Providence Project - 6

Updated 21 August 2019

The Providence Projects Rehab Group Limited is a substance misuse service that provides detoxification, primary treatment, secondary treatment and aftercare. All clients receiving care and treatment for detoxification are accommodated at Providence Project 6, which is a 5-bed service providing supervised detoxification for adults using the 12 steps programme. The 12 steps programme is a set of guiding principles outlining a course of action for recovery from addiction, compulsion or other behavioural problems. The service accepts clients funded by the National Health Service (NHS) and privately funded clients. At the time of this inspection there were three clients undergoing detoxification at the service.

The service is registered for the following regulated activities:

• Accommodation for persons who require treatment for substance misuse.

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

Providence Project 6 is situated in a former home that has been adapted for the service. There are two floors, with communal facilities and a double occupancy bedroom on the ground floor and 4 single bedrooms and a staff bedroom on the first floor. Clients spend the majority of their day at the main therapy centre on Caryscroft Road and return to Providence Project 6 to sleep. It is not a secure environment and all clients are voluntary. Each client is screened before admission, and criterion for entry is low risk.

Clients self-refer for private admissions and a small number of clients are admitted to the programme by the NHS.

At our last inspection of the service in September 2016, we did not rate the service but told the provider they must ensure:

• Opiate detoxification treatment is in line with guidance form National Institute for Health and Care Excellence (NICE) and Drug misuse and dependence.
• Formally monitor for clinical withdrawals on a daily basis for clients undergoing opiate detoxification to measure the effectiveness of the treatment provided.
• Provide safe supervision at night for clients who are receiving detoxification treatment from alcohol.
• Mandatory training for medicine administration training is repeated regularly.
• Governance structures are robust and able to assess and monitor the quality, safety and effectiveness of the service.
• Monitoring of clients’ nutrition and hydration and that clients receive advice regarding diet and nutrition.

At this inspection we saw the provider had addressed all of these requirement notices. Detoxification medication being prescribed was in line with NICE guidance, staff were formally monitoring clients for withdrawals, clients were being supervised overnight by staff, all training was repeated regularly, governance structures were robust and staff were monitoring and advising clients on nutrition and hydration.

Updated 21 August 2019

We rated Providence Project 6 as good because:

The building was clean, well equipped, well-furnished and fit for purpose.

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 care plans which staff reviewed regularly and updated as needed. 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).

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.

Systems and processes around prescribing, administering, recording and storage of medicines were robust. The service had an agreement with the local GP practise for a responsible clinician to prescribe all medicines, including detoxification medication.

Staff training compliance levels was 100% for mandatory training such as safeguarding, first aid and medicine management as well as some substance misuse specialist training courses. Staff were confident with their safeguarding responsibilities and made referrals to the local authority as appropriate to ensure that people were safe from abuse.

Staff treated clients with compassion, kindness and respected their privacy and dignity. The design, layout, and furnishings of the service supported clients’ treatment, privacy and dignity. Clients we spoke with spoke highly of the staff and the standard of care they delivered.

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. Staff received regular internal and external supervision, and all staff had been appraised.

Updated 21 August 2019