Livingstone House

Updated 5 April 2023

Livingstone House provides residential drug and alcohol detoxification along with a recovery and rehabilitation programme for men aged over 18. Livingstone House is a large residential property in an urban area of Birmingham and is registered to provide 10 residential treatment beds. The programme is abstinence-based and includes group therapy, individual counselling and support with life skills. Clients participate in a 12-step recovery programme, which is tailored to their individual needs. Most people access the service after being referred by a community substance misuse professional, their local authority or the police but the service also accepts privately funded self-referrals. Treatment is generally funded by statutory services, but the company hopes to continue offering a charity bed for people who would benefit from the treatment programme, but for whom funding is difficult to secure.

Livingstone House is registered with the CQC to carry out the following regulated activities:

• Accommodation for persons who require treatment for substance misuse.

The service had a registered manager in place at the time of our inspection.

We last inspected the service in 2019, when it was operated by a different provider. Livingstone House had previously been registered under a different legal entity, as a Charity. The new legal entity, Livingstone House Mother of the Harvest Ministries Ltd, became registered with the Care Quality Commission in May 2022. This is the first inspection of the newly registered service.

We inspected this service as part of our comprehensive inspection programme to make sure health and care services in England meet the Health and Social Care Act 2008 (regulated activities) regulations 2014.

The team was comprised of two CQC inspectors, one with a background in substance misuse services, and a substance misuse service specialist advisor. The inspection was overseen by a CQC inspection manager and a CQC deputy network director.

What people who use the service say

We spoke with 7 clients using the service and 2 relatives of clients who had recently used the service.

Clients told us they were very satisfied with the support they received from staff. They felt safe and understood their care and treatment. One client told us “it’s amazing”, “it’s saved my life” and another told us “they seem really lovely and they know what they’re doing”. They all told us that staff were kind, compassionate and caring.

Clients told us they had regular named keyworkers but could speak with other staff whenever they needed to, because there were always enough staff working in the service. They told us staff supported them to lead a healthier lifestyle and to see medical professionals if they needed help to manage their physical health. There were regular group and individual therapy sessions, which all the clients told us they found very helpful.

Clients who wanted their relatives to be involved in their treatment programme understood how staff would support them to stay in touch.

Clients told us the environment was clean and comfortable and they described how staff encouraged them to support each other to keep it that way, allocating tasks to each client to complete for the benefit of everyone.

Clients told us they met with the chef when they were admitted to the service which was really helpful for them. They all told us their specific preferences and dietary requirements, including allergies, were well catered for. They told us the food was tasty, of good quality, well presented and the portion sizes were good. One client told us they had reached a healthy weight since entering the service.

We reviewed a sample of client feedback surveys, which were all very positive about how clients had experienced their detoxification and rehabilitation programme. We also reviewed feedback the service had received from an external stakeholder, which stated “I hope all rehabs have a Livingstone House approach towards care, however I cannot imagine it is very common to come across such a dedicated team of people”.

All the clients and relatives we spoke with told us they would recommend the service to others.

Updated 5 April 2023

We rated Livingstone House as good because:

• The service provided safe care. The environment was safe and clean. The service had enough staff and they assessed and managed risk well. Staff minimised the use of restrictive practices, 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 suitable to the needs of the client group and in line with national guidance and best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• Managers ensured that staff received training, supervision and appraisal. The staff worked well together as a multidisciplinary team and communicated well with external agencies.
• Staff respected and valued people using the service, understanding their individual needs and supporting them to understand and manage their care. Staff treated clients with dignity, respect, compassion and kindness. They understood the individual needs of clients and supported them to develop long-term strategies to manage their addiction. Where appropriate, staff involved clients’ families and carers.
• The service provided a range of treatment options in line with best practice and national guidelines, including medication assisted detoxification. The service was easy to access. Staff supported clients to become involved in volunteering, peer support and employment opportunities. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet. They liaised well with statutory and community services.
• The service was well led and was developing the relevant governance processes to ensure that its procedures ran smoothly.

However:

• Some staff were not up to date with their mandatory training, but the provider had a plan in place to address this.
• The quality of cleaning that was carried out by clients in the communal areas was not always completed to a high standard, but managers put in place a regular “deep clean” regime to supplement it.
• Some audit paperwork that staff used had not been updated to reflect the change in legal entity.

Updated 5 April 2023

We rated Livingstone House as good because:

• The service provided safe care. The environment was safe and clean. The service had enough staff and they assessed and managed risk well. Staff minimised the use of restrictive practices, 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 suitable to the needs of the client group and in line with national guidance and best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• Managers ensured that staff received training, supervision and appraisal. The staff worked well together as a multidisciplinary team and communicated well with external agencies.
• Staff respected and valued people using the service, understanding their individual needs and supporting them to understand and manage their care. Staff treated clients with dignity, respect, compassion and kindness. They understood the individual needs of clients and supported them to develop long-term strategies to manage their addiction. Where appropriate, staff involved clients’ families and carers.
• The service provided a range of treatment options in line with best practice and national guidelines, including medication assisted detoxification. The service was easy to access. Staff supported clients to become involved in volunteering, peer support and employment opportunities. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet. They liaised well with statutory and community services.
• The service was well led and was developing the relevant governance processes to ensure that its procedures ran smoothly.

However:

• Some staff were not up to date with their mandatory training, but the provider had a plan in place to address this.
• The quality of cleaning that was carried out by clients in the communal areas was not always completed to a high standard, but managers put in place a regular “deep clean” regime to supplement it.
• Some audit paperwork that staff used had not been updated to reflect the change in legal entity.