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Inspection Summary


Overall summary & rating

Good

Updated 27 November 2018

We rated The Grange as good because:

  • Staff provided safe detoxification and treatment for clients based on national guidance and best practice. The Grange had a thorough assessment process which ensured that only clients who were appropriate for the service were admitted.

  • The environment was well-kept and fit for purpose and there were adequate rooms to provide therapy, activities and safe detoxification. Call alarms had recently been fitted to allow clients to alert staff.

  • Since the last inspection The Grange has made improvements in both its management of medicines and the building safety.

  • The staff were well trained, specialist and focused on client care, treatment, and recovery. Staff were up to date with their training.

  • Clients and family members consistently reported that the care and treatment that the clients received was exceptional. Staff were dedicated to client recovery and passionate about delivering a high standard of person-centred care to clients. Staff were aware of client’s individual needs.

  • The Grange had a comprehensive structured week of activities and therapy.

  • The service provided opportunity for clients, staff and families to provide feedback about the service and there were systems in place to monitor service risk through a register which was regularly reviewed by the senior management team.
Inspection areas

Safe

Good

Updated 27 November 2018

Our rating of this service improved. We rated it as good because:

  • Staff provided safe detoxification and treatment for clients based on national guidance and best practice. The Grange had a thorough assessment process which ensured that only clients who were appropriate for the service were admitted.

  • The environment was well-kept and fit for purpose and there were adequate rooms to provide therapy, activities and safe detoxification. Call alarms had recently been fitted to allow clients to alert staff and allow staff to respond to any emergencies.

  • At our previous inspection we found that the controlled drug prescriptions were not managed safely as serial numbers had not been recorded. During this inspection we saw that improvements had been made, this was no longer a problem and they were fully compliant with medicine management.

  • During this inspection we saw that a health and safety assessment had been carried out. The service had an action plan which dealt with any issues and signs had been placed around the building alerting people to potential hazards.

  • The service was adequately staffed day and night with a minimum of one nurse and one health care assistant who were skilled at meeting the needs of clients. The majority of staff had completed their mandatory training.

  • There was a robust admission process including criteria to ensure that the service could meet clients’ needs and that staff could manage them safely.

Effective

Good

Updated 27 November 2018

We rated effective as good because:

  • The service completed comprehensive pre-admission assessments. This assessment included a physical health assessment and physical health continued to be monitored throughout their admission.

  • A comprehensive, holistic structured timetable of therapy and activities for clients was available seven days a week.

  • There was a range of qualified staff including therapists, nurses, a nutritionist and doctors who were all recovery focused. Staff all had the required knowledge to deliver a high quality service.

  • Staff used recognised rating scales to assess and record symptom severity and outcomes of alcohol detoxification. The service specifically used the Clinical Institute Withdrawal Assessment for alcohol scale (CIWA-r) and the Subjective Opiate Withdrawal Scale (SOWS).

  • All staff appraisals and supervisions had been completed. Supervision is an opportunity for staff to discuss with their managers case management, reflecting on and learning from practice, personal support and professional development.

  • Communication between the different staff roles and members of the multi-disciplinary team was good.

Caring

Good

Updated 27 November 2018

We rated caring as good because:

  • All staff that we spoke to had a kind, caring, compassionate and respectful attitude when discussing clients’ needs and were highly motivated and dedicated to patient recovery. Staff were passionate about delivering a high standard of person-centred care.

  • Since the last inspection a new hospital manager had been appointed. She was passionate about the service provided and focused on quality improvement for clients and staff.

  • Staff had a high level of understanding of the individual clients’ needs and had specialist knowledge to assist clients in their recovery.

  • Staff were passionate about delivering a high standard of person-centred care to clients.

  • Clients told us that their care was exceptional. Family members were also invited to provide feedback, which was continually positive.

  • A two-day specialist therapeutic family therapy programme was offered to the families of clients receiving care.

Responsive

Good

Updated 27 November 2018

We rated responsive as good because:

  • The Grange used an effective and comprehensive process to manage referrals and ensure client suitability.

  • The service also had a comprehensive discharge checklist for planned discharge from the service, unexpected discharge was managed by support from the nursing and therapy team, signposting the client if necessary to local service or therapy, the consideration and assessment of the client’s capacity and best interests and alerting the client’s GP, if the client had given consent.

  • Clear written and verbal information was provided to new clients about their treatment at The Grange. There was also a complaints policy in place and staff and clients were aware of the process for handling complaints.

  • The Grange was comfortable and well-maintained, with a beautiful large garden. There were adequate rooms to support therapy.

Well-led

Good

Updated 27 November 2018

We rated well-led as good because:

  • The senior management team, including the hospital director, were competent, experienced and equipped with the knowledge necessary to perform their roles.

  • Staff reported that they felt supported in their roles. There was a clear governance structure in place led by the hospital director.

  • Since the last inspection the service was now fully aligned with the Priory group policies and procedures. The service had a clear vision, of helping clients recover from addiction or eating disorders.
  • There were good internal processes to discuss and review the care being provided such as handovers, multidisciplinary meetings, supervision, appraisals and team meetings.
Checks on specific services

Residential substance misuse services

Good

Updated 27 November 2018

Acute wards for adults of working age and psychiatric intensive care units

Good

Updated 22 November 2016