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Inspection carried out on 28 - 29 March 2019

During a routine inspection

We rated Sefton Park as outstanding because:

  • The staff had an overwhelming passion for the work they did. Staff were highly motivated to involve clients in their care and empower clients to have a voice and realise their potential. The culture of care ran throughout the organisation from the provider to the kitchen staff. Clients spoke highly of the care they received from staff, the registered manager and the provider. The provider fostered a caring recovery community amongst clients past and present. They hosted weekly community walks where previous clients, now in recovery, offered hope to current clients. The provider also organised a weekly coffee morning for previous clients to drop in and access peer support around any issues they were facing and to share successes.
  • Staff supported clients to plan for their discharge from Sefton Park. Discharge planning began from the beginning of treatment episodes and staff created resettlements plans with clients to ensure there was support in place when they left. The service provided aftercare to all clients. Clients had access to a 28-day intensive support program after discharge from Sefton Park and access to regular support groups indefinitely. Clients could repeat the 28-day program at any time. The provider offered sponsored beds, free of charge, to clients whose funding had run out and had nowhere to go or clients who required longer residential treatment. This prevented any clients from becoming homeless or discharged when they weren’t ready.
  • Staff managed opiate detoxification safely. Prescribing staff had appropriate qualifications and experience to undertake their roles. Staff assessed clients for suitability for detoxification prior to admission and clients received a full prescribing assessment on the day of admission. Prescribing regimes were in line with “Drug misuse and dependence: UK guidelines on clinical management (2017)” and relevant National Institute of Health and Care Excellence (NICE) guidelines. Staff monitored withdrawal symptoms effectively and were knowledgeable about what actions to take if a client’s health deteriorated during detoxification.
  • Clients’ individual needs and preferences were central to the planning and delivery of care. Staff fully involved clients as active partners in their care. Care plans reflected clients’ individual preferences and clients’ voices were intrinsic to the care plan review process. Care plans contained clients’ goals and creative solutions to achieve these goals. The service held service user forums to provide clients with an opportunity to give feedback on service delivery and discuss potential changes to the service. Clients could give feedback on the service through formal feedback forms provided at the end of each treatment phase.
  • Clients had access to a range of evidence based therapies. This included one to one counselling and eye movement desensitisation and reprogramming (EMDR) and a group program based on cognitive behavioural therapy and dialectical behavioural therapy. Clients could access relapse prevention work and complementary therapies, such as auricular acupuncture.
  • Staff managed medicines safely. Medicines were stored at the correct temperature and stock was regularly audited. Staff checked that medicines brought in by clients were prescribed for them. Staff were trained to administer medicines and their competency was regularly assessed.
  • The registered manager had suitable governance processes in place. There were effective systems to ensure that staff training was up to date. The system automatically flagged when training was due to expire and populated training requirements by job role. Staff checked the training weekly, recorded additional information, such as when training had been booked, and reported any necessary actions to the registered manager. Effective governance systems were also in place for reviewing policies, procedures, incidents and complaints. Senior staff met regularly in governance meetings and shared actions with the team in wider team meetings. Managers reviewed incidents and complaints for themes and trends and made changes to service provision in response.

Inspection carried out on 30 November 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • The owners and manager of the service were committed to providing high quality care and treatment to the clients. They offered unfunded admission to previous clients who had experienced a crisis in their recovery. They were knowledgeable, approachable and demonstrated care, compassion and empathy in their dealings with clients.

  • The provider had experienced staff that delivered care to the clients they worked with. The staff thoroughly assessed clients and completed risk assessments and holistic care plans that were tailored to the clients’ needs and treatment goals. Staff completed these plans in collaboration with the clients and their care managers. They demonstrated high levels of care and empathy towards the clients in the service.

  • Staff made clients at Sefton Park feel safe. They understood how to make safeguarding referrals if concerns arose. They followed the provider’s procedures when they did this. Clients felt that staff were approachable and felt able to raise complaints and make suggestions about the service. Staff safely managed clients’ medicine using robust policies and procedures.

  • There were positive and effective working relationships with the local GP, commissioners of the service and other local substance misuse treatment providers.

  • The provider had systems that supported service improvement and quality management. They completed audits to monitor the quality of work completed and had clinical governance meetings to discuss incidents and lessons learnt. Outside professionals provided further support in auditing and facilitating group and individual supervision to encourage reflective practice and individual development.

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

  • Systems to manage staff mandatory training were not robust. New staff had not completed mandatory training in a timely manner and long-standing staff had not received regular updates in some training topics in the mandatory programme. Consequently, some staff training was out of date. The registered manager had recognised the need to update training. They had organised sessions to take place after the inspection and we saw documentation including dates that confirmed this. However, staff were skilled and knowledgeable about the service that they were delivering.

Inspection carried out on 13 June 2013

During a routine inspection

This inspection was carried out to follow up the compliance action made at the last inspection 08 March 2013. We looked at the management of medication. We also looked at how the organisation was respecting and involving people, providing care, supporting workers and assessing the quality of service provided.

People spoken with told us they were very happy with the service provided by the staff at Sefton Park. One person told us, �I have told them I owe them my life. They say it was down to me but I say it is them that gave me the tools and the support and without them I would not be here today�. Another person told us, �I think they are very fair, they understand what we need and the pressures we are experiencing�.

We observed a very professional but supportive rapport between staff and people who used the service. People could talk with staff at any time.

We saw care plans were written by people who lived in the home. They discussed their identified needs, their goals and agreed how to achieve those goals.

Following the inspection on 08 March 2013 we saw people had clear risk assessments when they administered their own medication and all staff had attended training in medication management.

Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the manager.

The provider had a quality assurance system in place that ensured people were safe and changes could be made to improve the service provided.

Inspection carried out on 8 March 2013

During a routine inspection

We spoke with five people who used the service, three members of staff and the manager.

The people we spoke with who used the service all provided positive feedback regarding their experience of the service. Comments included �it�s a brilliant place, it saved my life�; �you are treated fairly and with respect all the time� and �it�s the best thing I�ve done".

We viewed four care plans. The planning was centred on the individual and considered all aspects of their individual circumstances. The care plans were specific to the individual's needs and preferences. People advised that they were involved in discussions about their care and support. There were robust arrangements in place that demonstrated that consent had been provided in relation to the care received.

We found that there were procedures in place regarding medicines handling which included arrangements to ensure the safe administration and disposal of medicines. The provider was unable to demonstrate that staff members had received up-to-date medication administration training. If a person was self medicating we found that there were no risk assessments in place.

Staff members demonstrated a good knowledge of the people they supported. The staff told us that they felt supported to undertake their role and staffing levels were adequate.

We found that there was a system in place to deal with complaints, including providing people who used the service with information about that system.

Inspection carried out on 17 August 2011

During a routine inspection

People told us that they felt that Sefton Park was a supportive place to stay. One

person said, �All the staff are very supportive you can go to them at any time�.

People said staff spent time with them and counselled them in a way that was respectful

and supportive. One person told us, �Sefton Park is comfortable, welcoming and safe�.

People told us that nearly all staff were always polite and respectful to them. A number of people told us there was one member of staff who was not always polite or respectful.

People felt safe at Sefton Park and they were supported in their treatment and recovery by staff who understood how to keep them safe from the risks of abuse.

People were being supported in their treatment and recovery by staff with a good knowledge of their range of needs. The staff had done a lot of training to help them understand what care and support people needed for successful treatment for addictions.

People were asked their views of the care and support they received. This information was used as part of the process of monitoring and improving the quality of service and outcomes for people.

Reports under our old system of regulation (including those from before CQC was created)