Bosence Farm

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Risk had been assessed on admission for all nine of the clients whose records we looked at. All nine had thorough, up-to-date risk assessments and risk management plans in line with national treatment agency guidelines for good practice. Risk and risk management plans were discussed in multi-disciplinary team meetings and plans were made for observation of clients when needed. Clients who chose to leave before the end of their treatment were provided with overdose awareness advice before leaving the service.

• Staff demonstrated a good awareness of safeguarding, including the need to be aware of safeguarding issues for the children of clients. Staff were able to give us examples of safeguarding concerns that they had referred to the local authority. Electronic records showed that staff involved the local authority safeguarding team appropriately.

• Medicines at Boswyns were stored securely in locked cupboards in the clinic room that was also locked when unattended. Staff managed stock levels well and carried out appropriate checks when administering medicines to make sure they were in date and safe to use.

• There was a robust assessment and monitoring system in place to ensure that clients at Bosence Farm rehabilitation could self-medicate safely. All clients at Bosence Farm rehabilitation had lockable storage boxes in their bedrooms.

• Care plans were up to date, personalised, holistic and recovery-oriented. The standard of assessment and care planning was very high. Ongoing monitoring of physical health took place and referrals were made to specialist healthcare if needed. Staff used a range of National Institute for health and Care Excellence approved tools to assess and monitor clients’ symptoms. Every client had an “exit plan” which included details of contacts and the place that the client would go to when they left. Information about relapse prevention and overdose was provided to clients who wanted to leave early and could not be persuaded to stay.

• Staff were experienced and motivated and told us they enjoyed their work. Sickness, absence rates and us they enjoyed their work. Sickness, absence rates and use of bank and agency staff were low.

• Supervision and appraisals for staff at Bosence Farm rehabilitation occurred regularly and was of good quality.

• The Boswyns building, which was completed in 2010, was light, spacious and well designed.

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

• Mandatory training rates were low. Although the provider was aware of this and had plans to improve training rates, the provider had not ensured that all staff were booked on to relevant mandatory training sessions.

• Staff at Boswyns who administered, or witnessed the administration of medication had not had an assessment of their competency to do so.

• Fridge temperatures at Boswyns were monitored regularly but we found that appropriate action had not been taken when temperatures were outside those recommended for safe storage of medication. The provider kept a limited supply of emergency medicines on site but had not reviewed this to ensure that the limited holdings were adequate.

• Staff at Boswyns were not receiving regular supervision that was in line with the provider’s policy.