Brookdell House

We rated Brookdell House as good because:

• The provider had developed a day care support service so that clients who made suitable progress could continue their treatment in the community.
• The provider recognised the benefits of exposure to community living and during the final month of treatment, clients had the opportunity for clients to attend the day care service. This offered clients information and support through visible recovery in the wider community.
• To develop more effective treatment within the residential setting, the provider offered ‘sharing sessions’ that gave clients opportunities to learn through the experiences of others who had completed treatment.
• The recovery programme was adapted to meet individual need by including, for example, additional one to one time or changing the timescale for completion. Clients set their own individual goals to develop their identified strengths and meet their needs. Individual work was linked to each client’s progression through the recovery programme.
• Staff provided treatments and care for clients based on national guidance and best practice. Treatment interventions included cognitive behavioural therapy, family therapy and activities intended to help clients to develop personal responsibility and acquire independent living skills.
• Recovery plans included clear pathways to other supporting services. The service worked with health, social care and other agencies to plan integrated and coordinated pathways of care.
• Staff actively engaged clients in planning their care and treatment. Clients reviewed their progress in personal development meetings with their keyworkers. Most clients had a risk management plan and recovery plan that demonstrated their preferences, recovery capital and goals.
• Successful treatment outcomes were above the national average.
• Staff supported clients with activities outside the service and to maintain contact with people that mattered to them.
• Staff were able to contribute to plans for the service. Managers promoted a positive culture. Staff felt respected, supported and valued, and the team worked well together.
• Cost improvements did not compromise client care. The provider had developed different methods of service delivery to ensure they could still meet clients’ needs where funding was reduced.
• Managers had information about the performance of the service that helped them plan service developments.
• Clients had opportunities to give feedback on the service they received.

However:

• Not all identified client risk had been explored so the risk could be managed.
• Not all recovery plans set out clearly how clients would progress through the recovery programme, how their identified goals were linked to the programme and what support they needed to achieve their goals.
• Systems for assessing, monitoring and improving the quality and safety of the service did not ensure the provider had effective oversight of governance issues.
• Policies and procedures were not always regularly reviewed.
• There was no central record of care record audits, so managers did not have easy access to information about actions needed.