14 May 2014
During a routine inspection
• Is the service caring?
• Is the service responsive?
• Is the service safe?
• Is the service effective?
• Is the service well led?
Below is a summary of what we found –
Is the service caring?
We saw that people’s needs were assessed and care delivered in line with their assessed needs. We saw that that people had access to professional staff and that they had regular appointments with the unit medical officer, therapists and counsellors. This meant there were systems in place to help maintain their health and wellbeing. One person we spoke with told us, "I am pleased I agreed to attend for treatment”, and “I am well cared for, well supported, and for me this is a life changing moment”.
We observed that staff responded in a caring and compassionate way to people’s needs and had a good understanding of people’s individual likes and dislikes. We saw staff interacted well with people, were warm, supportive and spent individual time with them. We observed staff supported people to be as independent as possible. One person we spoke with told us, “The staff in here have been a god send to me.”
Is the service responsive?
People’s needs were assessed and their care plans reviewed and revised in line with their changing needs. People had access to a range of outside services to ensure their health and wellbeing was maintained, including doctors, dentists and opticians.
We saw that people were provided with group counselling along with one to one interventions. There was a strong emphasis on peer support with people supporting and helping each other during both detoxification and the rehabilitation stages. One person told us, “I must have slept for three days, and people were often offering to make me a brew.” People we spoke with told us that the food was good and that they had a choice of meals to choose from. Another person told us, “The food is good, you can eat as much as you want.”
We found that staff had a good understanding of people’s individual needs and about people’s health needs. For example, we saw one person had been experiencing a relapse during their rehabilitation stage. We saw staff had contacted the unit medical officer who visited the home, and arranged for a specialist to call the same day.
Is the service safe?
People were cared for in an environment that was safe and well maintained. Audits of safety systems were in place. The building was clean and the servery and bathroom areas were regularly cleaned. Fridge and freezer temperatures were monitored to ensure food was kept in good condition.
We spoke to staff on duty at the time of our inspection. They told us that senior staff members work closely with the team and how the nurse prescribers provide support to people and out of hour’s advice to members of staff.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager told us that no applications have needed to be submitted and people’s care plans reflected that the issue of capacity had been assessed and considered. Following recent changes in the revised definition when assessing someone’s capacity we have asked the manager to review the current arrangements for people on admission for treatment when their ability to provide valid consent may be compromised due to alcohol or drug consumption.
Is the service effective?
People told us they were happy with the treatment they were receiving and their needs had been met. People who used the service told us the staff were “really supportive”. One person told us, “All the staff are really good.” Another person said, “I think the staff are alright.”
We saw that people were able to make choices about the kind of support they received and had regular appointments with the unit medical officer, therapists and counsellors.
We saw that any training undertaken was logged and a date highlighted when this training needed to be updated. This meant that there were systems in place, to ensure that staff had up to date knowledge and information in order to carry out their roles.
We noted there was a system in place for a rolling programme of regular audits and reviews of people’s care records and to update risk assessments.
Is the service well led?
The home had a range of quality assurance systems in place to monitor the quality and consistency of care. We saw copies of documents regarding checks on medication, care records and nutrition.
We saw that accidents, incidents, complaints and safeguarding incidents were investigated and, where necessary, action taken to change or improve care delivery.
People who used the service confirmed that there were regular residents’ meetings and we saw copies of notes from these meetings.
Staff confirmed that there were regular staff meetings and we saw minutes from these meetings. Staff told us, and records confirmed, that they had regular supervision with a senior member of staff and annual appraisals.