Archived: Whitecross House

We rated Western Counselling as good because:

• The service had sufficient staff to ensure the identified needs of clients were met. Staff were compassionate and respectful and treated clients with dignity. Staff provided practical and emotional support to a high standard.
• Risk assessments and recovery plans were personalised, thorough and reviewed regularly. Staff acted appropriately to keep people safe. Recovery plans were person-centred and included physical, psychological and social needs.
• Clients could access specialist services, support and urgent care when needed, and were supported to live healthier lives. Staff aimed to involve clients in all aspects of the service.
• The service was responsive to concerns identified and acted on these to make improvements.
• The service recruited volunteers, many of whom went on to be offered permanent roles.
• Staff we spoke with felt that leaders and managers of the service encouraged an open, supportive and honest culture. They valued the open-door policy that had been put in place. Staff received regular supervision and annual appraisals.

However:

• The service did not have a clear set of values that staff were able to articulate. Policies and procedures were not all up to date, accurate and fit for purpose despite having been recently reviewed.

We do not currently rate independent standalone substance misuse services. Our last comprehensive inspection of Western Counselling Services was in November 2016. At that inspection, we issued a requirement notice. Issuing a requirement notice notifies a provider that we consider they are in breach of legal requirements and must take steps to improve care standards. On 10 May 2018 we undertook an unannounced, focused inspection to see whether the provider had made the required improvements.

•  At the last inspection in 2016 we said the provider must ensure that all prescription/medicine administration records are signed by a doctor. In May 2018, we saw that all 13 of the current prescription/medicine administration records were signed by a GP.
•  At the last inspection in 2016 we said the provider must ensure that clients are fully informed when methadone is given in tablet form, rather than liquid (as per national guidelines) and should ensure the clients understand the reason for its use and their consent is sought. In May 2018, staff were able to explain their new process for highlighting this in their admission process. Clients who were due to receive methadone as part of their rehabilitation had the reasoning for using tablets instead of oral liquid explained to them. They were then asked to sign a consent form to show their understanding and consent. We saw that this practice was being followed.
•  At the last inspection in 2016 we said the provider must ensure that medicines are administered from their original packaging from the dispensing pharmacy. In May 2018, we saw that the service was now receiving medication from the pharmacy, in sealed dosset boxes to remove the need for staff to decant medicine into another packaging.