- Residential substance misuse service
T.H.O.M.A.S
Report from 10 June 2025 assessment
Contents
Ratings - Residential substance misuse services
Our view of the service
We rated the service Requires Improvement because we found 3 breaches of regulations in relation to premises and equipment, governance, and staffing.
We found that the environment was not consistently maintained. Some areas and furnishings were not clean and posed safety risks. Cleaning products were not always stored safely, and cleaning and monitoring practices were not consistently effective.
The service did not have clear governance processes to ensure resident safety through the use of Personal Emergency Evacuation Plans. There was a lack of effective oversight in relation to cleanliness, the environment, and implementation of some policies. Service leaders did not ensure staff received all required training in learning disability and autism, updated adult safeguarding Level 2, or had regular appraisals.
However, the service had enough staff to support residents. When additional cover was needed, the provider used bank staff who had existing or prior experience with the service. This ensured familiarity with provider procedures and supported consistency of care.
Residents spoke positively about the therapeutic programme and the staff who supported them. They said they felt safe and understood the contract commitment required to engage with their recovery journey during their admission.
Stakeholders and family members gave positive feedback about the recovery progress they saw residents making and they noted the support given to residents to develop healthier lifestyles. Stakeholders described the service as effective and responsive, and highlighted strong resident-staff relationships, and its development of a network of recovery peers and mentors.
Mental Capacity Act / Consent to Treatment Overview
Residents consented to care and treatment on admission. Residents’ mental capacity was assessed prior to admission, and the service did not admit residents who lacked capacity to engage with the recovery programme. We reviewed care records and saw that all residents were asked mental capacity assessment questions on admission, and these were recorded in the care record consent section.
The provider had a mental capacity policy in place. Staff had not received mandatory Mental Capacity Act training. However, staff we spoke with were able to describe what to do if they had concerns about a resident’s mental capacity, including reporting this to the referrer or to mental health services. Staff consistently supported residents to make decisions about their care and recovery plans.
People's experience of this service
We spoke to 4 of 6 residents during the onsite assessment, and 2 family members following the onsite assessment.
All residents said there were enough staff. Feedback from all residents and family members was highly positive about how supportive staff were in providing care and delivering the therapeutic programme. Residents told us they felt safe.
Two residents said they found the restrictions applied on admission difficult, such as limited access to mobile phones and family visits. However, all 4 residents understood the rationale for these restrictions, especially during the early phase of the therapeutic programme, and they accepted them.
We received feedback from 3 residents that the décor and maintenance of the building could be improved. However, all 4 residents placed greater importance on the purpose and outcome of their admission than on the quality of the environment. However, our assessment found that elements of the environment and its maintenance did not meet the expected standards. The large garden and bright, airy kitchen were especially appreciated by residents, and family members commented on the open space and quiet location.
Residents with mobility needs told us they were supported by staff and the resident group to attend the programme sessions and activities. Transport was provided if required.
Stakeholders reported that residents gave them positive feedback about the service and the role it had played in their recovery. Feedback often included comments about residents’ trust in staff and how approachable they found them. Family members told us staff were polite in their interactions and responsive when they needed to be in touch with the service.
During our assessment visit we observed 2 group sessions. Interactions between staff and residents were supportive and encouraging. Groups were goal and achievement focused, and the facilitator reminded residents of the progress they had made. We also observed one-to-one interactions between key workers or managers and residents, which were respectful, responsive, friendly, and at times appropriately light-hearted.