The Recovery Lodge

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

• Staff knew, and put into practice, the service’s values. Staff were positive about the leadership and management of the service. Staff felt supported and morale was good.
• The environment was clean, welcoming and of a good standard. Clients and their families were encouraged to visit the service prior to admission.
• Staff discussed incidents during handovers and team meetings. Following an incident, the service had installed CCTV in communal areas, apart from the lounge and dining area.
• The psychiatrist completed a comprehensive assessment when clients were admitted to the service. Medicines prescribed followed recommendations by the National Institute for Health and Care Excellence (NICE) guidelines. NICE provides national guidance and advice to improve health and social care.
• Care records contained a photograph of the client so that staff could clearly identify them when administering medicines.
• Staff encouraged family and carer involvement and the service offered family intervention support. Clients told us that the service had helped repair relationships with their partner and family.
• We received positive feedback from professionals who told us the service was responsive and communicated well.
• Staff treated clients with kindness, dignity and respect and were enthusiastic and passionate about supporting clients in their recovery.
• Current and previous clients were overwhelmingly positive in their feedback about the service. None of the clients we spoke with at the service had any concerns to report. Feedback received from carers and relatives was equally positive.
• The service provided opportunities for client feedback to develop and improve the service. Clients were involved in planning menus, therapeutic duties and weekly activities.
• Clients completed a continued recovery plan (CRP) prior to discharge to ensure a smooth transition home. There was a fortnightly aftercare group and clients were invited to attend group therapy after discharge.
• The service had made adaptions to accommodate wheelchairs. The service had worked closely with social services to organise and facilitate appropriate specialist support to ensure that a client’s needs had been met.
• The service completed regular audits including medicines and quality assurance. The quality assurance audit considered a range of subjects including environmental risk assessment, fire checks, care plans, incidents, staff training and graduation questionnaires.

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

• The service had a detox protocol which clearly listed inclusion and exclusion criteria. The protocol referred to use of the alcohol use disorders identification test (AUDIT) to assess inclusion criteria. However, staff did not complete an AUDIT or severity of alcohol dependence questionnaire (SADQ) prior to admission to assess the severity of dependence or alcohol related problems.
• The service did not include information on admission documentation that they may ask clients to move bedrooms to ensure same sex accommodation.
• Staff rotas did not record the attendance on site of the manager and director. This meant that the rotas did not accurately reflect staffing levels.
• The manager told us that the service ensured staff competency, including administering medicines. However, there was no documentation to evidence this.
• All staff had completed the care certificate which included training in safeguarding adults and safeguarding children. However, only three of the seven staff had completed specific training for safeguarding adults at risk and safeguarding children and only four of the seven staff had completed training in the Mental Capacity Act and Deprivation of Liberty Safeguards.
• Risk assessments consisted of tick boxes to identify risk. The form did not invite further comments for risks identified. None of the records reviewed contained a plan for a client’s unexpected exit from treatment.
• Care plans were generally holistic and demonstrated client involvement. However, two of the care plans did not fully demonstrate client strengths and goals. Staff did not record the support provided to clients concerning their physical health. Information around administration of ‘as and when required’ medication lacked sufficient detail.
• There was an induction checklist in all of the staff personnel files. However, only three of the seven forms had been completed. The frequency of supervision was poor and the quality of record keeping was inconsistent. This meant that staff development needs were not always captured so that appropriate action could be identified. The service did not have any key performance indicators and did not measure outcomes. This meant that the service was unable to measure their success or performance of the team.