Shardale St Annes

We rated Shardale St Annes as good because:

• The service provided safe care. The premises were safe and clean. The service had enough staff. Sickness and vacancies were low, which meant clients were cared for by a stable staff base who knew them well.
• Staff assessed and managed risk well. All clients were assessed and only admitted if it was safe to do so. Harm minimisation was an integral part of the recovery programme.
• All the records we looked at contained an up to date risk assessment and risk management plan that was reviewed by staff and clients on a regular basis. This had improved since we last inspected this service.
• Staff followed good practice in safeguarding. They had training on how to recognise and report abuse, and they knew how to apply it. They understood how to protect clients from abuse and worked well with other agencies to do so. Clients also received information about safeguarding to help them recognise abuse.
• The service had a good track record on safety and managed client safety incidents well. There was a clear process around reporting incidents, staff understood what they should report and how to do this. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service.
• Staff completed comprehensive assessments with clients and worked with them to develop individual recovery plans.
• The service was well led, and the governance processes ensured that its procedures ran smoothly.
• Leaders had appropriate skills and experience. They had a good understanding of the service and were approachable for clients and staff. Staff knew and understood the provider’s vision and values and how to apply them in their everyday practice.
• Staff felt respected, supported and valued. They told us their managers were supportive and caring. They felt able to raise concerns without fear of retribution. They received regular supervision, and training and appraisals were up to date.
• Governance processes operated effectively. Performance and risks were managed well.
• The provider collected and analysed data about outcomes and performance to monitor how well the service was performing. The service carried out regular audits to assess the quality of work. Managers reviewed the audits and fed back the results to the staff. This had improved since we last inspected this service.

We rated Shardale St Annes as requires improvement because:

• Risks identified through assessments were not formulated into individual risk management plans that provided guidance for staff.
• Recovery plans were limited in detail. They did not set out clearly what clients needed to do to complete the recovery programme or how they were progressing through the recovery programme.
• Essential information about clients’ individual risk and progress through recovery was discussed and contained in handover notes but was not always transferred to clients’ individual records following discussions.
• There was no date for review of therapeutic interventions.
• The policy that provided guidance for staff working alone did not set out how the risks of working alone would be mitigated.
• The provider’s monitoring systems had not identified the issues we found in care and treatment records.

However:

• The provider had developed a recovery programme based on seven core values and incorporating a disciplinary scaling process. The model focused on developing communication, resilience and personal responsibility within a supportive community environment.
• There was an aftercare support programme that clients could access following completion of the recovery programme, to maintain their recovery and develop their peer support networks in the community.
• Clients who were senior members of the community had roles of responsibility such as gatekeeper, safeguarder and community leader. The provider gave clients training and guidance in these roles so they could carry them out effectively.
• Staff provided a range of care and treatment interventions suitable for the client group, delivered in line with national guidance and best practice.
• The provider had a clear definition of recovery that all staff shared and understood. There was a clear sense of common purpose based on shared values. Staff were positive and proud about their work.
• Managers had access to information about the performance of the service that supported their management role. Clients and carers could give feedback on the service they received.