Archived: Verve Health

Verve Health is a residential substance misuse service in Norfolk that provides detoxification and rehabilitation treatment for people using drugs or alcohol.

This was our second inspection of the service. We conducted this inspection to follow up our previous concerns found during the first inspection of Verve Health, conducted in April 2022. During our previous inspection of Verve Health, we issued the provider with three warning notices against Regulation 12 Safe care and treatment, Regulation 18 Staffing and Regulation 17 Good governance. We asked the provider to act in order to make improvements and keep service users safe from harm. The service was placed in special measures and rated Inadequate overall and within the five domains of Safe, Effective, Caring, Responsive and Well-led.

During this follow up inspection, we checked to see if the provider had made the required improvements. The provider had not made the necessary improvements required to ensure service users were kept safe from harm and we found continued breaches under Regulations 12 Safe care and treatment, Regulation 18 Staffing, Regulation 17 Good governance, Regulation 9 Person-centred care and Regulation 11 Need for consent. Following this inspection, we issued the provider with a Notice of Proposal to cancel the providers registration.

Our rating of this location stayed the same. We rated it as inadequate because:

• Staff had not received all basic training for their roles, including safeguarding training. Managers were not supporting staff with appraisals or supervision. Managers had not provided an induction for all new staff. Managers were not holding regular full staff team meetings, handovers or multidisciplinary meetings to ensure key information was shared.
• Staff did not assess and manage risks to service users and themselves well. Staff did not make service users aware of harm minimisation and the risks of continued substance misuse.
• Staff did not always prescribe, administer or store medicines safely. Staff did not have access to adequate medical oversight for service user’s requiring detoxification. Staff were not adequately monitoring service user’s physical health during their detox programme.
• Staff did not keep accurate and up to date contemporaneous records for each service user. Staff did not complete comprehensive assessments with service users and were not always working with service users to develop and update individual care plans. Care plans did not always reflect the needs of service users and were not always personalised, holistic or recovery oriented. Staff were not completing discharge plans to reduce potential harm to service user’s upon discharge from the service.
• Staff did not report all incidents appropriately. Managers did not always investigate incidents thoroughly and learning was not always shared with the whole team and wider service. When things went wrong, staff were not following duty of candour principles.
• Staff did not always understand the service’s policy on the Mental Capacity Act 2015 and were unsure on what to do if a service user’s capacity to make decisions about their care might be impaired. Staff were not ensuring adequate consent had been obtained with service user’s in treatment.
• Staff did not always feel supported or valued. Managers did not ensure recruitment or performance processes were implemented to address past performance concerns with new staff.
• Governance processes were not operating effectively at the service and performance and risk were not always managed well. Key service audits remained absent and it was not clear how information from completed audits was being used to improve quality of care. Managers were not identifying and responding to key areas of risk in the service which was needed in order to provide safe and effective care.

However:

• Staff were trying to involve service users in care plans and service users could give feedback on the service and their treatment and staff supported them to do this.
• Following our previous inspection, an alarm system had been installed by the provider in bedrooms and most communal areas.
• All areas were clean, well maintained and well-furnished.
• Staff followed infection control guidelines.
• The design, layout, and furnishings of treatment rooms supported service user’s treatment, privacy and dignity. Service users could keep their personal belongings safe. There were quiet areas for privacy. The food was of good quality and service users could make hot drinks and snacks at any time.