Brookdell House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Staff completed comprehensive assessments with clients on accessing the service. Although all clients completed the same 12-week programme, staff worked with clients to develop individual care plans and updated them as needed. Care plans reflected the individual needs of each client.

Staff provided a range of treatment and care for clients based on national guidance and best practice. Teams included or had access to the full range of specialists required to meet the needs of clients using the service.

Staff worked together as a team to benefit clients. They understood their roles and responsibilities under the Mental Capacity Act and assured us that they continually assessed for consent. However, this was not recorded within care plans.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

Staff completed a comprehensive assessment of each client before they came into the service. The assessment considered the client’s substance misuse, physical health, mental health, social factors, criminal history, previous treatment episodes and support network.

We reviewed eight records and found each record contained a completed assessment and recovery plan that had been regularly reviewed. Staff developed care plans that met the needs identified during assessment. Care plans were personalised, holistic and recovery-oriented and identified the persons key worker. Care plans were updated when necessary. Individual risk management plans were regularly reviewed.

Clients felt that staff had considered their needs during the assessment process and that this was regularly discussed in key work sessions and groupwork. We saw one workshop where a former client had returned to talk about their experiences. Members of the group openly discussed the former client’s journey and how they were developing their own strategies to deal with the issues identified during their individual road to recovery.

Systems were also in place to provide post-discharge support. Those who had a planned discharge could access housing nearby and continue to attend day support at a separate location.

Staff worked closely with anyone identified as being at risk of leaving the service. They supported anyone who left the service unplanned to access services in their local area.

Staff provided a range of care and treatment interventions suitable for the client group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence.

Staff provided group and key work sessions underpinned by recommended interventions including cognitive behavioural therapy, motivational interviewing and solution-focused brief therapy. This was in line with the Department of Health’s guidance that treatment for drug misuse should always involve a psychosocial component. Staff supported clients to live healthier lives, for example, through participation in smoking cessation schemes, healthy eating advice, exercise and dealing with issues relating to substance misuse.

Managers provided staff with supervision and appraisal meetings to discuss case management, personal development and their work performance. The percentage of staff that had had an appraisal in the last 12 months was 100% and the average compliance with supervision was 98%.

Managers ensured that staff had access to regular team meetings. Staff attended a daily handover where managers discussed daily allocations, and staff could seek advice on more complex clients.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. Any areas for development were identified during supervision and appraisal sessions or team meetings.

Managers ensured that staff received the necessary specialist training for their roles.

Managers dealt with poor staff performance promptly and effectively. The provider had a performance management system to enable managers to deal with staff performance issues in a timely and appropriate manner.

Clients came from different areas of the north of England. However, staff had regular contact with client’s care coordinators from their local substance misuse teams. The service worked closely with social services, mental health services and criminal justice services. There was a multi-disciplinary approach to each client’s comprehensive assessment, which identified if the person was ready for the programme. Staff shared information about clients at effective handovers and shared information with other services involved with the client. There were effective working relationships with community drug and alcohol services and community mental health teams.

There was a daily handover meeting. The meetings discussed staff issues, the day’s activities, incidents from the previous day and any key concerns about clients. There were strong relationships with other local substance misuse services, with clients having access to services they provided, such as blood borne virus testing.

Clients attended numerous sessions within the recovery community outside the service. They told us that these links had made this service more effective in assisting their recovery. Clients were generally discharged after 12 weeks but they could apply for funding to stay longer if this was identified as part of their care plan. Staff worked with supporting agencies in the community to ensure timely transfer of information.

Staff supported clients to live healthier lives. We saw evidence in care records that staff had provided clients with advice about healthy eating and harm minimisation. We also saw evidence that staff referred clients to services that could improve their health and wellbeing, such as smoking cessation advice.

Staff used recognised rating scales to assess and record severity and outcomes. The recovery star was used to monitor progress. Clients had signed their recovery plans and described how they participated in completing them. Clients were given nationally recognised 12-step materials through which they self-assessed their life story and relationships, this included written work and self-reflection.

Managers monitored clinical outcomes and created reports for management monitoring.

All staff were actively engaged in activities to monitor and improve quality and outcomes. For example, they also participated in clinical audit, benchmarking and quality improvement initiatives. The service sent data to the national drug treatment monitoring service and the treatment outcome profiling system. The national drug treatment monitoring service collects, collates and analyses information from and for those involved in the drug treatment sector.

Staff understood the requirements of legislation and guidance when considering consent and decision making.

We saw consent to treatment was recorded in all the care records we looked at when the client entered the service. Staff supported clients to make decisions throughout the 12-week program and how they completed each step. However, while clients were consenting to their care, staff did not routinely record that within the clients’ care plans when making changes in their care.