Inspection on 07/02/06 for The Haven

This inspection was carried out on 7th February 2006.

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 but made no statutory requirements on the home.

Other inspections for this house

The Haven 30/09/09

The Haven 23/10/07

The Haven 14/08/06

The Haven 15/09/05

The Haven 09/02/05

The Haven 12/07/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE The Haven 29 Telscombe Cliffs Way Telscombe Cliffs East Sussex BN9 7DX Lead Inspector Debbie Calveley Unannounced Inspection 7th February 2006 10:40 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Haven DS0000013995.V266771.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Haven Address 29 Telscombe Cliffs Way Telscombe Cliffs East Sussex BN9 7DX 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) 01273-587183 01273-589428 ANS Homes Limited Mrs Caroline Anne Thomas Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (48) of places The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fortyeight (48). Service users must be aged sixty-five (65) years and over on admission. Service users may have a physical disability and be aged forty-five (45) years and over on admission. 15th September 2005 Date of last inspection Brief Description of the Service: The Haven is a registered care home for older people, which provide nursing care for up to forty-eight residents. An additional variation also allows the home to provide care to residents under the age of 60 years with a physical disability. The home was part of a group of homes previously owned by ANS Homes plc, and has been recently purchased by BUPA. The home is a converted family home and provides accommodation on two floors, which consists of twenty-five single rooms of which twenty-three have an ensuite bathroom, and nine double rooms, one with an ensuite bathroom. There is a lift, which is serviced regularly which ensures level access to all areas of the home. There are adequate communal bathrooms/showers to meet the residents’ needs. The home has equipment to support and assist residents in their daily lives, such as toilet raisers, air mattresses, hoists and assisted baths and showers. The home have communal areas on both floors, one lounge/ dining room on the upper floor, and a lounge and dining room on the first floor. The lower floor is for staff use only and comprises of a staff room and laundry facilities. The home is situated at Telscombe Cliffs, approximately half a mile from the sea front and the local shops. The home is situated on a central bus route. Car parking facilities are provided to the rear and front of the building, and a welltended garden area is accessible to all service users. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 07 February 2006. The inspection commenced at 10.40 am and was conducted over 6 hours. There were forty-one residents living in the home at this time. The methodology of the inspection included a tour of the building, inspection of documentation and records, the delivery of care for nine residents and informal interviews with twelve residents, five relatives and six members of staff. What the service does well: What has improved since the last inspection? The pre-admission assessments viewed at this inspection were correctly completed with signatures and dates. The recruitment process is improved and more robust. All staff have a Criminal Record Bureau check and POVA check and two references prior to commencement of employment. Formal supervision of all staff has commenced and this documented and placed on the staff files. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 6 Training for staff is now documented and in place to ensure the staff are competent in performing their job. The requirements relating to health and safety that were identified at the last inspection have been addressed which ensure that the resident’s health and welfare is protected. The standard of cleanliness throughout the building has improved. The new activity programme is now in place and the feedback from residents, staff and relatives is very positive. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5. The comprehensive Statement of Purpose and Service Users Guide give prospective residents the information required enabling them to make an informed choice about where they live. A pre-admission assessment is undertaken on all prospective residents before admission, which ensures the home can meet the identified needs. All prospective residents and /or their families are encouraged to visit the home before admission to meet other residents and staff and to ensure that the home meets their expectations in respect of facilities and ambience. EVIDENCE: The statement of purpose and service users guide were viewed, it now reflects the new organisation. It was found to be up to date and contained information that prospective service users need to make an informed choice of where to live. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 9 There is an assessment tool in place, which covers all the needs as defined in standard 3.3. Nine pre-admission assessments were viewed, the documents were found to be of a consistent improved standard. The assessment takes place at the prospective residents’ place of residence, and involves the relatives whenever possible and input from other relevant professionals is sought when required. Four residents spoken with, said they remembered someone from the home coming to see them before they left hospital. They felt it was helpful to be able to speak to someone from the home and it also gave them confidence that they would at least know someone when they arrived. As previously mentioned pre-admission assessment identifies any specific needs of the prospective resident and this informs the admission process. These can then be discussed with the resident and their representative to ensure that the home can meet their needs. The statement of purpose also provides information regarding the services they provide. Prospective residents can visit the home to meet residents, to look at rooms that are available and the facilities provided before they make any decision regarding accepting a place. Two relatives said they had visited the home before their parent was admitted, and had made the decision for them. Three residents said that they had visited the home and chosen it because of its location and the warm friendly staff they met when visiting. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Staff practice reflects a sound knowledge of the residents’ healthcare needs, however the documentation in place does not fully reflect the social, nutritional and communication needs of residents. The home has failed to maintain the improvement to their procedures for the administration and recording of medication thus placing residents at risk. EVIDENCE: Nine care plans were viewed and did not fully meet the identified needs of the residents. It was once again noted that the positive outcomes observed at this time are still dependent upon staff knowledge of the residents rather than full and detailed recording. The care planning system in use is under review and BUPA are in the process of introducing a new care planning system. There were omissions in care plans regarding dementia and communication, wound care and nutritional needs. Two residents were identified to the staff as needing a review of their nutritional requirements, whilst one resident was found not to have a care plan in place. Care practice was seen to be of a good standard. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 11 The risk assessments need further development, as they did not fully reflect what action was required for dealing with nutritional and behavioural problems, the identification and prevention of pressure sores and prevention of falls. The clinical rooms were seen to be clean and well stocked, there were up to date policies seen regarding the administration, recording and storage of medicines. The fridge and room temperatures are recorded on a daily basis. There was overstocking of insulin for one particular resident and more than one bottle in use at this time. The medicine administration record charts were viewed, there were a substantial amount of identified gaps on both floors, and these were discussed at the feedback session. An audit should be performed to ensure that the policies and procedures are followed by the trained nurses. The care staff were seen to be treating residents with respect and dignity whilst attending to their needs. Comments from the residents spoken with included, “the staff are very kind” “the staff always speak to me nicely”, “I could not ask for better care”. Two relatives said, “ The staff really care about the residents”. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15. The activities provided by the home meet the individual preferences of the residents. The dietary needs of the residents are well catered for and offer a balanced and varied selection of food that has been updated in line with the personal likes and choices of residents. EVIDENCE: The activities within the home environment have improved greatly since the last inspection. Residents were seen in the main lounge in the morning of the inspection enjoying their coffee and having a very chatty and humorous meeting with the activity co-ordinator. In the afternoon a large group of residents some with their family joined in the bingo session. The atmosphere during the day was positive and inclusive. The activity co-ordinator now comes in at 10 00 am and invites residents to the Gracie Field lounge, no activities are organised, but it gives residents an opportunity to chat and enjoy company. A newsletter “the Haven News” is now going out on a regular basis, which informs everybody of what is happening, has happened and any changes going on. Three residents with their family said The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 13 that they enjoyed getting the information and approved of the contents of the newsletter. From the programmes viewed and resident’s feedback, it evidences that trips are being organised and that a wide selection of entertainers are visiting the home. Feedback from the residents was very positive and some still talked about the Christmas festivities. The activity co-ordinator is gradually building up individual social profiles of all of the residents, which will be taken in to account when producing a programme of activities catering to resident’s personal preferences and interests as much as possible. The residents spoken with all said that the standard of food was good and that they are given a choice of meals. One resident did mention that the food was not her choice, but the staff when told, organised a meal, which she really enjoyed. Menus demonstrated that balanced and varied meals are offered. Records are held detailing daily food choices for each resident. However two queries were identified regarding food and this was discussed in full with the nurses and the chef. The meal served on the day of the inspection was enjoyed by most of the residents. Five residents said that the food was “good”. Another said, “ I enjoy the food, it is always hot and tasty”. Others said that they had no complaints or concerns regarding the food. Two relatives visiting together said that “the staff were great, they helped residents eat and always checked to make sure that they were eating enough, can not praise the patience of the staff enough”. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. The complaint procedure is clearly detailed in the Statement of Purpose and Services Users Guide and is available to residents and their families enabling them to share their concerns formally and confidentially. Staff interviewed had a good understanding and knowledge of Adult Protection policies and procedures, which protect the residents from harm and abuse. EVIDENCE: There are appropriate policies and procedures in place regarding complaints, and it was confirmed that these are followed when investigating any concerns raised at The Haven. The complaint book was viewed and this demonstrated that all complaints are recorded, along with the outcome and action taken by the home to resolve the complaint. The staff interviewed were knowledgeable regarding the complaint procedure and of how to start the process if the manager is not available. No complaints have been received by the CSCI since the last inspection. The Adult Protection policy in the home was found to be up to date and staff interviewed were knowledgeable about the systems in place to protect vulnerable service users. There is on-going training for all staff in Protection of Vulnerable Adults. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. The home provides a comfortable, clean and safe environment for those living there and for those visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the resident’s personalities and interests. EVIDENCE: A tour of the premises was carried out and the home was found well maintained and the décor is good throughout. The Haven provides comfortable and homely communal space, consisting of two lounge areas and a dining room. The upstairs dining room/lounge area has been decorated since the last visit and was found to be homely and comfortable. The downstairs lounge is now well used by the residents and was warm and comfortable. Bedrooms have been redecorated on a rolling programme and carpets previously identified as stained have been deep cleaned or replaced. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 16 Residents are encouraged to personalise their own rooms and many have done so with ornaments, pictures and small pieces of furniture. One room used at present for short stay was very plain, but the maintenance person found some pictures immediately much to the delight of the resident. There are toilet, washing and bathing facilities to meet the needs of the service users, including showers and assisted baths. Random water temperatures were taken and were of the recommended temperature of 42 ° Celsius, the record book for the tests of water, fire alarms and call bells indicate that they are regularly tested. Specialised equipment to encourage independence is provided e.g. handrails in bathrooms, hoists, wheelchairs and lifts to all areas of the home. A call bell facility is in place, however during the inspection not all call bells were not all found in reach of the residents. The residents in the dining areas and lounge areas did not have access to a call bell, those residents that can’t physically ring for help, need to have an appropriate risk assessment in place and a plan of action/monitoring to ensure their safety and comfort. This was identified at the last inspection and remains outstanding. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. Good practice by staff was observed during the day and there were gloves and aprons freely available in the home. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29. On the morning of the inspection, staffing levels were seen to be adequate to meet the needs of the residents. Recruitment files were viewed and were found to have all the relevant information required to safeguard the residents. EVIDENCE: The staffing levels for the morning shift comprised of two trained nurses and ten carers, which was seen to be sufficient to meet the resident’s needs at this time. The staff spoken to also said the staffing levels in the morning enabled them to give the standard of care required. Six residents said they felt the care was good and they were well looked over. The afternoon shift demonstrated that staffing levels are halved and that there were two trained nurses and four carers on duty. From discussions with staff and residents it is difficult to maintain the level of care in the afternoons. It was noted that all residents are bathed in the mornings and none in the afternoons. The care plans do not evidence that a choice is offered, again one resident said that she would prefer a relaxing bath in the afternoon instead of a shower in the morning but can’t because there are not enough staff. This was not reflected in her care plan. Staff confirmed that no baths are offered in the afternoon, as staffing levels do not allow it. This is highlighted as a concern for the second time because it reflects upon choice and lifestyle of individual residents. Staffing levels need to The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 18 reflect the needs of residents and respect their choice of lifestyle. Increased staff in the afternoon would allow staff to bathe people according to their wishes and free staff in the morning to interact more with residents. A selection of staff recruitment files were viewed and demonstrate that the process followed is more robust than previously found and contained all the relevant information required. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept in a lockable facility within a locked room. The induction programme now in place is more detailed and has been introduced for all new staff. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38. The Registered Manager has the necessary experience and qualifications to run the home effectively. Residents’ financial interests are safeguarded by the homes policies and procedures. All aspects of resident’s health, safety and welfare were seen to be protected and promoted. EVIDENCE: The Manager, Caroline Thomas, is a first level registered nurse and holds an orthopaedic nursing certificate. She has been the manager of The Haven for seven years; prior to this she has managed other nursing homes for nine years. She holds the NVQ D32/33 assessors course and has commenced the Registered Managers award course. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 20 The ethos of the home is to focus on the residents and staff were observed doing this. Resident meetings are held, but are poorly attended, residents spoken with said they did not want to attend the meetings, were happy with the home as it is. It may be beneficial to include these meetings in the newsletter and see if it promotes any interest. It was confirmed by the homes administrator and manager that the employment policies and procedures, induction training and formal supervision have been implemented. Residents’ financial interests are safeguarded by the homes policies and procedures. All staff spoken with were aware that they must not be involved in any financial matters of the residents, they also said that they would not accept money or gifts from residents. Regulation 26 visits take place and are sent to the CSCI area office. All records required by regulation for the protection of the residents are in place and accurate. Individual records and home records are kept secure and up to date and are maintained in accordance with the Data Protection Act 1998. The staff are issued with certificates yearly for Manual Handling, twice yearly for Fire Safety and Food and Hygiene. The home has a comprehensive set of policies and procedures, which govern the running of the home. All relevant legislation and procedures are in place in respect of Health and safety. Good practice was observed throughout the inspection in respect of the safety of residents when being moved and transferred. Fire precautions were seen to be adhered to and staff showed a good knowledge of the mandatory training that is required. All staff need to be reminded that residents’ call bells are to be in reach of the resident at all times. On speaking to staff they acknowledge that when residents are transferred from bedroom, to lounge then to the dining room it is sometimes forgotten. A system of checking by a senior nurse at certain key times would be beneficial. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15(2)(b) 13(4)(b) Requirement That a comprehensive plan of care is generated from a comprehensive assessment and drawn up for/with each service user, and it is reviewed at least once a month.(Previous time scales of 1/02/05 & 15/12/05 not met) Risk assessments must be undertaken for those service users at risk of falls, at risk from pressure damage and weight loss. Assessments must include the management of identified risks. That an identified service user has a care plan in place. That service users or their representatives are involved in the formation of care plans. That service users records comply with schedule 3 and that the nursing documentation complies with NMC guidelines.( Previous time scale of 1/02/05 & 15/12/05 not met) That the medication charts are DS0000013995.V266771.R01.S.doc Timescale for action 01/06/06 2 OP8 13(1)(b) 17(1)(a) Sc3 01/06/06 3 OP9 13 (2) 07/02/06 Page 23 The Haven Version 5.0 4 OP27 18 (1) (a) completed properly as Per NMC guidelines and the homes policy and procedure for the admininstration of medication. ( Previous time scale of 15/12/05 not met) That there sufficient staff are on duty at all times to meet the needs of the service users. (previous time scale of 15/12/05 not met.) 01/06/06 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 Refer to Standard OP38 Good Practice Recommendations That residents have access to a call bell at all times. The Haven DS0000013995.V266771.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 DS0000013995.V266771.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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