• Residential substance misuse service

Archived: PCP Leicester

Overall: Requires improvement read more about inspection ratings

158 Upper New Walk, Leicester, Leicestershire, LE1 7QA (0116) 258 0690

Provided and run by:
PCP (Clapham) Limited

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Background to this inspection

Updated 1 January 2020

PCP Leicester registered with the Care Quality Commission in December 2014 and is a residential psychosocial drug and alcohol, medically monitored detoxification and rehabilitation facility. It is based in Leicester city centre, Leicestershire. At the time of inspection, the service had a registered manager Rebecca Crutchley, and a nominated individual. They did not have a controlled drugs accountable officer.

The service includes a treatment centre where clients attend daily therapy sessions, and a seven-bedded detoxification house, known as St Stephens for people undergoing detoxification with 24-hour supervision. St Stephens is separately registered with the Care Quality Commission, and although inspected alongside PCP Leicester it has been reported on separately.

PCP Leicester provides ongoing abstinence-based treatment, which focuses on the 12- step programme and integrates cognitive behavioural therapy, motivational interviewing, integrated psychotherapy, psycho-social education and solution focussed therapy.

PCP Leicester is registered with CQC to provide treatment of disease, disorder or injury.

At the time of inspection, seven people were accessing the service for day treatment. The length of stay for clients in treatment was between two and twelve weeks.

The service provides care and treatment for male and female clients. PCP Leicester accepts self-referrals from privately funded individuals and drug and alcohol community teams primarily from the midlands area.

The Care Quality Commission has carried out three inspections in November 2015, March 2017 and July 2018. Following the last inspection, we found the following practices needing action by the provider:

Regulation 17 HSCA 2008 (Regulated Activities) Regulations 2014 Good Governance – Requirement Notice

  • Overarching governance of the service was not embedded practice. Management was not monitoring new guidance and policy to ensure it was working. Management was not evaluating and checking their quality improvements for effectiveness. The service did not have targets or key performance indicators. Quality assurance management and performance frameworks were not in place. The risk register was incomplete. Registered managers did not have enough time, authority or autonomy to carry out their duties effectively. Communication between senior management and location managers and staff was not always good. Not all recruitment processes were robust. The provider did not have clear vision and values.
  • Poor cleanliness due to lack of monitoring in the communal kitchen area posed risk of infection for staff and clients. Managers had not included blind spots on the environmental risk assessment.
  • Management had not completed clinical audits. We did not see any external audit of the processes relating to medicines management and dispensing medication for the three months prior to inspection.
  • The medications policy did not reflect amendments to the health and social care regulations or current guidance around medication management. There was no controlled drugs accountable officer for the service, and the provider had not addressed the need to work in partnership with a local pharmacist, or the local controlled drugs accountable officer group.

Furthermore, we asked the provider to consider action in respect of the following:

  • The provider should consider harm reduction measures in respect of their practice to accept new referrals on a Friday morning for detoxification.
  • The provider should consider inviting new clients to view the accommodation part of their service prior to signing admission agreements.
  • The provider should have clear vision and values, to ensure staff and clients know what to expect of the service.

At this inspection we found the provider had or were addressing all the above actions. How the provider addressed the issues is recorded in the detail below.

To be noted: Since writing this report the provider has de-registered this service with the Care Quality Commission. This means the service no longer exists.

Overall inspection

Requires improvement

Updated 1 January 2020

We rated PCP Leicester as requires improvement because:

  • The provider had not met legal requirements in relation to controlled drugs. Staff had not identified, through clinic room audits that the service was operating without a controlled drugs Home Office Stock licence between 30 August and 08 September 2019. This had not been picked up as part of the providers clinical audit process.
  • Staff did not always respect client’s privacy and dignity. We observed on two occasions that staff were taking clients physical observations in the reception area, even though there was a clinic room for these procedures to take place in private.
  • Mangers did not formally supervise new starters they had been post for three months. While this was in line with provider policy and there were other informal measures in place to ensure staff were not left unsupervised during their first three-month probationary period. We had concerns as the impact of this could be that new staff may encounter skills deficits or develop poor practice before they were formally picked up through the supervision process.
  • The provider did not always ensure the safe disposal of clinical waste. There was no yellow clinical waste bin in the clinic room, though there was one in the toilet where staff did urine testing. We raised this with the manager and before we left site she had ordered a second clinical waste bin.

However:

  • The service was well led, and the governance processes had been reviewed to ensure that its procedures ran smoothly. Since our previous inspection the provider had restructured the service to include four senior managers including an operational manager, a health and safety manager, compliance manager and services manager. The registered manager no longer carried any clinical responsibility.
  • The service provided safe care. The clinical premises where clients were seen were safe and clean. The service had enough staff, this was an improvement on our previous report. Staff assessed and managed risk well 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 clients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • Staff treated clients with compassion and kindness and understood the individual needs of clients. We heard some exceptional examples including how staff had supported and encouraged a client who wanted to leave on their first day at the service, the client decided to stay; staff liaising with a client’s employer to keep their job open for them whilst they underwent treatment; staff supporting clients to regain contact with their estranged children and the provider extending a client’s stay free of charge.
  • Staff actively involved clients in decisions and care planning. Clients told us the service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.