Cocoon Residential Rehab

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This meant we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question as good. At this assessment the rating has changed to requires improvement.

We found a breach of regulation 9 in relation to person centred care. People in treatment did not always have a care plan. Learning from complaints was not implemented. Staff did not always respond quickly when an issue was identified. This meant people’s needs were not always met.

However, people told us they felt they could raise any concerns with staff.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

We scored the service as 1. The evidence showed significant shortfalls. The service did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff did not ensure people at Cocoon Residential Rehab were receiving person-centred care. People in treatment did not have recovery plans in place at the time of our assessment. People we spoke with said they had not received a copy of their care plan. We raised this with the provider as an urgent concern and the provider ensured recovery plans were put in place for all people in treatment. Additional oversight of recovery planning was also implemented. Failure to deliver person centred care means that care was not provided around individual needs and people were not involved in their care.

We scored the service as 2. The evidence showed some shortfalls. There were some shortfalls in how The service understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Staff supported people to maintain contact with their families while in treatment. We found evidence that families were involved in treatment. For example, staff completed questionnaires with some family members and supported family connections.

Leaders did not ensure there was aftercare available for people once they had completed treatment. However, secondary stage treatment was available for people who wanted ongoing treatment at Cocoon Residential Rehab.

We scored the service as 2. The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff were aware of information governance systems, including confidentiality of personal information. Staff liaised with external agencies where necessary. For example, there was evidence of staff liaising on discharge with care co-ordinators and funders.

People’s care records were stored safely on the services electronic recording system. Some records were also on paper.

There was a data protection policy in place, which outlined data protection procedures. New starters and bank staff had not completed training in general data protection regulation (GDPR).

People told us they were given a welcome pack prior to admission.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve people in decisions about their care or tell them what had changed as a result.

The service had a complaints and compliments process in place. The service had a complaints log, where there were 3 complaints logged from January 2026. There was 1 complaint about a medication error and 2 complaints regarding staff behaviour. All complaints were upheld. Learning was identified on complaint logs, however we did not always see that learning had been implemented and learning was not specific to the complaint. For example, regular review of risk assessments was identified as learning. We did not find risk assessments were regularly reviewed. Failure to implement learning from complaints meant the incident could reoccur.

People we spoke with told us they could raise concerns with staff. One person told us there was a house group leader, who was responsible for checking in with people. The house group leader also kept a log of issues to share with staff. Some issues, such as the hob on the oven not working were logged. People told us it sometimes took a while for logged issues to be actioned.

We reviewed the service’s “you said, we did” responses. This included feedback that the service should have emergency medications, such as naloxone available. The service introduced an emergency grab bad with naloxone. Whilst this shows the service was responding to feedback, emergency medication such as naloxone should have been available for use in an emergency and for safe care and treatment.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

The service had a disabled access bedroom and a disabled access bathroom. We observed mobility aids, such as a shower chair in the downstairs bathroom. There were call bells in bedroom that we observed.

Leaders ensured there was a management of a deteriorating client policy. This included processes for physical observation monitoring, staff duties and responsibilities. There was also guidance on escalating deterioration. However, not all staff had completed their induction, which included training on monitoring vital signs and escalating physical health concerns.

There were no medical staff onsite. Staff told us that people would be made an appointment with a local GP or an ambulance would be called in an emergency.

At the time of our inspection there were no waiting times for admission. The service had reduced occupancy to 50% due to low staffing levels.

We scored the service as 2. The evidence showed some shortfalls. Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Leaders did not ensure staff were appropriately trained in equality, diversity and inclusion. One member of staff had completed training.

However, the service had an equality, diversity and inclusion policy. This stated policy on age, disability, race, gender, religion, pregnancy, marriage, sexual orientation and equal pay. This policy did not have a date of implementation or a review date.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff supported people with important changes, such as discharge from treatment. We reviewed discharge plans and found that a description of time in treatment and plans for discharge were included. For example, we found that discharge reports plans included goals for increasing recovery networks, physical health and employment and training opportunities. This meant that people were supported with planning for the future.

People had the opportunity to apply for secondary stage treatment at Cocoon, which could be funded privately or through commissioners. Leaders told us clients returning to their home area following treatment would be supported through contact with commissioners and local drug and alcohol agencies. People were given information on local support sessions. For example, details of local narcotics anonymous (NA) groups or community support sessions to enable people to access further support on discharge from treatment. There were no free aftercare sessions.