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East Coast Recovery Ltd Good

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 3 October 2019

We rated East Coast Recovery as good because:

  • All premises where clients received care were clean, well equipped, well furnished, well maintained and fit for purpose. The service had a full range of rooms and equipment to support treatment and care. The residential accommodation was homely, well-decorated and furnished and had quiet areas where clients could meet visitors and relax.
  • Staff completed comprehensive assessments with clients on admission to the service. They worked with clients to develop individual recovery plans and updated them as needed. We reviewed six recovery plans and found these were comprehensive, reflected the assessed needs, were personalised, holistic and recovery-oriented.
  • Staff treated clients with compassion and kindness. They understood the individual needs of clients and supported them to understand and manage their recovery, care and treatment.
  • The service treated concerns and complaints seriously, investigated them and learned lessons from the investigation outcomes. These were shared with the whole team.
  • Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the service they managed and were visible in the service and approachable for clients and staff.

However:

  • There were blind spots and ligature points throughout the recovery centre and the residential houses (a ligature point is anything which could be used to attach a cord, rope or other material for the purpose of hanging or strangulation). The provider risk assessment did not identify individual ligature anchor points within any of the buildings or state how the risk of these could be mitigated. We were concerned that the service was admitting clients with a history of self-ligation without staff being fully aware of the environmental risks and how to mitigate these. The lack of a ligature risk assessment was an issue at the last inspection.
  • Bedroom corridors contained a mixture of male and female bedrooms. There were no locks on the bedroom doors, so clients could not lock the door to maintain their safety, privacy, and dignity.
  • The service did not have an alarm call system in place within the bedrooms and communal areas of the residential houses. Staff did not carry personal alarms. Staff would be unable to summon assistance quickly in these areas if a client or staff member required assistance in an emergency. Alarms were situated in the offices of the residential houses.
  • We found that the risk management plans for clients were generic, all had the same wording and did not give details of how specific risks for individual clients should be managed. We could see evidence from talking with staff, and from client recovery plans, that staff had good knowledge of clients and were aware of their risks. However, this was not reflected in the risk management plans and we were concerned that new staff would not be aware of how to manage client risks by looking at this part of the risk assessment.

Inspection areas

Safe

Requires improvement

Updated 3 October 2019

  • There were blind spots and ligature points throughout the recovery centre and the residential houses (a ligature point is anything which could be used to attach a cord, rope or other material for the purpose of hanging or strangulation). The service risk assessment did not identify individual ligature anchor points within any of the buildings or state how the risk of these could be mitigated. We were concerned that the service was admitting clients with a history of self-ligation, without staff being fully aware of the environmental risks and how to mitigate these.

  •  Bedroom corridors contained a mixture of male and female bedrooms. There were no locks on the bedroom doors, so clients could not lock the door to maintain their safety, privacy, and dignity.

  • The service did not have an alarm call system in place within the bedrooms and communal areas of the residential houses. Staff did not carry personal alarms. Staff would be unable to summon assistance quickly in these areas if a client or staff member required assistance in an emergency. Alarms were situated in the offices of the residential houses.

  • We found that the risk management plans for clients were generic, all had the same wording and did not give details of how specific risks for individual clients should be managed. We could see evidence from talking with staff, and from client recovery plans, that staff had good knowledge of clients and were aware of their risks. However, this was not reflected in the risk management plans and we were concerned that new staff would not be aware of how to manage client risks by looking at this part of the risk assessment.

  • The doors to the basement at both residential houses were removed. This had been a concern at the last inspection. The doors were located immediately next to the kitchen door which was a potential falls hazard. In Albany House, where the basement was used for storage purposes only, a stair gate had been placed at the top of the stairs. However, in Fairways House the stair gate had been removed as staff felt this posed more of a trip hazard, as clients had to step over the lower bar to access bedrooms. Managers told us that they were currently in discussion with the local fire service regarding this issue and were awaiting further specialist advice as to how these risks could be mitigated. There was not an environmental risk assessment in place as to how these current risks could be mitigated.

However:

  • All premises where clients received care were clean, well equipped, well furnished, well maintained and fit for purpose. During the inspection we saw that a weekly cleaning schedule was in place which was an improvement since the last inspection.

  • Staff had replaced all the window restrictors in patient bedrooms. This was an improvement since the last inspection when some of the restrictors had been rusty and not fit for purpose.

  • The service had enough staff, who knew the clients and received basic training to keep clients safe from avoidable harm. Clients spoken with told us they had regular one to one time with their keyworker and that activities were never cancelled due to staffing shortages.

  • Controlled drugs were stored appropriately in a lockable metal cupboard that was fixed to a wall. This was an improvement since the last inspection.

  • 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.

Effective

Good

Updated 3 October 2019

We rated effective as good because:

  • Staff completed comprehensive assessments with clients on admission to the service. They worked with clients to develop individual recovery plans and updated them as needed. We reviewed six recovery plans and found these were comprehensive, reflected the assessed needs, were personalised, holistic and recovery-oriented.

  • The service offered individual and group psychological therapies recommended by the National Institute for Health and Care Excellence. The service employed a team of therapists who provided therapies such as Cognitive Behavioural Therapy, Psychodynamic therapy, Eye Movement Desensitization and Reprocessing and the12 step model of recovery.

  • The team included, or had access to, a range of specialists required to meet the needs of clients under their care. Managers made sure that staff had the range of skills needed to provide high quality care. They supported staff and volunteers with appraisals, supervision and opportunities to update and further develop their skills.

  • The service offered former clients the opportunity for training and to develop their skills and work experience by becoming peers, and then volunteers, within the service.

  • Staff assessed clients’ capacity to consent to treatment prior to admission. If a client arrived for admission in a state of intoxication, staff told us they would take the client’s willingness to stay as implied consent and then wait until the following day to ask the client to sign paperwork consenting to admission.

Caring

Good

Updated 3 October 2019

We rated caring as good because:

  • Staff treated clients with compassion and kindness. They understood the individual needs of clients and supported them to understand and manage their treatment, care and recovery.

  • We spoke with six clients. All the clients spoken with were highly appreciative of the support they were receiving and told us they found all the staff helpful, kind and empathic. Two clients told us how staff at the service had helped them turn their lives around. One client told us the service had saved their life.

  • Staff involved clients in recovery planning and risk assessment and actively sought their feedback on the quality of care provided. They ensured that clients had easy access to additional support available.

  • Clients had a named key worker who they met with weekly.

  • Staff informed and involved families and carers appropriately. The service offered a monthly meeting for family members and friends of clients, as well as written information about addiction and recovery. We spoke with two family members who told us that staff had communicated well with them and offered them support and understanding.

Responsive

Good

Updated 3 October 2019

We rated responsive as good because:

  • The service was easy to access. Staff planned and managed discharge well. The service had alternative care pathways and referral systems for people whose needs it could not meet.

  • The service had a full range of rooms and equipment to support treatment and care. The recovery centre had a variety of different rooms used for group therapy as well as smaller rooms for individual therapy and a relaxation room. The residential accommodation was homely, well-decorated and furnished and had quiet areas where clients could meet visitors.

  • The service had an activity time table for clients to participate in. For example, clients told us they could attend go-karting sessions, shopping and bowling as well as go on walks along the beach and in the local area.

  • A cook/food coach attended the houses every evening to support clients with preparing healthy, balanced meals. Clients took turns to prepare the evening meal on a rota basis. Clients told us they had a choice of food and each menu had options for vegetarians and other dietary requirements, including cultural requirements. Clients had access to snacks and hot drinks throughout the day and night.

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the investigation outcomes. These outcomes were shared with the whole team.

Well-led

Good

Updated 3 October 2019

We rated well-led as good because:

  • Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the service they managed and were visible in the service and approachable for clients and staff. We observed that clients interacted in a positive way with the managers of the service.

  • Staff reported there was good morale amongst the team. Staff confirmed that they felt proud to work for the service and had positive job satisfaction by helping clients overcome their addictions.

  • Staff knew and understood the provider’s vision and values and how they applied to the work of their team.

  • The manager had appropriate and effective systems in place to monitor staff compliance with training, supervision and appraisals.

  • Our findings from the other key questions demonstrated that governance processes operated effectively at team level and that performance and most risks were managed well.

However:

  • The service did not have a comprehensive ligature risk assessment which meant that managers did not have oversight of ligature risks and mitigation of these risks.

Checks on specific services

Residential substance misuse services

Good

Updated 3 October 2019

East Coast Recovery Ltd