Gloucester House

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.