15 November 2018
During a routine inspection
We rated Closereach as good because:
- Staff provided safe treatment for clients based on national guidance and best practice. Pre-admission assessments used by the service were high quality and included questions which assessed current substance use, risk of blood borne viruses and physical health needs. Staff used the pre-admission assessment to develop risk assessments and guide the completion of individually tailored treatment plans.
- Recovery treatment was provided based on the cognitive behavioural therapy programme. There were adequate rooms to provide psychosocial therapies and activities. All areas were safe, clean, well-equipped, well-furnished and well maintained. The design, layout, and furnishings of the service supported clients’ privacy and dignity.
- Staff were skilled, competent and knowledgeable in meeting the needs of people who used the service. The service provided training in key skills to all staff and made sure everyone completed it. Qualified counsellors provided psychosocial therapies. The manager of Closereach had the right skills and abilities to run a service providing a good quality of care.
- Clients spoke highly of the staff, and said they felt safe in the comfortable environment and found the treatment was positively impacting their lives. Clients told us they were treated with respect, compassion and kindness.
- Staff spent extensive time with clients through various activities to provide exceptional person-centred care. Staff were passionate about providing extra opportunities to clients that would be individually meaningful for them during their recovery and after discharge.
- Staff supported clients to make decisions on their care for themselves. They understood the service policy on the Mental Capacity Act 2005 and assessed and recorded capacity clearly when appropriate.
- There were systems in place to record, review and discuss complaints, compliments and incidents. Improvements had been made in response to this.
- Leaders within the service were visible and approachable for both clients and staff. The staff team felt respected and valued, worked well together and were supported by their managers.
- Leaders had effective systems in place to regularly support their staff and improve the quality of care they provide. This was achieved by regular managerial and clinical supervision, appraisals and staff meetings.
However:
- Although there was a sink in the clinic room, there was no sink dedicated to handwashing and the collection of urine samples did not ensure good infection control.
- The service had sought medical histories and medication information from clients GP’s up to four weeks prior to admission. This meant clients medication could have changed before they arrived at the service. However, the manager had ensured that clients were registered with a local GP within 48 hours and medicines reconciliation was completed with the local GP at registration.
- Although there were procedures in place to respond to an overnight emergency, there was no provision of staff at the premises overnight.
- The provider had some blanket restrictions which did not have a clear rationale. However, the manager allowed clients to make ‘special requests’ to allow them temporary alleviation from these restrictions.