You are here

Gloucester House Outstanding

Reports


Inspection carried out on 14 Jan 2019

During a routine inspection

We rated Gloucester House as outstanding because:

  • Staff truly respected clients and valued them as individuals. Staff were dedicated to working with clients, empowering them to be active partners in their care. People who use services had an active role in shaping the delivery of services. For example, clients were involved in recruitment of new staff, clients had reviewed the “house rules” for the service, and the service had made multiple changes to the care programme in response to client feedback.
  • Staff always treated clients with compassion and kindness and respected their privacy and dignity.
  • There was a strong, visible person-centred culture. People’s individual needs and preferences were central to the planning and delivery of care. Services were flexible, provided choice and ensured continuity of care. Staff developed innovative approaches to providing integrated person-centred care that involved other service providers, and the community resources, particularly for people with multiple and complex needs.
  • Feedback from people who use the service was continually positive about the way staff treated people. Clients said that staff go the extra mile. Clients highly valued their relationships with staff.
  • The service worked creatively with other providers to promote positive outcomes for clients. Staff maintained close links with local military veteran charities and hoped to improve access to care for this group. Staff planned and managed discharge well and liaised well with services that would provide aftercare. Staff made early exit plans with all clients. Staff supported clients to access move on housing and community support services.
  • The service belonged to a ‘treatment loop’ which enabled clients to continue treatment at another centre for no additional cost when they had breached specific treatment requirements. For example, those who may have relapsed while in treatment.
  • The service had a ‘buy-a-bed’ fundraising scheme to provide treatment for men who are unable to access local authority funding or fund treatment themselves. Staff worked with the local community to generate charitable funds.
  • The service provided safe care. The environments were safe and clean. The facility had enough staff with the right skills to provide safe care. Staff assessed and managed risk well. They managed medicines safely 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 in line with national best practice guidance, and which were suitable for clients cared for in a substance misuse rehabilitation unit. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • Gloucester House included or had access to the full range of specialists required to meet the needs of clients. Managers ensured that staff received training, supervision and appraisal. Gloucester House staff worked well together and with those outside the service who would have a role in providing aftercare.
  • Staff understood and carried out their roles and responsibilities under the Mental Capacity Act 2005.
  • The service worked to a recognised model of substance misuse rehabilitation. It was well led and the governance processes ensured that unit procedures ran smoothly.

However:

  • The service’s ligature risk assessment and management plan could be improved to offer staff better oversight and awareness of ligature risks in the environment.
  • The main building did not accommodate wheelchair users but staff signposted clients to other suitable services when they were unable to meet their needs.

Inspection carried out on 20 December 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • Gloucester House provided a safe service within a clean and appropriately equipped environment. The service managed risks effectively. The service ensured new staff underwent full checks before employment. Clients were assessed for both risk and treatment needs and the service developed plans in collaboration with clients to manage these.

  • Staff stored medicines safely and the service had a system in place to report and learn from incidents.

  • Clients were involved in developing their treatment plans which were based on the 12 step model of recovery from addiction. The service delivered a range of therapeutic interventions, workshops and activities to support clients in their recovery.Staff at Gloucester House worked closely with other agencies, in particular to develop support for clients on discharge. Clients who completed treatment were not discharged from the service until they had a safe place to move on to.

  • Clients were extremely complementary about their treatment at Gloucester House and the staff team. Clients told us they felt safe, supported and hopeful for the future. We were told all staff were caring and compassionate.

  • Clients were involved in their admissions and discharges which were planned according to each individual’s needs and circumstances. Clients were involved in the day to day running of the service and encouraged to understand fire and infection risks. Staff encouraged clients to complain and any complaints were followed up.

  • The service had experienced, effective leadership and a clear and comprehensive governance structure. All staff understood the ethos and culture of the service. Staff told us they felt supported by managers and confident to deliver an effective service to clients. All the staff we spoke with were passionate about the quality of the service. The provider regularly undertook quality audits at the service and client feedback was sought in order to improve the service.

Inspection carried out on 9 February 2014

During a routine inspection

We spoke with one staff member and the manager. They were able to describe the care needs of people who used the service and what kind of support each person needed. We saw they interacted with people in a warm and kind manner.

There was a wide selection of food available for people who used the service and they were involved about decisions about food to be included in the menu. The service had a full time cook who provided the meals for people who used the service during the week.

The service had detailed policies and procedures in relation to the safe keeping of medication. We saw there was also policies about supporting people to self-medicate which were known to the two staff members we spoke with. We saw the medication records were well maintained and staff were clear about the organisations expectations.

People who used the service benefited from a clear and comprehensive complaints procedure. One person told us �I know how to complain if I'm not happy but I haven�t needed to. I like it here.�

Inspection carried out on 30 January 2013

During a routine inspection

We spoke with four people living at Gloucester House and they told that us they were treated with dignity and respect. We asked people about the information provided to them about the service. They told us that had received comprehensive information about the rehabilitation programme and Gloucester House.

People were given choices in most aspects of their care and treatment. The rehabilitation programme does require a structured approach to help people build routine into their lives and keep them safe. We found that care plans were up to date and had regular reviews with the people using the service and their keyworker. Risk assessments were also recorded and reviewed. The care plans were person centred with information about people's family and social history.

People were protected from abuse. The people we spoke with told us that they felt safe living at Gloucester House.

The registered manager and provider told us about the quality assurance process in place to assess and monitor the quality of service. We saw records which confirmed the appropriate checks had been made. We spoke to people about the quality of service and they told that they had provided feedback. All of the feedback we saw about the service was positive.

Inspection carried out on 13, 14 January 2011

During an inspection looking at part of the service

People told us about their experience of admission to the home and the information they were given. They said that they were treated with respect for their rights and that the support given to them was good. They spoke about the ability to make complaints, if they had any, and told us how safe they feel at Gloucester House.

People spoke about the suitability of the staff and manager and their feelings about living at the home, all of which were positive.