Archived: Hope House

We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

• Medicines were not appropriately managed. In the two months prior to the inspection there had been 19 occasions where the actual medicines available did not correspond with the medicines tally recorded by staff. The provider had identified medicines administration and management as an area for improvement prior to this inspection and was reviewing its policy and procedures in this area at the time of our visit.

• Whilst overall the care and treatment provided to clients was safe, a range of records relating to the safe care and treatment of clients were not appropriately maintained. Potential risks for individual clients were not readily identified in client records and there was no plan in client care and treatment records to show how potential risks were managed or mitigated. Unexpected exit or discharge plans did not highlight to clients the increased risk of overdose associated with drug or alcohol misuse after a period of abstinence. Not all care plans were reviewed and updated in accordance with the provider’s policy and procedure. Some care plans were not holistic. A record of daily contacts by staff with clients was not maintained. Individual or group supervision sessions where decisions regarding client care and treatment could be made were not recorded. Employment records for staff did not include a record of staff previous employment records including an explanation of any gaps in employment history.

• The provider had not carried out some of their planned fire alarm checks. Whilst the provider had a lone working policy and procedure in place, staff did not take personal alarms with them when meeting with clients in interview rooms and it was unclear who would respond to the lone night relief workers alarm if activated.

• Not all staff had received training in areas such as mental health and eating disorders which could impact upon their ability to meet the needs of some clients.

  However, we also found the following areas of good practice:

• There were safe and consistent staffing levels. We observed that the staff were caring and supportive towards clients. All clients we spoke to commented on the positive nature of the staff input towards their treatment.

• The service promoted the importance of physical health within client’s recovery programmes and ensured that clients physical health needs were met.

• The service had a structured treatment and activity programme with clear expectations for clients on how to structure their time to help promote recovery. There was an additional aftercare programme that clients could attend after successful completion of the residential programme.

• The service had good links with the local community and other organisations. This included local authorities, the local mental health team and local community groups. This ensured that the clients were well supported both through Hope House and within the wider community.