The Hygrove Limited and the Abbeycare Group

Updated 29 May 2019

The Hygrove is a 28-bed substance misuse service providing clinically supervised detoxification and rehabilitation to adults using both the 12 steps programme and five ways to wellbeing models. Detoxification is managed by a non-medical-prescriber nurse and pharmacist and the service does not accept referrals of people whose needs they are not competent to meet.

The Hygrove was originally part of Drink & Drug Recovery Ltd, but became an independent entity on registration. The Hygrove is now a part of Abbeycare, alongside two other similar services across the country.

The service is registered for the following regulated activities:

• Accommodation for persons who require treatment for substance misuse.

• Treatment of disease, disorder or injury.

There was a registered manager in post at the time of this inspection.

The Hygrove is situated in an old building that has been adapted for the service. Clients have access to a wide number of facilities and large grounds. It is not a secure environment and all clients are voluntary. Each client is screened before admission, and criterion for entry are low to medium risk.

Clients self refer for private admissions, although a small number of clients are admitted to the programme with the support of charitable organisations. At the time of the inspection there were seven clients.

This service was registered by CQC on 10 May 2018 and has not been inspected previously.

Updated 29 May 2019

We rated The Hygrove as good because:

• The service had enough staff and had plans in place to adjust staffing levels when client numbers increased. Staff assessed and managed risks well. They achieved the right balance between maintaining safety and providing the least restrictive environment possible in order to facilitate client recovery.
• Staff assessed the physical and mental health of all clients on admission. They developed individual care plans which staff reviewed regularly and updated as needed. Care plans reflected clients’ assessed needs, and were personalised, holistic and recovery-oriented. Staff involved clients in care planning and risk assessment and actively sought their feedback on the quality of care provided.
• Staff provided a range of treatment and care for clients based on national guidance and best practice for substance misuse services from the National Institute for Health and Care Excellence (NICE).
• Staff treated clients with compassion, kindness and respected their privacy and dignity. They had an understanding of the impact care and treatment could have on emotional and social well-being. The design, layout, and furnishings of the service supported clients’ treatment, privacy and dignity.
• The service treated incidents, concerns and complaints seriously. They investigated them, learned lessons from the results, and shared these with the whole team and wider service to improve practice.
• Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of substance misuse and the service they managed. Leaders were visible in the service and approachable for clients and staff. Staff felt respected, supported and valued, and morale was good.

However:

• Systems and processes around administering and recording of medicines were not robust. We found a number of medicines errors during our visit. Medicines management and the related training was the responsibility of the lead nurse and clinical lead, and there was no external monitoring of this. Although the errors we found at the time of inspection carried a low risk, and the service took action to improve practice and learn from errors, we were concerned there was insufficient oversight.
• While the building was clean, well equipped, well-furnished and fit for purpose, there were some maintenance issues to be addressed. These included non-working lifts and irregular access to hot water due to boiler problems.
• Staff training compliance levels were 75% or below for training such as safeguarding and basic life support, as well as some core substance misuse specialist training courses. Although safeguarding was regularly discussed in team meetings and as part of supervision, staff were not confident with their safeguarding responsibilities. Staff would discuss any concerns with their manager or supervisor, who would follow these up with the local authority as appropriate to ensure that people were safe from abuse.