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Archived: Shardale Specialised Therapeutic Community

Reports


Inspection carried out on 3 May 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • There service was clean and well maintained. Maintenance records were up to date and comprehensively completed. There were good health and safety arrangements in place regarding cleaning and kitchen use. Staffing levels were adequate for the service with no use of bank or agency staff. Staff understood their responsibilities in terms of safeguarding. Staff completed thorough risk assessments. Medicines were managed safely including self-medication.

  • Staff completed comprehensive needs assessments for clients and staff and clients developed recovery based, outcome focussed care plans. The treatment programme evidenced good practice guidance. Staff completed audits to check clinical care and the service supplied required information to the national drug treatment monitoring service. Managerial and clinical supervision took place regularly and all staff received an annual appraisal.

  • Staff respected clients and valued them as individuals. Feedback from clients was positive about the way staff treated them. There was a strong, visible client-centred culture. All clients had full involvement with their treatment throughout their stay. Carers gave positive feedback on the service and the staff.

  • Admissions were planned with clients able to visit the service and spend time there prior to admission. Discharge planning began at admission and a clear plan and outcomes were devised to work within the timescale set. Staff worked with clients to prevent unplanned discharges.

  • There was good provision of rooms and space for therapy. The treatment programme provided activities for clients seven days a week. The rehabilitation programme included free time and dedicated time for clients to spend with their key worker.

  • There was a good governance structure to oversee the operation of the service. There were clinical governance plans in place with regular review and audit.

However, we also found the following issues that the service provider needs to improve:

  • The service currently has no registered manager.
  • Staff were not up to date with all mandatory training.
  • Staff did not have any further training provided in terms of substance misuse or therapeutic approaches or training in running group work programmes.
  • Staff do not receive training in understanding the Mental Capacity Act.
  • There was no Mental Capacity Act policy.
  • There was no Duty of Candour policy.

Inspection carried out on 20 June 2013

During a routine inspection

Before people came for treatment it was made clear to them that there were a wide range of restrictions in place and they would have to agree to abide by them. People told us that the restrictions were about keeping them and others safe.

The provider said what was important was that people were able to demonstrate that they were motivated to fully engage in the community and treatment programme to change their lifestyle.

People receiving treatment took responsibility for household tasks and work in teams. We spent time with the cooking team who were preparing the lunchtime meal. They said that the team gave them the opportunity to work together in a controlled environment.

People worked towards taking responsibility for their own medication in preparation for leaving the service. Over the counter medication was not used or allowed into the building because they could contain addictive substances.

We saw that criminal records checks were carried out on all staff, volunteers and external workers coming in to undertake counselling sessions, staff training, clinical supervision and external verification.

People we spoke with told us that there were plenty of opportunities to raise concerns. There was a daily community meeting in which people were encouraged to express their views and opinions, as well as a one to one key worker session every two weeks.

Inspection carried out on 3 July 2012

During a routine inspection

During our visit we spoke to many people using the service as part of a group discussion. People told us that they had visited Shardale before they came for treatment. They said that they had a structured day that included being involved in household activities such as cooking, budgeting for food, washing and cleaning. People said “I wanted to come here,” “we are all equal,” “people here are friendly and welcoming,” “I can now stand on my own two feet,” “I chose to come and I enjoy being busy,” and “I am learning how to make positive choices.”

People told us that group and peer support helped them become more confident. They were able to tell us in great detail about the treatment programme, how it work and ways they were able to demonstrate the progress they had made. They told us that they each had an individual treatment plan that they were involved in developing. People said “I lacked confidence when I came but I can now recognise the progress I am making,” “I can recognise my problems and behaviours,” “staff look at different approaches and help me find an answer,” “I am out of my comfort zone,” and “everybody is different.”

People told us “the door is always open and I can leave any time I want,” “the rules are keeping you safe and there is always a reason for them,” “rules are for our own safety, “rules are about taking back responsibility and getting routine and structure back into my life” and “the rules help me socialise safely.”

People told us that staff understood their problems and were not intimidated by them. They said “staff really do care,” “the support is unbelievable,” “we are not put under any pressure but encouraged,” “they are role models,” and “they help you get your life back together.”

People told us that when they came to live at Shardale they undertook a health and safety induction check that help to ensure the health and safety of the group by for example understanding the importance of fire safety procedures, signing in and out and confidentiality.

Everyone we spoke with gave positive views and opinions about the service they received.