last staff meeting, and the acting manager said that copies of meeting minutes were given to agency staff to ensure that they are kept ‘in the loop’. Due to the nature of the service, service users’ finances were being held and maintained by families/representatives and not the home. There were systems for holding small amounts of money during individuals’ stays however, should this be required. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 16 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 standard(s) 24, 25, 26, 27, 28, and 30. The standard of the environment does not adequately meet required standards, although efforts have been made to promote a comfortable and homely place to stay. EVIDENCE: The respite unit is part of the existing Cherrytrees building which has been ‘made good’ until reprovision of the service takes place. The unit was operating in partnership with Aldwyck Housing Association, who are responsible for the maintenance and upkeep of the building, fabrics and furnishings. The reprovision programme was moving slower than first thought, and suitable alternative land had not been found at the time of this inspection. It was discussed that a delay would significantly limit access to this service i.e. for people with physical disabilities. There was evidence that the local Environmental Health and Fire authorities had recently inspected the promises. The acting manager confirmed that where recommendations had been made that these had been acted upon although the resource manager was requested to follow up an issue raised by the fire authority in a letter dated 7/2/05. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 17 The inspector looked at one of the two bedrooms. Although small, the room appeared to be equipped with adequate fabrics and furnishings for the purpose of a respite service. There were no ensuite facilities and no washbasins in bedrooms. A cordless phone was available to allow service users to make calls in private. Shared space consisted of a small lounge/dining area, a kitchen and one bathroom. There was a small garden area with some new garden furniture. There was nowhere suitable within the respite flat for a washing machine to be fitted. As the building was only intended to be a temporary arrangement, it had previously been agreed with the CSCI and Biggleswade A R team that a washing machine for the flat could be fitted within the A R flat, which was located above the respite unit. The resource manager said that discussions were taking place with the environmental health authority and the housing association, to find a way of providing laundry facilities within the actual unit. There was one bathroom fitted with a toilet, hand basin and bath. There were no shower facilities or specialist equipment. The unit was noted to be clean, tidy, and free from offensive odours. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 35 and 36. Some clear progress had been made with regard to vetting and recruitment practices for permanent staff. Limited progress had been made however with regard to addressing the recruitment practices, training and supervision of agency staff. EVIDENCE: Service specific job descriptions for the respite service manager and support staff had been developed since the last CSCI inspection. Staff were being recruited according to County Council policies and procedures. Staff vetting documents were being held centrally and not within the home as required however, a BCC HR advisor arranged for a sample of BCC staff files to be examined during this inspection. There was evidence that since the last CSCI examination of staff files (10/11/04), that a number of improvements had taken place, and there were clear systems in place to ensure that (BCC care home) staff were being recruited in accordance with the Care Home Regulations 2001 (and amendments 2004). Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 19 Apart from the part time acting manager and 2 waking night staff, the majority of the care was being provided by a core group of agency workers. Staffing profiles, provided by the agency, had been developed for these workers and were being held by the home. A number of improvements had also been made to these profiles since the last CSCI inspection however; a random selection showed that these still did not yet fully meet the requirements of the regulations for care homes. In addition, there was no evidence that the acting manager had made any checks to verify the authenticity of these profiles. Although staff training records were being maintained, a training and development plan had not yet been developed. There was also no evidence that agency staff were completing the required LDAF (learning disability award framework) induction programme, or how many had completed a relevant NVQ. A supervision chart within the office indicated that core agency staff did not yet receive supervision. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 40. The acting manager had made a number of positive improvements however, she had not been provided with adequate time and resources, and to this end limited progress had been made in some areas. EVIDENCE: The CSCI had still not received an application to register the manager of the respite unit. The resource manager provided an update on this during this inspection. The acting manager said that she had recently completed the RMA (registered managers award) and was waiting for her work to be verified. There was no deputy support for the acting manager. At the time of this visit, there were 12 service users using the respite service on a regular basis. In addition, a number of new referrals were anticipated. The acting manager, who was part time, was expected to divide her time between the respite service and the adjacent BCC DCA (domiciliary care agency). On average, the acting manager confirmed that she was only Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 21 rostered for 7 hours a week within the respite unit and it was the opinion of the inspector that the service would benefit from this being significantly increased. The lack of equipment in the unit (such as a computer and printer), exacerbated the situation and did not support the separation of these services. Ultimately, consideration should be given to increasing management input given the rising levels of service users using the service. A number of internal auditing processes were in place however; a quality assurance system that fully met the requirements of this standard was not yet in place. Detailed reports as required by regulation 26 of the Care Homes Regulations 2001, were being received by the CSCI on a regular basis. The acting manager had introduced systems to ensure that accident records were legible, and being stored in accordance with data protection requirements. A staff rota solely for the respite unit had been introduced since the last inspection. There was evidence of correction fluid being used on this document. The unit’s fire alarm system was linked to the main system in the domiciliary service and was likely to remain so until re-provision took place. To this end, the fire logbook was not inspected on this occasion. Policies did not cover all the topics set out in Appendix 2 of the NMS for Adults (18-65). There was also no evidence of staff awareness of the organisation’s policies and procedures. There was evidence that fridge/freezer temperatures were being appropriately monitored. The hot water from the bath was tested and found to be at the required temperature. Evidence of appropriate insurance to cover the organisations’ assets and liabilities, was in place. A part completed business plan specific to the respite service, was provided to the inspector during this inspection. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x 2 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 1 2 1 1 x 1 Standard No 11 12 13 14 15 16 17 x x x 2 3 x 3 Standard No 31 32 33 34 35 36 Score 3 x x 2 1 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cherrytrees Respite Services Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 1 x 2 2 x x x I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 13 Requirement The registered person must ensure that individual risk assessments are updated and completed in line with the requirements of NMS 9. (Previous timescale of immediate not met). The registered person must ensure that there is a training and development programme for all staff, which incorporates induction, mandatory, specialist-training courses and NVQs as required. (Previous timescale of 31/12/03 not met). The registered person must ensure that an appropriate application form for a manager is received by CSCI as agreed. (Previous timescale of 31/5/04 not met). The registered person must revise the current medication policy with regard to administration and the reduced numbers of staff on duty within the respite unit. In addition, accredited training for staff with regard to basic knowledge of how medicines are used, how to recognise and deal with I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Timescale for action Revised timescale 31/8/05. 2. YA35 18 Revised timescale 31/8/05. 3. YA37 8 Revised timescale 31/8/05. 4. YA20 13 Revised timescale 31/8/05. Cherrytrees Respite Services Version 1.30 Page 24 5. YA40 17 6. YA39 35 7. YA36 18 8. YA6 15 problems in use, and the principles behind the home’s policy on medicines handling and records must be arranged. (Previous timescale of 31/8/04 not met). The registered person must ensure that the home’s written policies and procedures are specific to the respite service, and cover all the topics as set out in Appendix 2 of the NMS for Younger Adults. (Previous timescale of 31/8/04 not met). The registered person must ensure that a quality assurance and monitoring system is in place for the home, which meets the requirements as set out in standard 39 of the National Minimum Standards for Younger Adults. (Previous timescale of 30/9/04 not met). The registered person must ensure that staff understand the main aims and values of the home by providing formal supervision to regular agency members of staff. (Previous timescale of 5/11/04 not met). Develop current care plans with the involvement of the service users, to ensure that plans include measurable goals aimed at supporting individuals to maximise their independent living skills. Revised timescale 31/8/05. Revised timescale 31/8/05. Revised timescale 31/8/05. 31/8/05. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA33 and Good Practice Recommendations Consideration should be given to increasing the current I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 25 Cherrytrees Respite Services 37 allocated hours (specifically dedicated to the respite service), for the manager, to reflect the needs of this diverse and expanding service. Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 26 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK40 3NF 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 Cherrytrees Respite Services I51 s33114 CHERRYTREES RESPITE v216036 310505 Stage 2.doc Version 1.30 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!