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Inspection Summary


Overall summary & rating

Good

Updated 22 May 2019

This was our first inspection of Banbury Lodge. The service opened in April 2018.

We rated Banbury Lodge as Good because:

  • The service was fully staffed, with a range of well trained and experienced staff. Staff put into practice the service’s values, and had contact with managers at all levels, including the most senior.
  • The provider placed a significant emphasis on staff training and professional development.
  • The environment was clean, spacious and furnished to a high standard.
  • The service had the appropriate arrangements in place to support clients with their detoxification in line with national guidance
  • All clients had personalised and holistic care plans
  • Staff stored client information on a securely accessible electronic case management system with
  • other relevant records. Medical admissions records, including assessments, were stored in paper file separate from the electronic system. There were plans in place to address this.
  • Care planning tools consistently reflected the 12 step philosophy of the service.
  • Clients spoke very highly about their experiences of the service, their therapeutic relationships with staff and the impact the service had on their lives.
  • There were policies in place to manage risk, including to clients leaving treatment prematurely and clients who were at risk of self-harm. All clients had risk assessments and detailed risk management plans for every identified risk.
  • The service showed a commitment to quality improvement.

Inspection areas

Safe

Good

Updated 22 May 2019

We rated safe as Good because:

  • The service was fully staffed. Therapist caseloads did not exceed six clients at any one time.
  • The building was clean and well-maintained. All clients had lockable en-suite bedrooms.
  • All clients received a medical assessment by a consultant psychiatrist who prescribed detoxification medicine. The service employed a full-time nurse.
  • Clients’ physical health and withdrawal symptoms were assessed and closely monitored by staff.
  • The service followed best practice in administering and monitoring medicine. Medicine reduction regimes were clearly recorded with evidence of regular audits.
  • The service followed best practice in the detoxification of clients from substances, which staff carried out safely under instruction from a consultant psychiatrist.
  • Client risk was well assessed prior to admission, at assessment and throughout their treatment. This included plans for clients’ unexpected exits from treatment that addressed risk of overdose and ensured that carers were included.
  • The service supported clients to maintain appropriate contact with families and partners, and had care plans for all clients around maintaining healthy relationships.
  • The service had a good track record on safety and had no adverse events or serious incidents recorded since opening.
  • Medical admissions records, including assessments, were stored in paper files separate from the electronic system. Other medical information, including GP summaries and test results were stored on the electronic system, along with risk assessments, care plans and daily updates. The parent organisation was in the process of moving all records on the case management system, and was piloting this at another site at the time of our visit.

Effective

Good

Updated 22 May 2019

We rated effective as Good because:

  • Clients had assessments prior to and on the day of their admission to the service.
  • A consultant psychiatrist carried out physical and mental health checks on all clients before they began their detoxification treatment programmes.
  • Staff completed and updated holistic care plans for clients on the eight client records we reviewed.
  • Co-existing conditions, such as mental health support needs, were identified at the admission and risk assessment stages prior to admission, and supported through personalised care plans.
  • Staff followed national guidance for people undergoing alcohol and opiate detoxifications.
  • The service offered a group programme to support clients’ overall wellbeing, including sound therapy, as well as individual counselling sessions.
  • All staff received annual appraisals and six weekly supervision. Counselling staff received appropriate clinical supervision.
  • The service had strong links to local 12 step recovery groups such as alcoholics anonymous and narcotics anonymous.
  • All staff were trained in and had a good understanding of the Mental Capacity Act.
  • The service used a suite of key performance indicators which included the number of clients successfully completing treatments and exit surveys.

Caring

Good

Updated 22 May 2019

We rated caring as Good because:

  • Staff treated clients with warmth and respect, showing compassion and understanding for the impact of their substance misuse. Staff showed a high degree of sensitivity to clients’ emotional and spiritual needs, especially the impact of trauma and its role in addictive behaviour.
  • All clients we spoke to spoke highly about the staff and the therapeutic relationships they had with them.
  • All clients received a client handbook and induction on admission.
  • Clients were involved in their care. They planned their detoxification with the consultant and this was reviewed throughout their admission.
  • Care plans were highly personalised with evidence of detailed input from individual clients and their carers. Care notes showed staff and management to be responsive to changes in client’s mood and presentation.

Responsive

Good

Updated 22 May 2019

We rated responsive as Good because:

  • There was a range of rooms for meetings, one to one sessions, group sessions, family visits and socialising. Clients had free access to the garden and smoking area.
  • Clients were able to make hot drinks and snacks day and night. The chef prepared three meals a day with suggestions from a nutritionist, and clients could choose an alternative meal if they did not want what was on the menu that day.
  • The nutritionist provided clients with personalised meal plans during their stay and post discharge.
  • Clients personalised their bedrooms and could safely store their valuables during their treatment.
  • The service had a range of activities seven days per week.
  • The service gathered and monitored compliments and complaints, providing timely responses and refunds where agreed.
  • The service offered a “recovery credit” system whereby clients leaving treatment prematurely could use the money they had paid for the remainder of their stay at another service within the group.
  • Service user feedback was actively sought through surveys and community meetings, with actions displayed on a “you said, we did” board.

Well-led

Good

Updated 22 May 2019

We rated well led as Good because:

  • Managers were skilled, experienced and well equipped to lead the service, showing a hands -on approach as well as driving improvements to the service overall. The service had a clear definition of recovery which was based on the 12 step philosophy.
  • The service had robust systems in place to ensure the service was adequately staffed, incidents were recorded, and staff received mandatory training, regular supervision and appraisals.
  • The service ensured that a range of compliance audits took place regularly and that actions were followed up in a timely way.
  • Staff and managers described high morale within the team and a high level of engagement with the wider organisation. In particular, staff felt that their learning and development was a high priority for the organisation.
  • Senior managers were a regular presence in the service and approachable by staff.
  • Staff understood the service’s whistleblowing policy. No whistleblowing concerns had been raised with CQC in the 12 months prior to the inspection.
  • The organisation set key performance indicators to measure the service’s performance.
  • The organisation showed a commitment to quality improvement, maintaining a log of local initiatives to improve service delivery and actively encouraging innovation.
Checks on specific services

Residential substance misuse services

Good

Updated 22 May 2019