The Care Quality Commission
  • Residential substance misuse service

Archived: Mitcham Park

3 Mitcham Park, Mitcham, Sutton, Surrey, CR4 4EN (020) 8646 0975

Provided and run by:
Equinox Care

All Inspections

11, 12 July 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • The service had enough skilled and competent staff who were assessed through an appropriate recruitment process. Staff received adequate training, support, supervision and professional development. Staff had skills in counselling and long-term experience of working with clients who had substance misuse and mental health issues.

  • Every client had a comprehensive assessment to help staff understand their needs, personal histories and issues associated with their substance misuse. The provider had a holistic approach to supporting people with substance misuse issues. Clients valued the structured therapeutic programme with their recovery and goals and service that focused around their individual needs. There were opportunities to engage in a broad range of activities from the local and wider community to support clients with their recovery and community re-integration.

  • Staff monitored the heath and wellbeing of clients who promptly responded to any signs of deterioration in their physical or mental health.

  • The provider had strong partnership links with multi-agency and community services to assist in providing support and additional services to prepare clients for independent living.All clients had care coordinators and their care was regularly reviewed. Commissioning and health and social care professionals provided strong and clear feedback about their positive relationships with the service. Feedback provided by stakeholders described the service as a valuable resource that consistently provided a high quality, well managed, safe and secure environment for clients who used this service.

  • Staff were kind, caring, compassionate and enabling. Staff encouraged clients to fully participate in their care planning and recovery programme, having good insight into how best to support them. Staff took action to promote and protect the needs and rights of clients. Clients were empowered to make decisions wherever possible and staff took a balanced approach to how risks were managed. Staff understood the diverse social and cultural backgrounds who had complex personal histories.

  • Clients were informed about the complaints procedure, understood how to make a complaint and had access to external independent advocates.

  • Overall the service was well led and there was a clear vision and values that were understood and shared by the majority of staff. The provider had a clear audit cycle which was used to audit and monitor the quality of the service as well as outcomes for clients. The provider monitored staff performance, supported their needs and had a commitment to improve the quality of the service.

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

  • Following an allegation of abuse, the provider did not take action in line with their safeguarding procedure to safeguard a client and prevent the possibility of abuse from happening. The management of the service did not openly communicate with staff and clients about their safeguarding concerns and their response in how they dealt with it.

  • While risks to clients were assessed, these were limited to one or two areas of risk and were not comprehensive. The provider had not ensured they did all that was reasonably practicable to mitigate any such risks.

  • The provider used alcohol and drug plans with clients who had misused these substances. The plans were used to help clients identify their progress and were a good visual aid. However, there were no plans in place in order for clients to meet their identified needs and future goals.

  • A store of used medicines had not been promptly returned or disposed of and could pose a risk to clients.

  • The care records for all clients were not kept in an organised way and made it difficult to locate information about them.

  • Staff respected the rights of clients to make informed decisions and had some awareness of the principles of the Mental Capacity Act (MCA). However staff lacked an understanding about the legal requirements of the MCA and its use in the service.

23 January & 5 February 2015

During a routine inspection

This was an unannounced inspection and took place on 23 January and 5 February 2015. We have not rated this service as we inspected this service during the pilot phase for our approach to specialist substance misuse services.

Mitcham Park provides support for up to eight men who have completed an alcohol detoxification programme and who wish to develop life skills to enable them to lead a life free from alcohol dependency. At the time of our visit there were seven people using the service.

At our previous visit in October 2013, we judged that the service was meeting all the regulations that we looked at.

The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and the associated Regulations about how a service is run.

People told us they were kept safe and free from harm. They said they felt well supported by the staff team and with their rehabilitation care programme. Staff knew how to protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise and manage identified risks in order to keep people on track with their care programme.

There were enough properly trained and well supported staff to meet people’s needs. People told us and we saw that staff had built up good trusting relationships with people. Staff were familiar with people’s care programmes and their individual needs and the choices they had made about the care they wanted to receive.

People were responsible for taking their own medicines however staff knew how to manage medicines safely and were able to offer appropriate support when it was needed.

Staff received regular training and supervision and had annual appraisals of their work. They were knowledgeable about their roles and responsibilities. Staff had the skills, knowledge and experience required to support people with their care and support needs.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their support and care. People told us they liked the staff and felt the support they received was helping them to achieve their aim to live an independent life in the community free from alcohol dependency.

People were supported to lead a healthy lifestyle and to maintain their own health care by attending healthcare appointments as necessary.

People told us staff were kind and caring, and our observations and discussions with staff supported this. We saw they treated people with dignity, respect and compassion.

People told us they were responsible for their own shopping and cooking and they ensured they had a varied and nutritious diet and choice of meals. Staff were able to offer appropriate support when it was needed.

Staff supported people to keep healthy and well through regular monitoring of their general health and wellbeing.

People were encouraged to maintain relationships that were important to them. There were no restrictions on when people could visit the home and staff made visitors feel welcome.

People had rehabilitative care programmes that encouraged independence and access to the local community and a variety of community based social activities.

Care plans were in place which reflected people’s specific needs and their individual choices.

People using the service, relatives and care professionals were encouraged to give feedback on the service as there was an effective complaints system in place.

Staff told us they felt well supported and enjoyed working in a positive environment. They said they were clear about their roles and responsibilities. They had a good understanding of the ethos of the service.

Systems were in place to monitor the safety and quality of the service and to get the views of people about the service. The registered manager was accessible and approachable. Staff and other people including those who used the service felt able to speak with the registered manager and provide feedback on how the service was run.

14 October 2013

During a routine inspection

People told us they were very happy with the care they were receiving at the service and they found the approach of the staff very positive. One person told us, "I'm very happy with the care here, it is a relaxed environment." Another person told us, "Staff do their jobs with passion and care." And another person told us "It feels like my home." People were involved in decisions about their care and regular assessments informed the care they received.

People told us that they were treated with dignity and respect. One person told us "We are treated as adults."

We observed a group session for seven service users led by a staff member who was knowledgeable, professional and empathetic to individual people's needs. People were able to speak freely without fear of discrimination. We reviewed seven paper and four electronic records which included individual care plans and we also looked at policies and procedures.

We found that although records were kept secure, the dual system of keeping both paper and electronic records resulted in duplication and omission of records, difficulty in accurately reviewing care plans and not always being promptly located.

We found that the service was regularly reviewed and monitored by the providing organisation and feedback was sought periodically from people whilst using the service and after they had left. We found evidence that this feedback was acted upon.

30 January 2013

During a routine inspection

At the time of our visit there were four people using the service and we spoke with three of these. They told us how the service had supported them to understand their reasons for misusing alcohol, and enabled them to develop skills to lead a better quality of life. They all said the staff were supportive, knowledgeable about their work and knew how to support them to become more independent in their lives. We saw the staff had developed a good rapport with the people who use the service, and they treated them as an individual.

People who use the service told us they liked living at the service. They said they liked being able to spend time on their own, and to be able to talk to staff when they needed to. People told us that staff had time to spend with them, and there was always someone available to talk with.

The staff we spoke with said they felt there was good team work and there were enough staff to meet people's needs.

People who use the service said they knew how to make a complaint if they needed to, but had not had reason to. They said that if they did have any concerns these would be listened to and dealt with appropriately.