Archived: No. 3

No. 3 is a residential substance misuse service in East Maling, Kent. The service offers medically monitored alcohol detoxification and rehabilitation, for up to three people, using motivational interviewing and cognitive behavioural therapy. This is a programme that assists people with a alcohol dependency by helping them to recognise problems, or potential problems, related to their drinking and how to resolve these problems through positive change and the belief in the ability to change.

This was the first time we had rated this service. We rated it as requires improvement because:

• There was a lack of oversight and quality assurance processes were not fully developed. The service did not have a risk register and had no audit programme to evaluate the quality of care provided.
• There was a lack of relevant information regarding the employment of staff. There were gaps in employment history and missing references.
• Not all staff had detoxification and recovery training relevant to the service.
• There was lack of regular staff supervisions and the induction programme was not comprehensive.
• Regular team meetings were not taking place and staff did not have mechanisms to give feedback about the service.
• Not all policies were current.
• Staff had a lack of understanding of the Mental Capacity Act.
• The provider needed to develop their vision and strategy for the service and share with the staff.
• Staff were not set productivity measures related to recovery or well-being.
• The provider did not have a risk register to demonstrate and review knowledge of their biggest risks.

However:

• The service had enough staff, who knew the clients and there was a clear focus on recovery within the service and clients were encouraged to take ownership of this. They provided treatments suitable to the needs of the clients.
• Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning. Clients we spoke with gave excellent feedback about the service and the way staff treated them. They told us they felt involved in their care.
• The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet. Staff worked well with other agencies to ensure the best outcomes for clients, for example they had a positive working relationship with a local GP surgery.
• There was a good range of activities on offer for clients, including on and off-site activities.