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Inspection Summary


Overall summary & rating

Good

Updated 5 September 2019

We rated Brighton Oasis Project as Good because:

  • People’s individual needs and preferences were central to the delivery of services. People could access services and appointments in a way and at a time that suited them. Staff had alternative pathways for people whose needs it could not meet. The provider ran a separate therapeutic counselling service for the children affected by family drug/alcohol use in treatment. The provider operated a separate creche for the children of parents in treatment. Staff were proactive in their attempts to re-engage clients who missed appointments or stopped the programme before completion. The service was flexible and innovative in meeting the needs of all clients, including those with a protected characteristic or with communication support needs.

  • Staff treated clients with kindness, compassion, dignity and respect. Feedback from clients confirmed that staff treated them well and offered them personalised care. Clients were involved in their care planning and encouraged to give feedback about the service. Staff were able to offer support to the children of clients. The service offered clients sanitary products, contraception and essential toiletries. The service organised a ceremony for those clients who completed structured programmes.

  • The service provided safe care. The premises where clients were seen were safe and clean. Staff assessed and managed risk well and followed good practice with respect to safeguarding.

  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the female clients undergoing treatment for alcohol and drug addictions and in line with national guidance about best practice. Clients’ physical health was monitored throughout their treatment. Clients gave their consent to treatment and had been given enough information about treatment options and risks. Staff engaged in clinical audit to evaluate the quality of care they provided.

  • The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. The service provided mandatory training in key skills to all staff and made sure everyone completed it. Staff had the knowledge and ability to monitor and recognise the signs of deterioration in clients’ physical and mental health during treatment and how to seek or provide help. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.

  • The service was well led, and the governance processes ensured that its procedures ran smoothly.

However:

  • Clients’ notes did not clearly document whether clients had received a copy of their care plan.
Inspection areas

Safe

Good

Updated 5 September 2019

We rated safe as good because:

  • All premises where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose. Staff adhered to infection control principles, including hand washing and the disposal of clinical waste.
  • The service had enough staff, who knew the clients and received basic training to keep them safe from avoidable harm. The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed.
  • Comprehensive risk assessments were undertaken at the start of treatment. Staff assessed and managed risks to clients and themselves well. They responded promptly to sudden deterioration in clients’ physical and mental health. Staff made clients aware of harm minimisation and the risks of continued substance misuse.
  • Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.
  • Staff kept detailed records of clients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.
  • The service had a good track record on safety. The service managed client safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave clients honest information and suitable support.

Effective

Good

Updated 5 September 2019

Are services effective?

We rated effective as good because:

  • Staff completed comprehensive assessments with clients on accessing the service. They worked with clients to develop individual care plans and updated them as needed. Care plans reflected the assessed needs, were personalised, holistic and recovery-oriented.
  • Staff provided a range of care and treatment interventions suitable for the client group and consistent with national guidance on best practice. They ensured that clients had good access to physical healthcare and supported clients to live healthier lives.
  • Staff used recognised rating scales to assess and record severity and outcomes. They also participated in clinical audit, benchmarking and quality improvement initiatives.
  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers made sure that staff had the range of skills needed to provide high quality care. They supported staff with appraisals, supervision and opportunities to update and further develop their skills. Managers provided an induction programme for new staff.
  • Staff from different disciplines worked together as a team to benefit clients. The team had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation.

  • Staff supported clients to make decisions on their care for themselves. Staff had completed their Mental Capacity Act (MCA) training. Staff were able to explain how they supported clients with impaired capacity. Staff knew where to seek support if needed.

  • The service had enough staff with the right qualifications, skills, training and experience to keep people safe. All staff received regular supervision and staff received appropriate appraisals.

Caring

Good

Updated 5 September 2019

We rated caring as good because:

  • Staff treated clients with kindness, compassion, dignity and respect. Feedback from clients confirmed that staff treated them well and offered them personalised care.

  • The service offered clients sanitary products, contraception and essential toiletries.

  • The service organised a ceremony for those clients who completed structured programmes. Each client was given a certificate of achievement and a bouquet of flowers.

  • Staff involved clients in decisions about their care and treatment and had a high level of understanding of individual clients’ needs.

  • The service sought client feedback in several ways.

However:

  • It was not always clear whether the client had received a copy of their care plan.

Responsive

Outstanding

Updated 5 September 2019

We rated responsive as outstanding because:

  • People’s individual needs and preferences were central to the delivery of services. People could access services and appointments in a way and at a time that suited them. The service were flexible in their approach and offered open access appointments two days a week. New clients could be seen on the same day, if there was capacity or an appointment would be made for the next available time.

  • The service provided integrated person-centred pathways of care that involved other service providers. Another organisation within the partnership could assess clients on admission to the service. Clients with complex needs and who were less likely to engage with services were enabled to access the service through outreach work.

  • Staff were proactive in their attempts to re-engage clients who missed appointments or stopped the programme before completion. Staff worked to maximise client engagement within the service. Whilst group and one to one interventions were arranged on set days, staff tried to be flexible, particularly for people with complex needs or those who had difficulty engaging with the services.

  • Facilities and premises met the needs of a range of people who used the service. The provider operated a separate crèche for any child affected by family drug/alcohol use and the provider ran a separate therapeutic counselling service for the children of parents in treatment, called Young Oasis.

  • Staff ensured that clients had access to education and work opportunities, when they were ready to benefit from them. The service had access to an education and work pilot programme, led by another organisation, to which clients could be referred. There was a range of rooms for meetings, one to one sessions and group sessions. All rooms were quiet and private.
  • External consultants were brought in to facilitate groups on sleep hygiene and other aspects of wellbeing. Clients were also consulted on the re-design of their client rights and responsibilities charter.

  • The service treated concerns and complaints seriously, investigated them thoroughly and learned lessons from the results, and shared these with the whole team and the wider service. The service could demonstrate where improvements were made as a result of learning from reviews.

  • The service was flexible and innovative in meeting the needs of all clients, including those with a protected characteristic or with communication support needs. It had a proactive approach to understanding the needs and preferences of different groups of people and to delivering care in a way that met these needs, which is accessible and promotes equality. This includes people with protected characteristics under the Equality Act and the LGBT plus community. The service monitored the characteristics of clients who used the service and matched this against the local demographic. The provider worked with local organisations and events to reach a diverse variety of ethnic groups.

Well-led

Good

Updated 5 September 2019

We rated well-led as good because:

  • Leaders had the skills, knowledge and experience to perform their roles, had a good understanding of the services they managed, and were visible in the service and approachable for clients and staff.
  • Staff knew and understood the provider’s vision and values and how they were applied in the work of their team.
  • Staff felt respected, supported and valued. They reported that the provider promoted equality and diversity in its day-to-day work. Staff felt able to raise concerns without fear of retribution.
  • Our findings from the other key questions demonstrated that governance processes operated effectively and that performance and risks were managed well.
  • Teams had access to the information they needed to provide safe and effective care and used that information to good effect.
  • Staff collected and analysed data about outcomes and performance.
  • The provider sought continuous learning and improvement by working with independent organisations to produce audits on the service environment and service user consultation to inform the changes needed to the service.

Checks on specific services

Community-based substance misuse services

Good

Updated 5 September 2019