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Allington House - Bournemouth Good

Reports


Inspection carried out on 8 January 2019

During a routine inspection

We rated Allington House good because:

  • Staff treated clients with dignity, respect, compassion and kindness. Clients told us that staff were empathic, caring and approachable. Staff involved clients and carers in decisions about their care, treatment and changes to the service. Staff supported clients to maintain contact with their families and carers and provided a space for them to meet. The service encouraged dog owners to attend rehabilitation by enabling them to bring their dog with them.
  • Clients who used service were active partners in their care. Staff were fully committed to working in partnership with people and making this a reality for each person. The service had a strong recovery ethos with staff devoted to ensuring that clients had excellent outcomes. Clients praised the staff in helping them open-up and talk about areas of their life they had previously kept to themselves.
  • All clients we spoke with said they felt safe. Clients described Allington House as a quiet, calm and homely environment. Clients told us that the service had a community spirit, and that everyone looked out for each other. They felt that the staff were very interested in their welfare and that they “went the extra mile” to ensure they were happy and able to succeed in their recovery. Clients described the service as having ‘saved their lives’ and felt that the skills staff taught them would enable them to move back into the community safely.
  • Managers and staff shared a clear definition and vision of recovery for clients that was embedded throughout the service. Staff understood their roles in supporting clients in their recovery journey and treated them as partners in their care. Staff said they felt respected, supported and valued, and were proud of the work they did.
  • The provider actively worked to reduce barriers to treatment for their clients. For example, the service had admitted clients with their pets, purchased support from domiciliary care agencies for clients requiring personal care and employed a driver who collected clients when public transport was a barrier to treatment.
  • Staff were very motivated and inspired to offer care that was kind and promoted clients’ dignity. Staffing levels were safe and there were plans in place to cover vacancies, sickness and annual leave. There was a positive culture within the house, staff felt respected and valued as members of the team and there was support from the registered manager. Staff received the specialist training needed to carry out their work effectively. Through safeguarding training and information, staff understood how to protect clients. Staff had two monthly supervision and yearly appraisal.
  • Staff had good knowledge of safeguarding procedures that helped them protect vulnerable adults from abuse. Staff reported incidents as they arose and learnt from accidents and incidents in the house.
  • The service was clean, well equipped, well-furnished and had good facilities. The design, layout, and furnishings of the service supported clients’ treatment, privacy and dignity and there were adaptations for people with disabilities. The manager completed environment health and safety checks, this included an assessment of ligature points. A ligature point is anything which could be used to attach a cord, rope or other material for hanging or strangulation.
  • The service provided care based on National Institute for Health and Care Excellence guidance. Allington House provided one to one time and group work to clients. Staff monitored and addressed physical health of clients in the house. Staff received mandatory and specialist training and they had a good understanding of the Mental Capacity Act.
  • There was no waiting list for the service. In the event of clients relapsing, staff tried to work around triggers for relapse. The service had a range of rooms for clients, including living rooms, a large dining room and a multi-faith room. There was wheelchair access and access to outside space. Staff provided care according to ethnic, cultural differences and personal preferences. Staff supported clients to access and attend external support groups.
  • Clients knew how to complain. There were policies in place to guide staff within their work. The provider maintained and discussed the organisational risk register. Clients had regular opportunities to give feedback about the service, including; house meetings, evaluation forms, suggestion box and a feedback book.

However:

  • Staff did not complete comprehensive risk assessments for clients admitted to the service and there was no evidence of crisis planning. Staff did not complete individualised care plans for clients accessing the service. Staff did not document discharge plans. Staff kept a lot of information in their heads and this was not translated into the documentation. There were blanket restrictions in place.
  • Medicines were not always prescribed safely due to staff not using medicines reconciliation processes as routine. This means that staff did not routinely check that the medicines they were giving were the ones prescribed by the GP.
  • The service did not have sufficient governance systems in place to ensure sufficient oversight and risk management of incidents and safeguarding. Managers therefore did not monitor to look for trends, this meant that if the same incident kept on occurring then there was no oversight to look at the reasons why or for example, if there was a gap in staff training.

Inspection carried out on 24 February 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice.

  • The organisation’s leadership team was committed to the clients who used the service, were approachable and extremely knowledgeable. They demonstrated care, compassion and went the extra mile to support the clients. They offered unfunded crisis admissions to former clients and fundraising to be able to offer a service to clients who were unable to access statutory referrals or funding.

  • The service had experienced staff who received appropriate training and support to enable them to care for clients. All staff demonstrated very high levels of care and concern towards the clients. The staff thoroughly assessed clients. They clearly documented any risks identified and created plans to manage them.

  • Staff made clients receiving treatment at Allington House feel safe. They understood how to recognise safeguarding issues and make referrals. They followed the organisation’s policies when doing so. Staff safely managed medicine using robust systems and the environment was clean and well maintained.

  • Clients and staff worked together to formulate effective person centred care plans; these addressed clients’ individual needs including access to religious places of worship, there was a comprehensive activity and therapy programme for clients. Staff encouraged clients to access college and work opportunities in the community to develop further skills to help them after discharge.

  • There were positive and effective working relationships with the local general practitioner and community mental health team.

  • There were systems in place to monitor the quality of the service, which included regular audits and feedback from clients using the service and staff. Staff learnt from incidents that occurred and complaints that clients and carers had made.

  • The organisation’s leadership team had identified the importance of maintaining staff morale. Staff felt that the senior management always responded to their concerns in a prompt and appropriate manner.

However, we also found areas that the service provider could improve:

  • The service did not have an automated external defibrillator (AED) available for use in a medical emergency.

Inspection carried out on 16 September 2013

During a routine inspection

At the time of our inspection there were 15 people accommodated at Allington House. We spoke with ten of them about the treatment programmes they were involved in and their experiences of living at Allington House. We also spoke with four people who had moved onto more independent living but continued to spend some time at Allington House.

We spoke with five members of the staff team about matters such as working practices and procedures, work experiences and training.

People told us they were given appropriate information and understood the care and treatment choices available to them. They said they expressed their views and were involved in making decisions about their treatment. People told us their independence was promoted and their diversity, values and human rights were respected.

People accommodated at Allington House were involved in preparing meals. They told us told us they were encouraged to eat healthily and there was always a choice of suitable and nutritious food and drink available to them.

There were appropriate arrangements in place to manage people�s prescribed medication.

People told us they thought there were enough qualified, skilled and experienced staff on duty at all times.

There were arrangements in place to check and monitor the quality of the service provided and also to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

Inspection carried out on 15 March 2013

During a routine inspection

We spoke with two people using services, the manager and a member of staff, about their experiences of the service. We looked at two people�s care records and other records kept by the provider.

People's consent was obtained before they started treatment. People told us they felt they had received sufficient information about Allington House beforehand.

People's individual needs were assessed and care and treatment was planned and delivered in a way that ensured their safety and welfare. People spoke highly of the support they received. For example, one individual said, �Instead of going against me, they work with me� they check on me in a caring way rather than as an authority figure�.

People told us that the provider kept in regular contact with other services supporting them. Records showed that Allington House worked in co-operation with other providers.

People using the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

People were protected from unsafe or unsuitable equipment because the provider ensured it was properly maintained and suitable for its purpose.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff spoke positively about their work and the support they received from the provider.

There was an effective complaints system. People did not raise any concerns with us during our visit.

Inspection carried out on 4 January 2012

During a routine inspection

We carried out an inspection of Allington House between 10:45am and 2:30pm on 4 Jan 2012. The manager of the home, as well as the staff on duty, assisted us throughout the inspection.

Streetscene offers a complete treatment programme, from �tail-end� detoxification from drugs and/or alcohol to re-integration into the community and aftercare. The programme uses evidence based interventions such as; abstinence based treatment, relapse prevention, anger management, motivational interviewing, cognitive behavioural therapy and the twelve step approach. The treatment programme is based on 3 phases. The first phase focuses on containment and information, giving people time to stop and reassess their lives. The second phase gives people more responsibility to use and put into practise the life skills, coping skills and relapse prevention skills they have learned. The third phase of treatment prepares people for their return back into the community and includes benefit advice, career training and support with securing and maintaining a home. The organisation also has some move on accommodation and provides an aftercare service.

At the time of this inspection there were 13 people staying at the home. We spoke with six of these people about their experience of the treatment they were receiving and how they were involved in this. Everyone we spoke with had very positive things to say about the service and the way they were treated. People told us that the programme was effective and provided a safe environment for them to make changes to their lives. They told us that they were very much involved in their treatment through setting their own goals with support from the staff team. People said that the staff team were very supportive, non-judgemental and knowledgeable.

Reports under our old system of regulation (including those from before CQC was created)