• Residential substance misuse service


Overall: Good read more about inspection ratings

London Road, Nascent House, Hemel Hempstead, Hertfordshire, HP3 9ST

Provided and run by:

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Oxygen 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 Oxygen, you can give feedback on this service.

07 September 2022

During a routine inspection

Oxygen is a nine-bedded residential drug and/or alcohol, medically monitored detoxification and rehabilitation facility based in Hemel Hempstead, Hertfordshire. Oxygen provides ongoing abstinence-based treatment, which includes group therapy, individual counselling and support in life skills.

Our rating of this location stayed the same. We rated it as good because:

  • The service provided safe care. The premises where clients were seen were safe and clean. The service had enough staff. 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.
  • The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
  • Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
  • The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
  • The service was well led, and the governance processes ensured that its procedures ran smoothly.


  • There was a toilet that was used for urine testing in a side room attached to the clinic room. There was medical equipment stored in boxes in the room and there was not a cubicle around the toilet. This meant there was a potential infection prevention and control issue.
  • Staff did not receive regular management supervision in line with the service policy. We reviewed the supervision records of 7 staff for the past year. We found that 5 staff had not received 6 supervisions a year, as per the service policy.

15 August 2018

During a routine inspection

We rated Oxygen as good because:

• Rooms and furnishings in areas accessed by clients were clean and well maintained.

• The service was fully staffed at the time of inspection. Staff absences were planned for in advance and were managed effectively.

• All clients had an initial risk assessment, risk assessments were comprehensive and regularly updated.

• The service had a clear medicines management process in place, all medication was stored appropriately. Medication was audited regularly.

• Trained staff completed blood pressure checks, breathalysing, and urine drug screening at regular intervals.

• Staff reviewed and updated individual care plans regularly. Care plans were personalised, recovery orientated, holistic and looked at areas of strength. All clients we spoke with said they were involved in their care plan.

• Staff used recognised monitoring forms to record and assess client withdrawal, outcomes and strengths as recommended in drug misuse and dependence: UK guidelines on clinical management.

• All staff, including volunteers received a thorough induction, all eligible staff were being supervised and appraised. Staff had access to regular team meetings and daily handovers. Staff could access additional and specialist training to support them in their role.

• The service held weekly house meetings where clients were encouraged to raise any issues with staff. Staff welcomed feedback from clients using the comments box or weekly house meetings.

• Staff morale at the service was high. Staff told us that they felt valued and supported within their roles.

• We saw evidence of recruiting from within the service and internal promotion. Staff felt able to input into developments within the service.


• The blood pressure machine had not been calibrated.

• Staff were not wearing their lanyard alarms in line with the providers lone-working policy.

• Toilets and bathrooms were mixed sex and not designated male or female. Risk assessments did not clearly indicate if the risk of being in mixed-sex accommodation had been considered and male and female bedrooms were located next to each other.

• Naloxone was stored in a locked cupboard within the clinic room and was not accessible immediately in an emergency.

07 December 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • All clients had an initial risk assessment. Risk assessments were comprehensive and updated regularly and following incidents. Staff completed comprehensive admission assessments for each client.

  • The service manager completed environmental risk assessments, including ligature audits.

  • Key workers allocated weekly one-to-one time with clients. Staff documented interactions with clients in treatment records.

  • All staff had completed a comprehensive induction. Staff had access to specialist training.

  • Staff undertook physical health checks prior to client's starting detoxification, and regularly throughout. Clinical assessments, case notes and discharge summaries were comprehensive. Clients accessing treatment were temporarily registered with the local GP surgery and dentist for any healthcare needs.

  • Care plans were reviewed and updated weekly. Care plans were holistic, personalised, recovery orientated and looked at a client’s areas of strength.

  • Staff had access to weekly team meetings and clinical meetings and daily handovers.

  • Oxygen provided follow on support for clients who had completed their treatment programme. Clients who had completed treatment had the opportunity to live at move on housing and attend the service for additional support. All clients were contacted following discharge.

  • We observed staff interacting with clients in a kind, considerate and caring manner. Clients we spoke with told us staff were interested in their wellbeing and that staff were respectful, polite and compassionate. Clients felt involved in their care.

  • Families could be involved in treatment with client agreement.

  • The provider rarely cancelled appointments or groups due staff shortages or sickness.

  • We saw comfortable dining areas. Snacks and hot or cold drinks were available at all times. Clients were encouraged to take responsibility for therapeutic duties.

  • The service had not received any formal complaints since June 2015, clients we spoke with knew how to complain.

  • We saw thank you cards and letters displayed on the information board from clients who had successfully completed treatment.

  • Staff turnover and sickness levels were low. Staff morale at the service was high. Staff told us that they felt valued and rewarded for the job they did. We saw evidence of recruiting from within the service. Staff felt able to contribute to developments within the service.

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

  • The clinic room temperature was not recorded. The fridge in the clinic room was used for staff lunches and not as a clinic room fridge, there was no medication that required refrigeration at the time of inspection. We saw disposable cups in the sink within the clinic room that were being reused. Staff could not confirm if they were used for giving clients medication or for urine testing.

  • The service had nine single bedrooms, all of which were unisex and risk assessments did not include the risk of shared sex accommodation. Bathrooms were not designated for males or females.

  • Only one member of staff was allocated to an overnight shift which both staff and clients felt was unsafe. Clients we spoke with said if there was an issue with the staff member they would need to exit the building to summon help as clients did not have access to phones or alarm systems.

  • Staff did not transport medication to other sites in lockable transportation bags.

  • The service did not have a standardised way of reporting incidents. We saw incidents reported on incidents templates, by email and on word documents.

  • Staff were not being supervised regularly in line with the provider’s supervision policy.

  • Clients felt the house rules, confidentiality and information sharing should be revisited a week after admission as there is a lot of information given to them on admission and they may have been under the influence of substances on admission.

  • There was a lack of 1:1 space available.