The Recovery Lodge

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

We scored the service as 2. The evidence showed some shortfalls. The service did not ensure that goals documented in care plans were individualised, and that there was documented mitigation in place for risks identified during the assessment.

People newly admitted to the service were assessed by an Advanced Nurse Practitioner (ANP). Staff worked with other healthcare services, such as a GP and therapists, to support a joined-up approach.

Staff obtained GP summaries when people were admitted to the service to ensure they had any relevant medical history.

We reviewed care records for all 6 people admitted to the service at the time of our inspection. Care plans were not person-centred. These were generic, with several parts pre-typed, with little information centred on the person. All 6 people at the service had the same goals and objectives documented. The discharge planning section was also generic, noting ‘Follow up with 12 step programme, attend further meetings’. Staff told us this section of the care plans had not yet been fully completed as none of the people receiving treatment at the service were approaching discharge.

Staff assessed peoples’ physical health needs in a timely manner after admission. However, they did not always document any mitigation for any physical health risks that were identified. Care note entries around physical health were vague. For example, staff had documented that a person was ‘unwell’ and therefore the ANP was to be contacted. However, there was no details about what symptoms they had. The ANP had prescribed medicines for this person after reviewing them, however there was no further documentation around whether this had been effective in relieving their symptoms.

We scored the service as 3. The evidence showed a good standard. Staff delivered care and treatment to people in line with legislation and current evidence-based practice and standards.

Staff provided a range of care and treatment interventions suitable for the people using the service. The service delivered a 12-step programme alongside person-centred therapy. They also provided alternative therapies, such as acupuncture and massage.

People had access to a range of specialists. This included therapists and counsellors. Therapists were experienced and qualified and had the right skills and knowledge to meet the needs of the people using the service. Counselling was provided on a one-to-one and group basis. Group therapy included process groups to discuss and reflect on learning and share insights with peers. People spoke positively about the support they received. People had also given positive feedback following their discharge from the service.

The National Institute of Health and Care Excellence (NICE) recommends that healthcare professionals should routinely provide information about mutual aid groups and facilitate access for those who want to attend. Staff supported people to attend mutual aid groups, and attendance following discharge was encouraged.

The registered manager provided new staff with appropriate induction. New staff were given the opportunity to shadow more experienced members of the team. Therapists and counsellors were well supported throughout their induction.

The registered manager held weekly team meetings. Minutes were shared with any staff unable to attend. Admissions and discharges were discussed. Feedback from people and relatives was shared to celebrate good practice.

The registered manager identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. Staff had completed the care certificate. This is a set of standards that social care and health workers adhere to in their daily working life. Staff received one-to-one supervision and an annual appraisal.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had weekly team meetings. They discussed people using the service, incidents, medicines and any feedback received.

Staff shared information about people using the service at shift handovers. An end-to-end, encrypted messaging service was used to communicate any urgent information within the staff team.

The team had effective working relationships with teams outside the organisation. The registered manager promptly liaised with the local authority’s safeguarding team when needed and effectively liaised with other external health care professionals, such as GPs, where appropriate.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported people to live healthier lives. For example, there was advice regarding smoking cessation, healthy eating and dealing with issues relating to substance misuse.

Therapeutic activities, such as massage and yoga, helped promote a healthy lifestyle. People were supported with regular local walks and to attend alcohol and drug support meetings.

An Advanced Nurse Practitioner (ANP) assessed people’s physical and mental health. When staff had a concern about a person’s health they spoke with the ANP for advice and guidance.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised tools, such as severity of alcohol dependence questionnaires and the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) to monitor the severity of alcohol withdrawal.

Staff provided after care for people which involved contacting them 7 days, 14 days and 12 weeks after they had been discharged from the service. When a person had spent 28 days at the service, they were able to access the service for 4 days of in person after-care.

Quality Statement Score: 3

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service provided care for people who could consent to treatment. Staff took all practical steps to support people to make decisions about their care for themselves.

Staff discussed information sharing with each person at the point of admission, such as for sharing treatment information with their GP.

Staff had a good understanding of and knew where to get accurate advice on the Mental Capacity Act. Training records showed that all staff were up to date with training in the Mental Capacity Act.