Inspection on 08/12/05 for Haven Residential Rehabilitation Alcohol Dependency Unit The

This inspection was carried out on 8th December 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Haven Residential Rehabilitation... 01/06/09

Haven Residential Rehabilitation... 30/04/09

Haven Residential Rehabilitation... 02/05/08

Haven Residential Rehabilitation... 10/05/07

Haven Residential Rehabilitation... 15/06/06

Haven Residential Rehabilitation... 22/06/05

Haven Residential Rehabilitation... 02/12/04

Haven Residential Rehabilitation... 19/05/04

Similar services:

Oakmount Hostel

Ark House

St Anne`s Alcohol Services - Leeds

Lynwode Park

Parkfield Rest Home

Priory Road

Elmhurst

Linwood Court

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Haven Residential Rehabilitation Alcohol Dependency Unit The The Haven 5-7 Marshall Avenue Bridlington East Yorkshire YO15 2DT Lead Inspector Mr M. Tomlinson Unannounced Inspection 8th December 2005 09:45 Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 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 Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 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. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Haven Residential Rehabilitation Alcohol Dependency Unit The The Haven 5-7 Marshall Avenue Bridlington East Yorkshire YO15 2DT 01262 400329 Address 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) Mr Cyril Herbert Dennis Marsburg *** Post Vacant *** Care Home 10 Category(ies) of Past or present alcohol dependence (10) registration, with number of places Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd July 2005 Brief Description of the Service: The Haven is a residential facility for up to ten service users who have alcohol dependency problems. It is situated in the centre of Bridlington close to all main community facilities and the public transport network. The staff team consists of the registered person who lives on the premises the manager (not currently registered) and two qualified counsellors employed on a ‘sessional’ basis. The double fronted property has two floors. There are eight single and two double bedrooms. None have en suite facilities. The property does not have a passenger lift and is consequently not suitable for service users who have mobility problems. Nursing care or medical detoxification is not provided. The home provides a programme of recovery for service users who have made a positive decision to stop drinking alcohol. The service users are required to be alcohol free prior to their admission into the home and must remain so 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 admission process and incorporated in the Service Users’ Guide. The rehabilitation and recovery programme is generally based on the recognised ‘twelve step’ approach as advocated by Alcoholics Anonymous. This process involves manageable stages so that the service users can obtain sobriety and are prepared for living within the community. The programme of recovery takes a minimum of three months to complete but the time scale is flexible to take into account each service user’s needs, abilities and circumstances. 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 relearn, life skills in order to develop their confidence so that eventually they are able to live independently within the community. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two unannounced statutory inspections to be undertaken on The Haven by the Commission for Social Care Inspection during this inspectoral year. The inspection took six hours in total including preparation time and telephone conversations with social care professionals. The manager and registered provider were available throughout the inspection. The inspection focussed primarily on the requirements and recommendations made during the previous inspection and the ‘key’ National Minimum Standards not assessed on that occasion. The inspection also incorporated an investigation into concerns raised by a former service user alleging poor care practices. Whilst these concerns were not substantiated, it was apparent that some specific practices and arrangements were not clearly identified in the home’s brochure or the Service Users’ Guide thereby restricting a placing authority’s ability to make a considered decision on the appropriateness of a proposed placement. In addition to the manager, discussions were also held with service users both individually and on a group basis. Without exception they commended the quality of the service provided by The Haven. This was also supported by a visiting social worker. In the light of the concerns raised by a previous service user, a number of social care professionals, who have used the service, were contacted in order to obtain their views on the service provided by The Haven. Without exception they expressed satisfaction with the quality of the service provided and the balance achieved between the recovery and rehabilitation programmes. A general comment made by these social care professionals was that care must always be taken by the placing authority to ensure that the placement is appropriate for the individual and that this is particularly important for this client group given the range and diversity of the rehabilitation and recovery programmes available. What the service does well: The Haven provides the service users with an opportunity to obtain sobriety and undertake a programme of rehabilitation to enable them to live independently within the community. This is primarily achieved through a programme of therapy and excellent staff and peer group support. From discussions with several social care professionals it was apparent that The Haven has achieved a good rate of success with the majority of ex-service users retaining sobriety. It was also evident that the service users are treated with appropriate respect and are encouraged to take responsibility for their own actions thereby promoting their independence. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 6 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. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 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 Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 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): 1, 2, 3, 4 and 5 The information provided for prospective service users and/or their placing authority does not provide sufficient detailed information on which a considered decision can be made as to the appropriateness of the proposed placement. EVIDENCE: In response to a request from a placing authority for a client to be accommodated at The Haven, they are sent a copy of the home’s brochure. This, however, is written in very general terms and does not provide sufficient detail of the programme of recovery for the authority to make a considered decision as to whether the prospective placement is appropriate. For example, there is no detail of the staffing arrangements and whether the staffing provides 24-hour coverage. It refers to the ‘twelve-step’ approach to recovery but again does not provide detail on how that is to be addressed. It also refers to alternative methods of recovery but does not expand on this. The brochure is, however, supplemented by the Service Users’ Guide, which is provided to a prospective service user when they visit the home for a pre-admission assessment. On the day of the inspection a prospective service user was visiting the home accompanied by their social worker. A discussion was held with the social worker who expressed satisfaction with the service provided by the home and the balance achieved between the formal recovery programme and the Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 9 rehabilitation element of the programme. The social worker stated that whilst the approach of The Haven to the recovery programme was less formal and was not as structured as that employed in other rehabilitation units, it was, in his opinion, appropriate for certain clients who did not respond well to the more formalised approach. He said that all four of his previous clients had maintained sobriety after leaving The Haven. He also confirmed that all prospective service users had undergone a pre-admission assessment carried out by the manager of the home. It was evident from an inspection of the service users’ care records that they had been provided with a contract by their placing authority. There was, however, a considerable variation in the standard of content of these contracts. At one end of the scale contracts were provided in considerable detail and clearly stated the expectations of the placing authority, and at the other extreme, contracts consisted of one sheet of paper that identified the client, the cost of residence and the notice to be provided by the placing authority. The service users are required to sign an ‘agreement of residency’ to comply with the Rules and Terms and Conditions of The Haven. These were incorporated into the Service Users’ Guide that was provided for all prospective service users. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 10 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): 10 The service users are provided with appropriate support and guidance by the staff and their peers to enable them to obtain sobriety. EVIDENCE: These standards were not assessed in full on this occasion. From discussions with the service users both as a group and as individuals, it was evident that they were very aware of what was going on in the home. They felt that they had reasonable say in the routines of the home and that they had been provided with appropriate levels of responsibility. They were of the opinion that the registered person and the manager listened to their views and opinions and that the manager and registered person were always available for personal discussions in private. The service users also had the opportunity to discussions any issues or problems during their daily meeting. Some of the service users expressed concern that personal information that had been discussed during their one-to-one meeting with their counsellor had also been discussed during the group sessions. They felt that this was a breach of confidentiality. The manager was aware of this problem and had addressed it with the counsellor concerned. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 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): 11, 15 and 16 The service users are provided with an opportunity to learn, or re-learn, life skills to enable them to live independently within the community. EVIDENCE: According to the service users they were provided with the opportunity to develop their skills as part of the rehabilitation programme. They felt that one of the most important aims of the recovery programme was to build up their self-confidence, self-esteem and pride in themselves. They were of the opinion that the method rehabilitation employed by the home was very successful in achieving this aim. They provided several examples of how they had made progress with respect to this aim and how they had been assisted by the manager and registered person to be re-integrated into the community. Whilst they acknowledged that ‘boundaries’ and rules were necessary for them to achieve their aim of sobriety, they also considered that they had to take personal responsibility for achieving that aim. They stated that in their opinion an appropriate balance had been achieved with regard to this approach. As part of the rehabilitation programme the service users were allocated domestic tasks on a rota basis. It was evident that the service users undertook these Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 12 tasks willingly. The service users confirmed that the recovery programme, the associated house rules and conditions for their residence in the home were fully explained to them during the admission process. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 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): None EVIDENCE: Whilst these standards were not fully assessed on this occasion, time was spent in discussing the procedure and outcome for service users who relapsed during their stay at The Haven and took alcohol. The Service Users’ Guide specifically states on this subject that; ‘No one who has been drinking may enter the premises’ and ‘ any resident who drinks (alcohol), takes drugs or abuses prescribed medication, will be asked to leave’. In practice these ‘house rules’ have not been applied in their entirety. For example where service users have had a relapse and have consumed alcohol, the circumstances for their relapse had been taken into account and the service users and the manager had taken a decision as to whether or not they should continue with the programme of recovery. Two recent examples of this process were given. Without exception the service users spoken to were in agreement with regard to this procedure. Another aspect discussed was the fact that the responsible person lives on the premises and on occasions he would drink alcohol socially when out of the building. It could, therefore, be argued that he should not enter the premises as stated by the house rules. In reality, the service users were aware that the registered provider had an occasional social drink and did not object to this. They were of the opinion that they had to face reality if they were going to live successfully in the community. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 14 As stated in the Service Users’ Guide there are times when service users may be requested to undertake a ‘breath test’ to see if they have been consuming alcohol. According to the manager this action is not taken ‘as a matter of course’ but is normally used if there is a suspicion of alcohol use. It was the manager’s opinion that to overuse this practice would undermine the trust built up with the service users and that in reality the decision as to whether to drink alcohol remained ultimately with the service users. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 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 and 23 The network of support provided for the service users should ensure that any concern would be quickly identified and acted upon. EVIDENCE: As identified during the previous inspection, 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 available to the service users should ensure that any adult protection issue would be quickly identified and acted upon. Several of the social care professionals who had clients at The Haven stated that they had regular and personal contact with their clients and by doing so the service users had the opportunity to discuss any problems or issues relating to the service provided at The Haven. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 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 the following standard(s): None EVIDENCE: These standards were not assessed on this occasion. In response, however, to a concern raised by an ex-service user the security arrangement for the home were discussed. In general the main entrance door was kept unlocked and service users had unrestricted access into, and from, the property. During the evening the main door and the rear door were locked. Although there was a mortise lock on the main entrance doors, this was not, according to the staff and the service users, ever used and reliance was placed on the use of the Yale lock. This consequently meant that the service users could leave by the main door at any time whilst the security of the property was maintained. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 17 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): 31, 32, 33 and 35 The service users are provided with good support from knowledgeable and experienced staff. EVIDENCE: It was apparent that there had been no changes made to the staffing levels since the previous inspection. The day staffing continued to consist of the manager, the registered person and two counsellors who were employed on a ‘sessional basis’. The manager had also undertaken training in counselling. In general the registered person provided cover at night. According to the manager there were short periods of time when there were no staff on the premises. On such occasions a member of staff would be on-call and a nominated service user would take responsibility for overseeing the safety and welfare of the service users. Once again, however, these arrangements were not clearly identified in the home’s brochure or the Service Users’ Guide. According to a Counsellor there was some confusion as to the remit, responsibilities and roles of the staff. An ex-service user was in the process of being trained with a view of them becoming a member of staff. This had a considered decision by the manager and had taken into account this person’s skills, qualifications and experience. The manager confirmed that a full vetting procedure is to be undertaken on this prospective member of staff. The training of this ex- service user was with the knowledge, cooperation and agreement of their social worker and the service users accommodated at The Haven at the time of the inspection. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 18 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): 37,38,41 and 42 The service users and staff would benefit from having the manager registered with the Commission for Social Care Inspection by her increased accountability. EVIDENCE: It was apparent from discussions with the service users that the home was managed and run primarily for their benefit. The service users were, for example, very aware of the contents of their personal records and confirmed that they had regular access to them. Following the previous inspection the contents and security of the service users’ records had been improved. The manager, who is in the process of applying to be registered by the Commission for Social Care Inspection, employed an open, inclusive and democratic style of management. It was evident that she had established a good relationship with the service users and had gained their trust and respect. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 19 From an examination of the records, it was evident that the manager and registered provider had taken appropriate action to ensure a safe environment for the service users. Training for staff in statutory subjects such as first aid and moving and handling procedures had yet to be implemented. It is, however, acknowledged that the manager is in the process of addressing this issue possibly through the use of training videos. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 20 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 1 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X x 2 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 4 12 X 13 X 14 X 15 3 16 4 17 Standard No 31 32 33 34 35 36 Score 2 3 3 X 1 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X Standard No 37 38 39 40 41 42 43 Score 1 X 3 X X 3 x Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 5 Requirement The Service Users’ Guide and Statement of Purpose must accurately reflect the service provided, the staffing arrangements and details of the recovery programme. Staff must be provided with training in statutory subjects such as first aid, moving and handling and food hygiene procedures. The manager must apply for registration to the Commission for Social Care Inspection Timescale for action 01/03/06 2 YA35 18 01/05/06 3 YA37 8 01/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA10 YA31 Good Practice Recommendations Action should be taken to ensure that the confidentiality of information on service users is maintained. The job descriptions for the staff should clearly identify their role, remit and responsibilities. Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection York Area Office 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 Haven Residential Rehabilitation Alcohol Dependency Unit The DS0000019743.V267932.R01.S.doc Version 5.0 Page 23 - 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!