• Residential substance misuse service

Archived: St Clements Court

Falcon Street, Oldham, Greater Manchester, OL8 1NG (0161) 633 4205

Provided and run by:
Community Mediation Housing Limited

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Background to this inspection

Updated 16 February 2017

St Clements Court is based in Oldham. It offered an alcohol reduction programme for men with alcohol dependency, using reducing regimes of alcohol rather than a chemical detoxification.

The service was on three floors and accommodation was in the form of 29 self-contained flats. At the time of the inspection, there were 23 clients residing there.

Most clients were funded by local commissioners but several were self-funding via housing benefit.

The service was registered for the regulated activity of accommodation for persons who require treatment for substance use. This regulated activity requires that clients are receiving active treatment for substance misuse. At the time of the inspection one client was on an alcohol reduction programme. We have concerns that the service was providing a regulated activity which they were not registered for and are looking into this.

There was a registered manager at the time of this inspection. The registered manager was not available at the time of the planned inspection due to sickness. An unannounced visit took place the following week when we interviewed the manager and looked at records.

This service was previously inspected by CQC in 2014 and was found to be meeting the standards that were in place at that time.

Overall inspection

Updated 16 February 2017

We do not currently rate independent standalone substance misuse services.

We found multiple breaches of regulations. We used our enforcement powers to take urgent action and prevent the provider from admitting any more people to the service. We did this to ensure that people received safe care and treatment. We also required the provider to send us a weekly summary of the care and treatment provided to people using the services.

Full information about our regulatory response to the concerns we have described in this report will be added to a final version of this report we will publish in due course.

We found the following areas of concern:

  • Risks were not managed safely. There were no fire safety risk assessments and personal emergency evacuation plans, despite several clients having mobility difficulties and two wheelchair users. There was no assessment of ligature points, despite the service admitting clients who were intoxicated and with little risk history available. Staff were not following the infection control policy. Medicines management was unsafe. Staff did not report incidents and there was no policy or procedure for incidents to guide them.
  • Staffing levels were unsafe and not sufficient for the service. The provider did not follow recruitment procedures in terms of disclosure and barring checks and obtaining references prior to employing staff. Staff had not received mandatory training. Staff and managers had no awareness of safeguarding and policies were poor. Staff did not receive supervision or appraisals. There were no male support staff employed despite the service being for male clients.
  • Record keeping was poor. The service did not maintain individual contemporaneous records. We found no care plans in the records we reviewed. There was little information about the reason why clients were admitted. There were no physical health plans or information for staff, despite several clients having physical health conditions which required monitoring.
  • There was no structured alcohol treatment programme and no policies, procedures or guidance relating to alcohol treatment. Staff were not correctly totalling alcohol or reviewing the total daily quantities being received for the client undergoing a reduction. There was no use of recognised assessment tools or withdrawal scales. Staff had not received training in alcohol misuse or treatment.
  • Staff had no awareness of the Mental Capacity Act. There was no Mental Capacity Act training available to staff. The Mental Capacity Act policy was undated and did not contain practical guidance for staff. There were no assessments of client’s capacity undertaken, for example, in relation to medication.
  • One client reported that a previous member of staff had shouted at him, the provider had not investigated this or referred it to safeguarding. Two clients expressed concerns about financial arrangements. The registered manager had written a derogatory comment in the day book and spoke in a derogatory manner about clients at interview.
  • There was no structured activity programme. There was no information displayed about local services, client’s rights, how to complain, CQC registration or information about the service. The complaints policy was not followed. There was no interpreter provision for one client who did not speak English.
  • The overall governance and management of this service was poor. The provider failed to provide information we requested before the inspection. Managers had not registered the service with organisations such as the environmental health department and the information commissioner’s office. Managers did not display knowledge of relevant legislation, for example the Mental Capacity Act. Safeguarding procedures were not in place and staff and managers did not understand safeguarding. All policies and procedures had been written in 2013/14 and had not been reviewed. They provided no guidance to staff. Overall, the service had a task based approach to care, with several recording books serving as the only continuous records of the day to day life of clients residing there.

However, we also found the following areas of good practice:

  • The overall building was clean and tidy and the kitchen where the chef prepared food for clients was well maintained.
  • Clients described staff as positive, helpful and supportive and a carer was positive about the care their relative was receiving.
  • The provider offered support to clients with housing applications and resettlement plans.
  • There was a small gym available for clients and two computers were available so clients could access the internet.