We carried out a review of the data available to us about We are With You - Chy on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about We are With You - Chy, you can give feedback on this service.
Our rating of this service stayed the same. We rated it as good because:
The service provided safe care. The environment was safe and clean. The service had enough staff. The service used sessional staff, or community staff from the same organisation, who were known to the service so they did not have to use agency staff. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. Staff adopted a very person-centred approach to safeguarding and asked residents how they wanted to proceed. Staff empowered residents to make the safeguarding referral themselves where appropriate.
Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the residents and in line with national guidance about best practice. The provider had developed a treatment program called Recovery and Aftercare from Formative Trauma (RAFT) that was independently validated by the University of Bath. RAFT provided clients with a bespoke treatment plan that aimed to treat trauma underlying addiction. Staff engaged in clinical audit to evaluate the quality of care they provided.
Teams included, or had access, to the full range of specialists required to meet the needs of residents. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with those outside the service who would have a role in providing aftercare. Staff had good working relationships with the community team from the same organisation who provided aftercare to residents leaving the service.
Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
Staff treated residents with compassion and kindness, respected their privacy and dignity and understood the individual needs of residents. They actively involved residents and families and carers in care decisions. To encourage dog owners to attend rehabilitation, the service had heated kennels for residents’ dogs so they could bring their dog with them. Residents said that staff were approachable and that they were treated with respect, care and understanding. Residents said most of the staff went above and beyond to equip them with the tools they needed for their recovery.
The service managed beds well so that a bed was always available locally to a person who would benefit from admission and residents were discharged promptly once their condition warranted this. Staff made sure residents understood their discharge care plan which included harm minimisation and a departure risk assessment. Discharge plans were discussed in team meetings. Post discharge, community workers took residents onto their caseload and followed up with their recovery support.
The service was well led, and the governance processes ensured that service procedures ran smoothly. Staff reported their job satisfaction as high. Staff said they felt their roles were empowering to others and that they had a positive working relationship with their peers. Staff said they felt proud to work for the organisation. Managers recognised that their staff team experienced fatigue and stress during the pandemic. They invested in a full subscription for each staff member to a wellbeing app. Staff could also access the organisation’s employee assistance programme. The service had an effective governance structure and performed well in their audits. The provider’s risk register formed part of a shared regional risk register which fed into a national risk register. Managers completed a separate review of their local risk register in relation to the pandemic
However:
Staff did not always follow the provider’s policies and procedures when they needed to search residents or their bedrooms to keep them safe from harm. The service had a draft standard operating procedure for searching residents’ bedrooms but not all staff were aware of it and how to keep themselves safe.
Staff did not give carers information on how to access a carers’ assessment.
We rated Addaction Chy as good because:
However
We do not currently rate independent standalone substance misuse services.
We found the following areas of good practice:
The facilities were clean and well maintained. The service had installed kennels so people could bring their dogs to the service. The environment had a positive atmosphere.
Experienced staff were available to clients 24 hours per day. Staff were responsive, genuine, caring and respectful in their interactions with clients.
Clients had comprehensive up to date risk assessments. Recovery plans were of a good standard and they showed clients were receiving person centred care. Clients had individual time with their keyworkers and the group delivered interventions that met their recovery needs. The service had good links with external agencies that provided clients with holistic care.
There was a programme of therapeutic and leisure activities. Staff provided acupuncture in the evenings.
The service had good leadership and a clear aim. Morale and job satisfaction were high and staff felt motivated, valued and respected.
However, we also found the following issues that the service provider needs to improve:
The provider conducted searches of clients’ rooms and possessions but they did not have a policy or guidelines for undertaking searches. This had the potential to leave clients vulnerable to improper treatment.
We inspected rehabilitation (substance abuse) services provided by Addaction Chy but we do not yet rate these services. The following is a summary of our findings in relation to the five key questions we always ask about a service: Is it safe, effective, caring, responsive and well led?
Addaction is a national charity which provides support to residents to overcome substance misuse. Addaction Chy is a second stage, residential rehabilitation centre for adults who have already detoxed.
We found the service was meeting the needs of its residents. All residents had a recovery plan although three were incomplete. Recovery plans showed residents had had input into the planning of their care and that their history and circumstances were being considered. Family and friends could visit the facility and meet with a resident in private. Risk was assessed and residents were receiving care that enabled them to recover. Incidents were recorded and responded to appropriately. However, two Care Quality Commission (CQC) reportable incidents, while managed appropriately within the organisation, were not reported to the CQC. Staffing levels ensured residents could have one to one care 24 hours per day if needed. There was a range of group interventions on offer and also activities for residents to take part in to aid their recovery. Residents were given the opportunity to complain and managers responded effectively to complaints by trying to resolve them proactively.
Staff were respectful of residents and offered an appropriate level of support. Staff had received training although there were some who had not completed mandatory training. Only the manager had done manual handling and Mental Capacity Act (MCA) training. One member of permanent staff had not completed safeguarding children and adults and none of the bank staff had completed safeguarding children and adults. Three permanent staff plus all the bank staff had not done infection control. First aid and safe medicine handling had been completed by all staff. Staff told us that they enjoyed their jobs.
The service had recently moved into its new premises and maintenance tasks were being undertaken. Management were committed to resolving maintenance issues swiftly. For example, we saw that the manager had been in contact with senior managers and that there were clear plans in place to complete all maintenance issues within a reasonable time period. The environment was not clean in all areas. For example, dust had accumulated in high up areas including on window frames, door frames and some walls. The facility had a positive atmosphere and was well suited to accommodating therapeutic groups.