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Inspection Summary


Overall summary & rating

Good

Updated 23 August 2019

We rated St Thomas Fund as good because:

  • Staff supported clients to safely complete their community drug or alcohol detoxification treatment with a local substance misuse service. St Thomas Fund provided accommodation for clients completing their community detoxification treatment programme in premises that were safe, clean, well equipped, well furnished and well maintained.
  • Staff carried out a comprehensive assessment with each client, before they accessed the service. The assessment incorporated physical and mental health, plus social support needs. Staff referred clients to partner agencies as appropriate.
  • The prescribing doctor at the local community substance misuse service conducted a face-to-face consultation with all clients before prescribing medicines to them. Staff reviewed the effects of medicines on patients’ physical health regularly and in line with National Institute of Health and Care Excellence guidance.
  • Client care records contained a comprehensive, up-to-date risk assessment, which included a risk management plan in relation to potential risks associated with an unexpected exit from treatment.
  • Client recovery plans were written with the joint input of the clients and their support worker. The recovery plans were holistic, addressed all the identified needs of the clients and based upon the strengths of the client, to enable the client to build upon their personal strengths towards recovery.
  • Staff had completed all mandatory training, including safeguarding children and adults. Staff also completed a wide range of specialist training, to enable them to effectively carry out their roles.
  • Staff were discreet, respectful, and responsive when caring for clients. They gave clients help, emotional support and advice when they needed it. Staff understood and respected the individual needs of each client.
  • Clients expressed strong, positive views about the service accepting dogs, subject to individual risk assessment. They told us that not allowing dogs into the service would have constituted a significant barrier to accessing treatment for some people.
  • Clients could give feedback on the service and their treatment and staff supported them to do this. Clients participated in recruitment interviews for new members of staff and service contract review meetings with commissioners.
  • Clients had access to a range of activities and complementary therapies, such as massage, meditation, acupuncture, creative writing, mindfulness, yoga, cycling and badminton. Clients attended mutual aid groups throughout the week.
  • The management team had the skills, knowledge and experience to perform their roles. They had a thorough understanding of the service and a clear understanding of how their service worked with other agencies, to meet the needs of clients.
  • Staff expressed enthusiasm and pride in their work. They felt supported and respected by their managers and able to raise concerns without fear of retribution.

However:

  • At the time of our inspection, there was no risk assessment in place for a selection of exercise equipment in the garden.

Inspection areas

Safe

Good

Updated 23 August 2019

We rated safe as good because:

  • Staff supported clients to safely complete their community drug or alcohol detoxification treatment with a local substance misuse service. St Thomas Fund provided accommodation for clients completing their community detoxification treatment programme in premises that were safe, clean, well equipped, well furnished and well maintained.
  • Doctors at a local community substance misuse service prescribed medicines to clients. The prescribing doctor conducted a face-to-face consultation with all clients before prescribing medicines to them. Medicines were stored appropriately within the clinic room.
  • The service had enough staff, who knew the clients and received basic training to keep clients safe from avoidable harm.
  • Client risk assessments were holistic and up-to-date. Risk assessments contained a risk management plan in relation to potential risks associated with an unexpected exit from treatment.
  • Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

  • Staff gave Naloxone kits to clients and trained them in how to use the single-injection dose of Naloxone. Naloxone is an emergency medicine administered to temporarily reverse opiate overdose.

However:

  • At the time of our inspection, there was no risk assessment in place for a selection of exercise equipment in the garden. Immediately following our inspection, staff suspended client use of the exercise equipment until a risk assessment had been carried out so they could ensure clients were fit to use the equipment and able to use it safely.

Effective

Good

Updated 23 August 2019

We rated effective as good because:

  • Staff carried out a comprehensive assessment with each client, before they accessed the service. The assessment incorporated physical and mental health, plus social support needs. Staff referred clients to partner agencies as appropriate.
  • Client recovery plans were holistic and based upon the strengths of the client, to enable them to build upon their personal strengths towards recovery.
  • Staff provided a range of care and treatment interventions suitable for the client group and consistent with National Institute for Health and Care Excellence guidance on best practice. They ensured that clients had good access to physical healthcare and supported patients to live healthier lives.
  • Staff received monthly supervision and attended regular team meetings. Staff had access to training relevant to their roles.
  • Staff supported clients to make decisions on their care for themselves. They understood the provider’s policy on the Mental Capacity Act 2005 and assessed and recorded capacity clearly for clients who might have impaired mental capacity.
  • Staff had effective working links with local services, such as community mental health teams, housing providers, children and family services, social work and criminal justice agencies.

Caring

Good

Updated 23 August 2019

We rated caring as good because:

  • Clients told us they felt welcomed and that coming into the service was the best decision they had ever made.
  • Staff spoke with respect, dignity and compassion when discussing clients. They demonstrated a genuine interest in clients’ well-being; were non-judgemental; and, they ensured that clients’ needs were met.
  • Clients attended a weekly community group meeting, during which they provided feedback on the service they received. Staff discussed client feedback from these meetings during team meetings.
  • Clients participated in recruitment interviews for new members of staff and service contract review meetings with commissioners.
  • Clients we spoke with gave very positive feedback about relationships with their recovery workers.
  • Clients expressed strong positive views about the service accepting dogs, subject to individual risk assessment. They told us that not allowing dogs into the service would have constituted a significant barrier to accessing treatment for some people.

Responsive

Good

Updated 23 August 2019

We rated responsive as good because:

  • Staff completed a comprehensive discharge plan with each client. Clients could return to the services if needed following discharge. Most clients who completed treatment transferred to the second stage within the provider’s three-stage treatment pathway.
  • Clients had access to a range of activities and complementary therapies, such as massage, meditation, acupuncture, creative writing, mindfulness, yoga, cycling and badminton. Clients attended mutual aid groups throughout the week.
  • Clients had unrestricted access to the kitchen, so could make hot and cold drinks and snacks whenever they wanted. Clients participated in a rota for shared cooking and household chores.
  • The service met the needs of all patients who used the service – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support.
  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with the whole team and the wider service.

Well-led

Good

Updated 23 August 2019

We rated well-led as good because:

  • Managers had the skills, knowledge and experience to perform their roles. They had a thorough understanding of the service they managed and could explain clearly how the team was working to provide high quality care.
  • Managers dealt with poor performance when needed.
  • Staff expressed enthusiasm and pride in their work and told us they felt safe to raise concerns without fear of retribution. Staff said they felt supported and respected by their managers.
  • Staff reported that they had strong working relationships within their team and with staff from partner organisations. Staff we spoke with had a clear understanding of how their service worked with other agencies, to meet the needs of clients.
  • Staff could submit items to the provider’s risk register. The service had a contingency plan which outlined how the service would continue to meet clients’ needs if the building was not operational, for instance in the event of a fire.
  • Staff had access to the equipment and information technology needed to do their work. Information governance systems safeguarded the confidentiality of client records.
  • Clients and carers had opportunities to give feedback on the service they received. Staff discussed feedback from clients and carers during meetings.
Checks on specific services

Substance misuse services

Good

Updated 23 August 2019