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Inspection on 22/06/05 for Haven Residential Rehabilitation Alcohol Dependency Unit The

Also see our care home review for Haven Residential Rehabilitation Alcohol Dependency Unit The for more information

This inspection was carried out on 22nd June 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service users were provided with good standards of support and guidance that gave them an excellent opportunity to obtain their aim of sobriety. They were also provided with a range of opportunities to develop their social skills and enhance their ability to live independently within the community. It was the view of the service users that the programme of recovery succeeded due to the attitude of the staff towards them as it was based on respect and understanding. One service user stated, "If I didn`t like it here then I would pack my bags and go".

What has improved since the last inspection?

The manager had continued to develop the service particularly with regard the service users` integration into the community. Progress had also been made in the development of policies, procedures and record keeping.

What the care home could do better:

The information in the Statement of Purpose and Service Users` Guide needs to be reviewed to ensure that it is accurate and consistent. This particularly applied to the description of the number of service users that can be accommodated and details of the telephone and fax. numbers. Consideration needs to be given to making the care records more secure and to ensure that the care plans and associated documentation is maintained in a logical sequence thereby providing an audit trail of these records.

CARE HOME ADULTS 18-65 The Haven Residential Rehabilitation Alcohol Dependency Unit 5-7 Marshall Avenue Bridlington East Yorkshire YO15 2DT Lead Inspector M.A. Tomlinson Unannounced 22 June 2005 09:30 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. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Haven Residential Rehabilitation Alcohol Dependency Unit The Haven 5-7 Marshall Avenue Bridlington YO15 2DT 01262 400329 01262 400329 haven-alcoholicinfo@yahoo.com Mr Cyril Herbert Dennis Marsburg Address 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) Position vacant Care home only 10 Category(ies) of A Alcohol dependency past/present (10) registration, with number of places The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 02.12.04 The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: The Haven is a residential facility for up to ten people with alcohol dependency problems. It is situated in the centre of Bridlington close to local amenities and public transport facilities. The double fronted property has two floors. There are eight single and two double bedrooms. None are en suite. The property does not have a passenger lift and is consequently not suitable for service users who have problems of mobility. Nursing care or medical detoxification is not provided. The home offers support to people who have made a positive decision to stop drinking. Service users have to agree to remain alcohol-free whilst resident in the home. They are encouraged to maintain contact with family and friends within agreed limitations. Specific house rules deemed to be necessary and of benefit to the service users are explained during the admision process and are incorporated in the Service Users Guide. The rehabilitation and recovery programme is generally based on the twelve step approach so that by manageable stages the service users can obtain sobriety and are prepared for reintroduction into the community. The programme takes a minimum of three months to complete but the time scale is flexible to take into account the service users individual needs and abilities. It is primarily based on group and individual therapy/counselling and places considerable emphasis on peer group support. Through the use of a planned daily routine, the service users are provided with an opportunity to learn, or re-learn, life skills in order to develop their independence and live within the community. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two statutory inspections to be undertaken by the Commission for Social Care Inspection during the current inspectoral year. The inspection took a total of six and a half hours including one hour preparation time. Time was spent with the manager to discuss the progress made to address the requirements and recommendations identified during the previous inspection. The five service users were spoken to as a group without staff being present. Since the previous inspection the registered manager had left and the registered provider and the current manager had taken over the management role jointly. The intention is for the current manager to be registered with the Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? What they could do better: The information in the Statement of Purpose and Service Users’ Guide needs to be reviewed to ensure that it is accurate and consistent. This particularly applied to the description of the number of service users that can be accommodated and details of the telephone and fax. numbers. Consideration needs to be given to making the care records more secure and to ensure that the care plans and associated documentation is maintained in a logical sequence thereby providing an audit trail of these records. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 7 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 Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 8 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 The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 9 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) 1,2,3,4 and 5 Prospective service users are provided with excellent information on the services provided by the home thereby enabling them to make an informed decision about their admission into the home. EVIDENCE: Following the requirement made during the previous inspection, the manager (not registered) had produced a separate Statement of Purpose and Service Users’ Guide that contained all of the required information. The information was clear and unambiguous. Additional information specific to the role of The Haven was also included. For example, the ‘House Rules’ were clearly stated. A copy of the Guide had been provided for all prospective service users during the admission stage. The Guide had been produced to a high standard and was ‘user friendly’ and professional in presentation. It was noted, however, that the telephone and fax number were different in the Statement from those contained in the Guide. It was also noted that the Statement referred to The Haven as being ‘an alcohol free community of up to 14 people’. This could be seen as being misleading as the home is actually registered for 10 service users although there are 14 beds available including those in shared rooms. The service users spoken to confirmed that they were advised of the service to be provided during the assessment process. They said that ‘nothing came as a surprise’. The service users had been provided with contracts of residence, copies of which were retained with the care records. Contracts had also been The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 10 provided by the placing agencies. The manager had undertaken the preadmission assessments. They were reasonably comprehensive and provided sufficient information on which a considered decision could be made regarding the appropriateness of a prospective placement. The service users confirmed that during the assessment process they were provided with an opportunity to discuss the rehabilitation programme and were advised of any restrictions or ‘house rules’. An important aspect of the assessment process was to establish the prospective service users’ motivation to obtain sobriety. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 11 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) 6,7,8 and 9 The service users’ needs are met through the provision of a clear and consistent assessment and care planning process. EVIDENCE: Following the previous inspection, the manager had developed a care plan for all of the service users. This was in addition to the care plan provided by a service user’s placing agency. The care plans were retained along with care records. Three care plans were inspected. The care plans were primarily based on the prime remit of the home (i.e. recovery) but also took into account any specific needs of a service user. The care plans also included a risk assessment of each service user, a health record and evidence of reviews. There was recorded evidence of service user involvement in the development and implementation of the care plans and they had signed their care plans in agreement. Confidential records were also maintained of the discussions between a service user and their Counsellor. These were not inspected on this occasion. It was evident from discussions with the service users that they are actively encouraged to make decisions and choices themselves. The possible consequences for such decisions being discussed with the staff and The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 12 Counsellors. A service user reiterated that they are encouraged by the staff to ‘take decisions and take responsibility for their lives and actions’ as part of their life skills training and rehabilitation back into the community. Risk taking was also an important element of the service users’ rehabilitation programme. One service user stated, “Life is full of risks and we will be vulnerable when living in the community, so it is important that we accept and acknowledge those risks now” and another “I intend to return to college and train in IT Networking”. It was evident that the service users could participate in community activities, albeit with peer group support. On the day of the inspection two service users were, for example, going swimming in the local pool. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 13 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) 11,12,13,14,15,16 and 17. The service users have good links with the community and are provided with opportunities to participate in a range of educational and social activities that enable them to develop their social and life skills. EVIDENCE: The service users cited their personal development as being an integral part of the recovery programme. Not only was this the core aim of obtaining sobriety but also included developing their life and social skills. The service users provided practical examples on how this was achieved including participation in community activities. The service users said that they had ‘free time’ during the evenings and weekends to follow their social activities. One service user had become involved in the local church and was undertaking an ‘Alpha Course’. The service users confirmed that they were encouraged to maintain contact with their families although some had chosen not to do so for understandable reasons. One female service user said “ I have a family and have found it difficult being away from them.” Whilst the staff respected the rights of the service users, it was explained to them during the admission The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 14 process that some of these rights have to be tempered to take into account their vulnerability and the need to achieve sobriety. Any limitations to rights were identified in the Service Users’ Guide. The menus indicated that the meals provided for the service users were varied and provided a reasonably balanced diet. It was observed that lunch was a social occasion with the service users assisting with the preparation and serving of the meals. They also laid and cleared the dining room table without reference to, or encouragement from, the staff. Without exception the service users expressed their satisfaction with the standard of the meals. They also confirmed that they occasionally had meals out often paid for by the registered provider. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 15 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 Personal support is provided for the service users in such a way as to promote and protect their independence, privacy and dignity. EVIDENCE: The service users were unanimous in their view that the programme of recovery succeeded because of the attitude of the staff towards them. One service user said that they were treated with respect and that their views and opinions were taken seriously and personal support was provided in a mature and encouraging manner by the staff. Some service users had experience of other rehabilitation units but said that they preferred The Haven for its ethos of informality and personal responsibility. One service user stated “If I didn’t like it here or the way the staff treat me, then I would pack my bags and go”. The records confirmed that the service users had good access to health and social care professionals. One said, “My social worker telephones me every week”. The service users accommodated at the time of the inspection were not on medication. The service users agreed in their contract of residence to initially handover all medication on admission to the home’s manager so that it could be appropriately monitored. It is the aim of the home that the service users will take greater responsibility for their medication as they progress through the recovery programme. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 16 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 The service users are protected by a good support network. The systems for service user consultation are good with a variety of evidence that their views are sought and acted upon. EVIDENCE: An appropriate complaints procedure was in place. The service users had the ability and confidence to make a formal complaint if they deemed it necessary. They considered that this would be unlikely as they always had an opportunity to raise and discuss problems and issues either on an individual or a group basis. The complaints procedure was incorporated in the Statement of Purpose and the Service Users’ Guide. The manager had implemented an Adult Protection procedure including a Whistle Blowing policy. From information provided by the staff and service users, it was evident that the internal and external support for the service users should ensure that any adult protection issue would be quickly identified and acted upon. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 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 standard(s) 24,28 and 30 The service users continue to be provided with a comfortable and safe environment that is conducive to their aim of achieving sobriety and the development of their life skills. EVIDENCE: An inspection of the service users’ bedrooms and bathing facilities was not undertaken on this occasion. Following the previous inspection, the dining room had been divided in half with the portion at the front of the building being converted into the manager’s office. This had made the manager physically more accessible to the service users and visitors to the home and provided the manager with an improved working environment. The rear portion of the original room had been retained as a dining room, which provided adequate space for the number of clients being accommodated. The manager’s original office at the rear of the building had a multi-purpose use including a counselling area, gymnasium and therapy room. The service users still had access to a games room and a lounge. The latter also being used for meetings and group work. These rooms were furnished and decorated to a good standard. The service users had responsibility for the cleanliness of the The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 18 premises as an integral part of their life skills training. Those parts of the premises inspected were clean, hygienic and totally free of any unpleasant odours. The overall impression was one of informality and homeliness. The service users expressed satisfaction with their accommodation. None of the current service users required the use of specialist equipment. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33 and 35 The service users are provided with excellent levels of support by knowledgeable and experienced staff. EVIDENCE: No changes had been made to the level of staffing since the previous inspection although it was the intention of the manager to employ an exservice user as part of the staff team. The current staff team consisted of three qualified counsellors, including the manager, and the registered provider. The staff were assisted by two volunteers. The service users primarily required emotional and social support. They were physically and mentally able and considerable emphasis was placed on peer-group support and selfreliance. It was evident form discussions with the service users that the staffing levels were appropriate for their needs. Whilst the staff were qualified for their primary role, there was no evidence that they had received training in statutory subjects such as first aid, health and safety or adult protection procedures. The manager acknowledged this shortfall and was considering the use of training videos to address the problem. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.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) 37,38,39,41,42 and 43 The manager has a clear development vision for the home which has been communicated to the service users and the staff. EVIDENCE: It was evident from discussions with the service users that the home was well managed and provided a good standard of service to enable them to achieve their aim of sobriety. It was also evident that they had a good relationship with the staff and that this relationship had been established on the basis of mutual respect. The management of the home was transparent and democratic. The manager presented as being enthusiastic and had a clear view on how they would like to see the service develop. It was evident that the service users were directly involved in the development of the service provided and that their views and opinions were taken into account in respect to any proposed changes to the service. The service users presented as having a degree of control over the running of the home and ownership over their environment. The home’s policies, procedures and records generally satisfied the National Minimum Standards and were designed and implemented The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 21 primarily for the benefit of the service users. The care plans, however, were kept in ‘loose leaf folders’ and pages could easily be misplaced. It was difficult to cross-reference between the care plans and other records, as some information in the care plans was not in sequence. The manager also had some difficulty in locating some of the care plans. Inspections had been undertaken by the Fire and Rescue and Environmental Health Departments and evidence was provided to confirm that action had been taken to address recommendations made by these inspections. The fire and accident records were in inspected. It was evident that action had been taken to provide a safe environment for the service users and the staff, including the development and implementation of risk assessments. The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.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 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 3 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 Standard No 11 12 13 14 15 16 17 4 3 4 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Haven Residential Rehabilitation Alcohol Dependency Unit Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 4 3 x 2 2 3 Version 1.30 Page 23 J53-J04 S19743 The Haven V231749 220605 Stage 4.doc 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. 1. Standard 35 and 42 Regulation 18(c)(i) Timescale for action The staff must receive training 1st in statutory subjects such as first December aid, health and safety and adult 2005. protection procedures. Requirement 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 1 Good Practice Recommendations The information contained in the Statement of Purpose and Service Users Guide should be accurate, consistent and unambiguous. For example, the number of service users that may be accommodated must relate to the registration criteria. The care records should be maintained in such a way as to enable an audit to be undertaken of the information and where necessary cross-referenced with other records. An improved standard of security should provided for these records. 2. 41 The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross York YO32 9GZ 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 The Haven Residential Rehabilitation Alcohol Dependency Unit J53-J04 S19743 The Haven V231749 220605 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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