Archived: St John's House

We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

• Staff understanding of the Mental Capacity Act and its application in practice varied and staff were unclear of their role in the application with the Act. A client’s mental capacity had not been formally assessed. This meant the client’s ability to make decisions and choices regarding their care and treatment had not been considered. Attendance of training in the Mental Capacity Act was low. The service did not have a Mental Capacity Act policy or arrangements in place to monitor the application of the Act

• Compliance for three out of the nine mandatory training courses were below 75% including anaphylaxis so we could not be sure that staff skills were up to date.

However, we also found the following areas of good practice:

• The service had recruitment and selection policies and procedures which supported the safe recruitment of staff. The service had sufficient staff and had not used bank or agency staff in the last 12 months prior to the inspection. It had good lone working systems in place to ensure staff safety.

• Staff received quarterly supervision and annual appraisals in line with the service’s own policy. All staff felt well supported within the organisation. They felt there was support amongst peers and that management supported them well. There was a strong team ethic.

• Staff could identify the different types of abuse and knew how to make safeguarding referrals. The service had effective systems and processes in place to report and monitor incidents. Staff could provide examples of lessons learned when things went wrong and improvements made following incidents.

• Staff had good working relationships with external organisations and worked closely alongside them to support the clients. The service delivered care and treatment in line with national guidance and best practice. Staff attended practice development groups to ensure they kept up to date with current guidance. Staff used evidence based assessment tools to measure clients’ substance misuse and emotional wellbeing.

• Clients told us that staff kept them informed of other services which were available to offer support to them. Clients were happy with the service they received. They said staff understood them, treated them as individuals and as adults. Staff worked with clients’ families as well as the client and offered support where they could. Volunteers were clients who had completed treatment and they told us they felt part of the team and were all happy within their roles.

• The service offered a robust system for contacting clients who failed to attend appointments. It offered one late night clinic per week for clients who were unable to attend during normal opening hours. The service reported there was a rapid access procedure which ensured clients released from prison were seen that day.

• The service had seen an increase in both alcohol and drug clients successfully completing treatment. Quality assurance visits to assess the quality of the care provision had been undertaken by senior managers in the last 12 months.

• Governance systems to ensure monitoring of staff supervision, appraisals, key performance indicators, audits, incidents and complaints were mostly effective. Systems and partnership working at all levels appeared cohesive and seamless, with a strong partnership approach.