The Care Quality Commission
  • Residential substance misuse service

Archived: Ley Community Drug Services

Overall: Good read more about inspection ratings

26 Sandy Lane, Yarnton, Kidlington, Oxfordshire, OX5 1PB (01865) 378600

Provided and run by:
Ley Community Drug Services

All Inspections

16-17 January 2018

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • The organisation had a site safety team, staff monitored environmental risks daily and health and safety records were in order.
  • The organisation had enough staff to care for the number of clients. Clients said they always had access to support from staff, their peer group and had regular key work sessions.
  • The organisation had developed a new mandatory training matrix. This was discussed and monitored in staff personal development plans. Staff were encouraged to further develop their skills through specialist training.
  • There were good links with local community and employers for clients to move on to the supported work stage of the programme.
  • The Ley is a peer led therapeutic community, the organisation made it clear about behaviours that would not be accepted and all we spoke to were aware of this. Clients had to sign a resident’s charter and staff signed a code of conduct.
  • The Ley offers a range of activities that promote recovery and these are tailored to individuals needs and strengths, these include physical exercise groups, art,  therapy groups at all stages and voluntary work at later stages of a clients programme with employment as the main outcome at the end of the programme.
  • Staff were caring, supportive and showed real commitment in their work.
  • Staff knew and put into practice the service’s values, and they had contact with managers at all levels.
  • There were clear frameworks in place for quality assurance, which had recently been established. There were regular board meetings and regular audits were completed.
  • All who we spoke to stated that there had been significant improvements in the organisation since the new management came into place. The management team were approachable and receptive to new ideas.

However, we also found the following issues that the service organisation needs to improve:

  • Staff did not record essential information about the client’s allergies to medicines on the medication charts.
  • Staff appraisal figures were low, the organisation was using ongoing performance review rather than an annual appraisal system we were told that appraisals are being implemented and they are working towards being up to date with appraisals.

23rd - 24th August 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

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

  • There were failings in safeguarding practices amongst the staff and management. Staff were not auditing the services performance so were not aware of what might need improving. There were issues with the transparency of the service with CQC and the local authority and the management’s ability to safeguard the clients within the service.

  • There was a breach of same sex accommodation guidance. Disabled access was very poor.

  • The service had not conducted a health and safety assessment of the environment. There was no physical health monitoring equipment on site.

  • Staff turnover was high and there was no on site medical or nursing cover. There was poor staff induction and there was no overdose prevention training or other specialist training for staff. Mandatory training compliance was very poor. Staff were not provided with regular supervision. Management oversight of training was poor and there was no oversight of who had been supervised

  • Children were not adequately supervised when visiting the service.

  • There was not a robust complaints process. There was a lack of recovery orientated information displayed around the site.

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

  • The service had a clean environment, the clinic room was clean and well maintained. Sickness rates were low. Pre-employment checks were conducted.

  • There was excellent comprehensive individual risk assessment and management. Staff were able to respond to changes in risk.

  • There was comprehensive needs assessment that was transferred into evidenced based recovery plans using up to date guidance. Clients were registered with the local GP who undertook physical health checks on admission. There were good links with local recovery services.

  • Staff were caring and understood individual client need. Clients were allocated a key worker and they were involved in recruiting staff into the service. They were given the opportunity to feedback about the service and help create an action plan around changes they would like to see.

  • Beds were available due to low client numbers. The service was able to respond quickly to referrals into the service. There were transition arrangements in place for clients at the end of their stay.

  • There was a range of rooms, the food was reported to be of a good quality and the chef was able to respond to cultural need. Activities were provided throughout the week and weekend and there were complementary therapies available.

  • Staff felt management of the service had improved. There was a clear recovery focus and morale was good amongst the staff.

16 July 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The service could provide accommodation for up to 58 people who needed support with rehabilitation from addictions. At the time of our visit 29 people were using the service.

This was an unannounced inspection.

The last inspection for this service took place in January 2014. We found the provider did not have appropriate systems to assess and manage identified risks of people’s treatment. We received an action plan from the provider who told us what they would do to improve. We found the provider had taken appropriate action. Where a risk had been identified as part of the person’s care, support workers had implemented risk assessments.

People told us the support they received from all staff whilst receiving treatment at the Ley Community was great. People were supported with their rehabilitation, and felt they were never judged by support staff.

People had a structured rehabilitation programme and were given jobs in the community. People were involved in cooking and cleaning. These tasks enabled people to develop skills they would need when living independently.

People received treatment and support which was based on their individual needs and goals. People were supported by support staff to recognise and achieve personal goals which they could use after they had completed their treatment.

People were safe from abuse and harassment. People were supported to raise concerns in group therapy sessions. These sessions allowed people to discuss their concerns in a safe environment. People knew how to raise concerns, but felt group sessions allowed them to deal with their concerns effectively.

Staff were well trained, committed and passionate about the support they provided. A number of staff had previously received treatment for drug and alcohol addiction. Staff used their knowledge and experience to help people who were anxious about the treatment they needed. People were wholly positive about the support they received from staff. People and staff celebrated the successes of people’s treatment and discussed how to ensure their treatment was current for their needs.

People’s views and concerns were respected and acted upon. Support staff discussed people’s concerns and ensured where action could be taken they were.

14 January 2014

During a routine inspection

The Ley Community (TLC) provides long term residential psychosocial treatment for people recovering from drug and alcohol addiction. Psychosocial treatments include certain forms of psychotherapy (often called talk therapy) and social and vocational training, guidance and support. At the time of our visit 31 people used the service. The service provided a highly structured psychosocial treatment programme. Therapeutic intervention was based on a philosophy of peer driven, self-help and abstinence. People were assigned a key worker who will arrange support groups, peer groups, support from senior residents, key working groups and one to one intervention sessions on a weekly basis.

Residents lived and worked together as a therapeutic community. The service's literature noted that 'there is a hierarchical structure with in which they are expected to participate. This is designed to provide the framework in which they can develop self-respect, confidence and friendships by sharing achievements, disappointments and anxieties'. The service worked closely with a local GP practice who independently undertook people's detoxification treatment. People were supported by the Ley Community to attend their appointments with the GP during their detoxification treatment.

We saw that staff, managers and senior residents were passionate about the people they supported and committed to ensuring people completed their treatment programme.

We found that this service treated people with complex psycho-social needs that could pose a significant risk to themselves and others. We saw that systems were in place to ensure that information about people's changing needs and risks were communicated between staff, managers and senior residents. We found however that treatment was not always planned to meet people's individualised needs and minimize the risks to people. People did not have treatment plans that always provided sufficient instruction to staff to enable them to manage risks and meet people's needs appropriately, consistently and in line with professional guidance. Information shared through handover and other meetings informed treatment planning and delivery. However, the information was not sufficient to ensure that the risks to people were managed robustly.

The provider had suitable arrangements in place to protect people from the risk of abuse. We found that staff knew their responsibility with respect of safeguarding adults and children. The agency acted in accordance with local safeguarding arrangements when abuse was identified or suspected.

Staff received regular supervision and support to enable them to undertake their roles. We found that the provider acknowledged that working in this type of service could be emotionally challenging and staff had access to regular counselling sessions to support them.

We found that systems were in place to enable the manager to monitor the quality of the service provided and to identify and respond to risks. We found that incidents and complaints had been investigated and improvements had been made to address concerns.

19 March 2013

During a routine inspection

This was a routine unannounced inspection carried out together with an Expert by Experience. This is someone who has experience of using services either themselves or through a close relative or friend. We were told that people living in the service preferred to be referred to as residents.

We were told that independence and individuality were promoted within the home. Residents living there were supported to be independent and eventually to support themselves. Residents told us 'This is the first time I've been clean and the longest in my life since the age of sixteen'. Another said, 'This is my second time here. I realise what I have lost and realise how the place made perfect sense of what I had to do'. Other residents told us, 'It has given me a life I never knew I had', 'We are well looked after', and 'I am excited about the future'.

We spoke with two commissioners of services. One represented an NHS commissioning team and the other represented a local authority. Both were highly complimentary about the service offered at the Ley Community. One told us that the Ley 'provides an excellent service. We are kept informed of progress and incidents'. The other told us that 'the Ley Community acts as the bench mark by which all other drug and alcohol services are judged. The Ley actually works'.