Linwood House

Updated 20 December 2023

Linwood House is a residential substance misuse service provided by Treatment Direct Limited, who have been the registered provider of this service since 1 October 2020. Linwood House is registered to provide residential alcohol and drug detoxification and/or rehabilitation to adults over 18 years of age. At the time of inspection, the service could accommodate 51 clients over two floors but managers told us they were only using 30 of those beds.

Linwood House accepts mainly privately funded clients for a medically monitored detoxification. This means they do not have medical staff on site and cannot accept clients with complex medical needs. Medical input is provided via video call with one of the provider’s prescribing doctors. The service is staffed by support workers and therapists who offer a therapeutic programme. The service offers rehabilitation services and aftercare support.

The service was registered by the Care Quality Commission to provide the following regulated activities:

• accommodation for persons who require treatment for substance misuse
• diagnostic and screening procedures
• treatment of disease, disorder, or injury

At the time of the inspection the service had a registered manager in post, but this person was not available for us to interview.

This is the second comprehensive inspection of this service since the new provider took over in October 2020. The first comprehensive inspection was carried out in April 2022 and was rated as requires improvement overall. We issued the provider with 3 requirement notices under Regulation 9, (person centred care), Regulation 12, (safe care and treatment), and Regulation 17, (good governance). We carried out this inspection to find out what improvements the provider had made since the last inspection. We found the provider had made improvements to client risk assessments, environmental checks, and care planning, but there were still improvments required in the overall governance of the service.

What people who use the service say

On inspection, we spoke with 17 current clients. Overall, the feedback about staff was positive. Most clients said staff were caring, responsive and treated them with compassion. However, one client said some staff were not caring and did not respect their privacy by knocking on the door to their room before entering. All but 2 clients said the service was short staffed, especially in the evening and at night. Most clients did not like the fact that there were no nurses on site, and they did not see the doctor face to face, only through video calls. Several clients told us they did not feel safe because of this. All but 2 clients said the house was not clean enough and the rooms were not cleaned properly before new clients were admitted. Most clients did not like the food and complained about a lack of salad and vegetables. Several clients told us food would be left out on a hot plate from 5pm until 9pm and they did not think this was very appetising or hygienic. Most of the clients we spoke with said the service had not met their expectations, but 2 of the clients we spoke with said they were very happy with the service.

Updated 20 December 2023

Our rating of this service improved. We rated it as good because:

• The premises were safe, and staff carried out regular safety checks. Staff followed good practice with respect to reporting safeguarding concerns.
• Staff provided all clients with a comprehensive assessment and offered a range of treatments including psychosocial interventions. Feedback from clients about the group therapy was highly positive and care plans were holistic and up to date.
• Staff managed clients’ medicines well and had appropriate physical health care plans in place.
• Managers ensured staff were up to date with their training, and received appropriate supervision and appraisal. Staff worked well together as a multidisciplinary team. They co-operated with relevant services outside the organisation.
• Staff treated clients with compassion and kindness, and understood the individual needs of clients. They involved clients in decisions and care planning.
• The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.

However

• The provider's governance processes could not demonstrate that the service was delivered in line with national guidance. Clients were subject to a large number of blanket restrictions, but the provider did not provide a rationale for why they were all necessary. The provider's improvement plans did not always reflect the improvements required.
• There were several occasions where the service did not have the minimum numbers of staff on shift and not all agency staff had been given a proper induction before starting their shift.
• The food on offer was not always of good quality and the service was not as clean as it should have been. Clients smoked in areas where they were not supposed to and this was off-putting for some clients.

Updated 28 September 2022

Updated 20 December 2023