• Residential substance misuse service

The Pavilion

Overall: Good read more about inspection ratings

Ashton Road, Lancaster, Lancashire, LA1 5AZ

Provided and run by:
Delphi Medical Limited

Latest inspection summary

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Background to this inspection

Updated 18 March 2019

The Pavilion provides inpatient residential detoxification programmes from alcohol and substance misuse. It is in a rural setting near Lancaster in Lancashire.

The length of stay at the centre was based on individual need and ranged from seven to 28 days. The detoxification programme was part of a holistic package of care, which focussed on health and wellbeing and provided clinical and therapeutic interventions to support progress and abstinence.

The Pavilion provided a total of 17 beds to both men and women over the age of 18. At the time of our inspection there were six clients and a further two clients were admitted during the two days we inspected.

The Pavilion had been registered with the Care Quality Commission since January 2017.

The service was commissioned by eight organisations; six in the Lancashire area, one in the Yorkshire area and one from the Isle of Man. Referrals were also accepted from clients who privately funded their stay.

The Care Quality Commission has registered The Pavilion to carry out the following regulated activities: Accommodation for persons who require treatment for substance misuse.

One previous inspection was carried out at The Pavilion in October 2017.The Pavilion was not rated at this time. However, there was one requirement notice issued for a breach against Regulation 12 HSCA (RA) Regulations for safe care and treatment. This requirement notice has now been met.

At the time of this inspection, there was a registered manager in place.

Overall inspection

Good

Updated 18 March 2019

We rated The Pavilion as good because:

  • Staff risk assessed clients and reviewed how they managed these risks daily to keep clients safe. Medicines were managed safely. The premises were safe, clean well equipped, well furnished, well maintained and fit for purpose.
  • There was a commitment to interagency working with good working practices with GPs commissioners, the police and the local accident and emergency department.
  • All clients had access to a group programme and one to one sessions to help them understand and manage their addictions. The service was organised to meet clients’ needs. Care and treatment was coordinated with other providers.
  • Clients were supported, treated with dignity, respect and compassion.
  • Staff helped clients prepare for discharge and ongoing support was offered through a weekly aftercare group. They sought and involved carers and family members when appropriate.
  • The governance structures within the organisation functioned effectively with clear visions and values.

However:

  • Care plans were not fully personalised.
  • Clients did not have a named key worker.
  • Of the three records we looked one out of three did not contain a risk management plan and plans were not comprehensive.
  • Supervision levels had not been fully completed in line with the organisations policy. Levels had significantly improved over the last two months before inspection and staff reported they were well supported.